Dental Anxiety Help – 7

Posted by on Nov 18, 2009 in Blogs | 0 comments

Dental Anxiety Help 7 – “Cognitive Distortions”

In this blog series, Dental Anxiety Help, we’d like to introduce our guest contributor, Andre Perreault, LMHC.  Every Wednesday we will be featuring his advice and helpful tips for people who experience anxiety, fear, and phobias about dental visits.  Please check back every week for more – we will tag our posts with “anxiety” for quick reference when viewing in a feeder program.  At the bottom of each “Dental Anxiety Help” you can find links to previous entries as well. If you’d like to reach Mr. Perreault directly, please call him at (617) 835-6581.

Anxiety help

Dental Anxiety Help – 7 “Cognitive Distortions”

Last week, I mentioned some questions you can use to analyze your worries – challenging them and holding them to a new light.  This week, I am providing a list of common cognitive distortions and examples of how they may apply to you and dental anxiety.

1.) All-or-nothing thinking – Thinking of things in absolute terms, like “always,” “every,” or “never.” Few experiences are so absolute.                                                     I always hate going to the dentist.

2.) Overgeneralization – Taking isolated cases and using them to make wide generalizations such as a painful trip to one dentist when you were young.                                All dental appointments are painful.

3.) Mental filler – Focusing exclusively on certain, usually negative or upsetting aspects of something while ignoring the rest. For example, focusing on the possibility of feeling some discomfort, eclipsing the health and well-being that you get with good dental health.                        Whenever I go to the dentist all I can think about is that drill!!!

4.) Disqualifying the positive – Continually “shooting down” positive experiences for arbitrary, ad hoc reasons.                    Bill said he had a great experience with the dentist. That had to be fake.

5.) Jumping to conclusions – Assuming something negative where there is no evidence to support it.  Two specific subtypes are also identified:

  •  Mind reading – Assuming the intentions of others
    • The hygienist just looked at me. She thinks I have bad teeth and she’s going to yell at me.
  • Fortune telling – Predicting how things will turn before they happen.
    • I just know it’s not going to go well.

6.) Magnification and minimization – Inappropriately understating the obvious or exaggerating the way people or situations truly are. Often the positive characteristics of other people are exaggerated and negative characteristics are understated. There is one subtype of magnification.

  • Catastrophizing – Focusing on the worst possible outcome, however unlikely, or thinking that a situation is unbearable or impossible when it is really just uncomfortable. This is what most people find their mind does with dental anxiety.          The hygienist is going to dig at my gums and I’m going to bleed all over the place and then they’re going to yell at me for not flossing!

7.) Emotional reasoning – Making decisions and arguments based on how you feel rather than objective reality. Once worry takes hold then your “rational” judgments can get a little sketchy.       I am nervous and you shouldn’t go to the dentist feeling nervous so I am going to cancel my cleaning….

8.) Making “should” statements – Concentrating on what you think “should” or “ought” to be rather than the actual situation you are faced with, or having rigid rules which you think should always apply no matter what the circumstances are.                  Dental work should be painful if it’s done right.

9.) Labeling and mislabeling – Explaining behaviors or events, merely by naming them; related to overgeneralization. Rather than describing the specific behavior, you assign a label to someone or yourself that puts them in absolute and unalterable terms. Mislabeling involves descriving an event with language that is highly colored and emotionally loaded. Such labels cast a bad light and enforce your worry.  

  • Dentists are just drill jockeys!
  • I am a big baby.

10. ) Personalization – Assuming you or others directly caused things when that may not have been the case. When applied to others, blame is an example.  

  • That bad trip to the dentist when I was 7 was totally my fault. I can’t handle the dentist.


In a few weeks the Dental Anxiety series will wrap, but you can always go back and refer to the previous entries as a resource. 

Entry 1 – “I think I have dental phobia” Click here

Entry 2 – “Reality Check” Click here

Entry 3- “To worry or not to worry” Click here

Entry 4 – “Positive Outcomes” Click here

Entry 5 – “Schedule your worry time” Click here

Entry 6 – “Ask these questions” Click here

For information on sedation dentistry, used by Drs. Ali and Ali to help nervous patients, please visit the “Sedation” section at  



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