Racism and Dental Anxiety

Authored by: Valentine Kim

Art by: Michelle Choi

Fear of going to the dentist is a widespread phenomenon. This specific anxiety about dental clinics, a common characteristic among children, is not just a fable. In fact, many adults have a fear of going to the dentist as well, a condition known as dental phobia or dental anxiety [3]. Dental anxiety mainly stems from pain caused by dental procedures and the invisible nature of such procedures [3]. Maintaining an open mouth without being able to see or understand the procedure properly causes nervousness. While at the height of this tension, pain kicks in, reinforcing a negative memory of the procedures. On top of this, dental equipment like the suction or drills can be loud and screechy, further contributing to this negative experience [3]. Overall, people are sensitive to sensory inputs and often correlate their emotions to these inputs [4]. With multiple negative inputs at the clinics, patients begin associating going to the dentist with an unpleasant experience. 

Notably, dental anxiety is more severe for certain races. For instance, around 20% of Black women reported experiencing dental anxiety, which is higher than the national average of around 10% [2]. There are multiple negative factors that ethnic minorities experience. An example of this is the greater likelihood for healthcare workers to mistreat patients of ethnic minority background, such as ignoring their symptom explanations or making them wait longer to be checked up [2]. This mistreatment and the stereotype that certain races have worse oral hygiene causes patients of color to be apprehensive on how they will be perceived [2]. Combined with the innate fear of dental procedures that many people experience, going to the dentist simply becomes a nightmare for racial minorities: expensive, painful, and humiliating. 

The problem that arises with this anxiety is that people stop going to the dentist. Since oral health often does not require immediate attention, it is commonly neglected. Therefore, in the long run, people who do not visit the dentist on a regular basis are likely to have worse oral health. This leads to a greater cost that comes around at an older age [3]. As mentioned before, racial minorities (especially Black and Hispanic people) are much more likely to skip going to the dentist. This adds on to the already-existing health disparity between different races [4]. The biggest concern is that these habits and lifestyles are passed on through generations, meaning that children of racial minorities are more likely to grow up with less access to dental care, contributing to generational disparities. 

What can be done to resolve this problem? There are multiple possible approaches, but the most important part depends on the dentist. Since most of the fear stems from the unknown nature of the procedures, communication between the patient and the dentist is crucial [1]. For the dentist, this is more difficult because it takes away focus and adds to the dentist’s already busy schedule [1]. Thus, it is critical for dental schools to adjust their curriculum to emphasize patient interaction and communication, as this is where most of the anxiety can be reduced. Also, for larger procedures, pharmaceutical solutions can be useful. Anesthesia in smaller doses can numb pain and prevent the patient from taking in negative sensory inputs [1]. As for racial differences, a change in cultural awareness and tradition is necessary. Policies that punish or reprimand racist behavior from healthcare professionals must also be enacted. In terms of reducing generational harm, the education system needs to teach children about the importance of dental hygiene [3]. 

Anxiety is a raw and elementary sensation that we feel. Reducing anxiety is not simple, and when combined with racial discrimination, it will take a long time to solve this issue. It may even be difficult to change the perception of some adults on dentists no matter what changes are made. Therefore, we should emphasize educating the upcoming generations to demonstrate that dental clinics are not something to be afraid of, but rather crucial in the long-run. With these initiatives, dental discrimination can be reduced and anxiety can be alleviated naturally.

References:

1. Appukuttan, D. (2016). Strategies to manage patients with dental anxiety and dental phobia: literature review. Clin Cosmet Investig Dent, 10(8), 35-50. https://pmc.ncbi.nlm.nih.gov/articles/PMC4790493/

2. Heaton, B., Bond, J., Bae, J., & Cozier, Y. (2022). Perceived experiences of racism linked to dental fear and anxiety among Black women. Community Dent Oral Epidemiol, 51(5), 896-907. https://pmc.ncbi.nlm.nih.gov/articles/PMC9925613/

3. Muneer, M., Ismail, F., Muneer, N., Shakoor, A., & Das, G. (2022). Dental Anxiety and Influencing Factors in Adults. Healthcare (Basel), 10(12), 2352. https://pmc.ncbi.nlm.nih.gov/articles/PMC9777862/ 

4. Wide, U., & Hakeberg, M. (2021). Treatment of Dental Anxiety and Phobia—Diagnostic Criteria and Conceptual Model of Behavioural Treatment. Dent J (Basel), 9(12), 153. https://pmc.ncbi.nlm.nih.gov/articles/PMC8700242/