I've had at least a couple of bad experiences with the dentist. One of these related to a difficult extraction for which I don't blame the dentist. The second related to a painful and deep filling in which, for a reason I can't fathom, the anesthetic did not do its job. Rather than stopping or offering alternatives, the dentist pressed on, despite my protestations. I sweated and moaned and so did he. A week later I had to visit another dentist in order to correct the resulting problems. The contrast in approach and technique was stark and I'm pleased to report that several years later I still pay regular visits to my ‘new' dentist.
Everyone has a story about the dentist. My 19 year old daughter has a very different relationship with her dentist. She is of a generation where fluoride toothpaste and a complete lack of drilling and filling is normal, whereas I was born too soon. Neither of us fear the dentist, but I am certainly more cautious!
Fear of the dentist is extremely common and ranges from slight levels of apprehension, to moderate anxiety, to an outright phobia. Phobia's are defined along the lines of an intense and irrational fear that leads to avoidance. I consider dental phobia as one that often blurs the boundary. Whilst many people's fears are groundless and would certainly fall into the accepted definition, a great many others have very good reasons to be extremely anxious. In fact some estimates put previous bad experiences as accounting for nearly 80 percent of dental phobia.
Dental phobia is best thought of as a category. Within this category fall a number of issues which commonly include:
Fear of needles or the act of being injected.
Fear of anesthetics.
Fear of pain.
Fear of the invasiveness or intimacy of work within the mouth.
Fear of the drill, either the sound or of being drilled.
Fear of choking.
A sense of powerlessness during procedures.
There is also the issue of embarrassment which can cover a number of issues. For example, people may feel embarrassed by their concerns over any of the things previously listed. They feel that as an adult they should be above such things. Embarrassment can also occur because of the time spent avoiding the dentist. Insensitive remarks by the dentist about oral hygiene can often shame people into staying away rather than motivating them to do better.
Dental phobia is also more common in people who suffer with anxiety disorders and more common in people who have suffered sexual abuse and sometimes bullying. Painful and sometimes lengthy dental procedures can also leave some people with symptoms remarkably similar to post-traumatic stress disorder (PTSD).
So what can be done? Finding a dentist you feel comfortable with is really important. Many dentists now advertise services specifically geared to work with people suffering from dental phobia. Often, people's fears can be resolved if they explain to the dentist exactly what they fear. The dentist can then offer solutions that can instantly calm fears. For example, fear of injections can be overcome by simple relaxation techniques coupled with the application of an anesthetic gel on the gum. This enables the needle to be inserted without any sensation. The fear of choking can often be resolved by the dentist not tilting the chair back so far. With the use of iPod players, the sound of the drill can be masked. Many dental surgeries are fitted with technology geared and calming and distracting, like music and video players.
The sense of powerlessness is another common feature of dental phobia. There are several easy ways for a patient to gain a level of control. Again, discussing this with the dentist is the best starting point. Some have offered buttons to patients, when if pressed, sounds a small alarm which alerts the dentist to stop. Sometimes the water spray from instruments can irritate the back of the throat and increase a sense of choking, but dentists should have a dental dam at their disposal that can protect the throat. These are just a couple of examples but knowledge of the options is often key to reducing anxiety.
Whilst a dentist may be sensitive and caring it is not their prime role to work with panic attacks or extreme anxiety. If you know this is an issue for you it may be far better to see a psychologist or counselor for treatment. If your main fear is the dentist you may want to consider hypnotherapy. Some medications can help to take the edge off extreme anxiety, in which case a visit to the doctor is called for.
Published On: August 12, 2009