. ▁The ▁emer gency ▁nature ▁of ▁this ▁appointment ▁may ▁serve ▁to ▁w ors en ▁the ▁ph ob ia . ▁This ▁phenomen on ▁may ▁also ▁be ▁called ▁the ▁cycle ▁of ▁dent al ▁fear . ▁D ental ▁anx iety ▁typically ▁starts ▁in ▁child hood . ▁There ▁is ▁the ▁potential ▁for ▁this ▁to ▁place ▁stra ins ▁on ▁relationships ▁and ▁neg atively ▁impact ▁on ▁employ ment . ▁ ▁Sign s ▁and ▁sympt oms ▁As ▁with ▁all ▁types ▁of ▁fear ▁and ▁ph ob ias , ▁dent al ▁fear ▁can ▁manifest ▁as ▁single ▁or ▁combination ▁of ▁emot ional , ▁phys i ological , ▁cogn itive ▁and ▁behaviour al ▁sympt oms . ▁ ▁Em ot ional ▁response ▁▁ ▁Fe eling ▁of ▁fear ▁ ▁Fe eling ▁of ▁anx iety ▁ ▁App reh ension ▁ ▁Pan ic ▁ ▁Phys i ological ▁response ▁▁ ▁In cre ased ▁heart ▁rate ▁ ▁Bre ath less ness ▁ ▁S we ating ▁ ▁N ause a ▁ ▁Sh aking ▁ ▁C ogn itive ▁response ▁▁ ▁" I ▁don ' t ▁like ▁the ▁feeling ▁of ▁this ..." ▁ ▁" I ▁am ▁ch oking ▁to ▁death " ▁ ▁" I ▁am ▁having ▁a ▁heart ▁attack " ▁ ▁" I ▁am ▁going ▁to ▁die " ▁ ▁Be hav iour al ▁response ▁▁ ▁Ag itation ▁ ▁High ▁vig il ance ▁ ▁C ause ▁▁ ▁Research ▁suggests ▁that ▁there ▁is ▁a ▁complex ▁set ▁of ▁factors ▁that ▁lead ▁to ▁the ▁development ▁and ▁maintenance ▁of ▁significant ▁dent al ▁anx iety ▁or ▁dent al ▁ph ob ia , ▁which ▁can ▁be ▁grouped ▁as ▁gen etic