Self-assessment and physiological arousal: Do dental phobic patients know how they fear?

Objectives: The aim of the present investigation was to investigate the correspondence between self-reported physiologic fear-responses and registered psychophysiological responses in dental phobic patients. Methods: 126 individuals (95 women) applying for treatment of severe dental anxiety at a specialized dental fear clinic completed the Dental Fear Survey (DFS) prior to treatment. Subjects were also exposed to video-scenes showing different dental procedures while forehead muscle tension, heart rate and skin conductance were recorded. The same procedure with questionnaires and psychophysiological registration was repeated after dental fear treatment was completed. Results: Data analysis showed only one significant, although weak, correlation between DFS arousal assessments and their corresponding psychophysiological reactions during video stimulation. This correlation was found between self-assessment of higher heart rate during treatment and heart rate during video presentation of a local anesthesia injection (r=.19; p<0.05) A better correspondence was found between physiological responses to video scenes of local anesthesia and drilling and DFS scores concerning how much subjects feared these situations (DFS item: “To see the drill” vs. skin conductance during exposure to drilling, r=.25; p<0.05). This was especially true when autonomic response was measured by heart rate (Heart rate during exposure to local anesthesia injection vs. “Seeing the anesthetic needle”, r=.35, p<.001; “Feeling the needle injected”,r=.21, p<.05, and during exposure to drilling of a tooth vs. “Hearing the drill”, r=.37;p<01). Conclusions: In conclusion, dental phobic patients appear to be better aware of what they fear in the dental situation than how they fear it. Supported by NIDCR (grant DE 08296), the Swedish Research Council (grants 11259, 11335), and the Swedish Foundation for Health Care and Allergy Research (grant V98392).