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Dental

Have you ever heard a good story about going to the dentist? People simply don't tell you that they went to the dentist and had a great experience.

Even from an early age we are told by our parents that we have to go to the dentist every 6 months and "it won't hurt". You also hear stories from other people, possibly including your parents, who had a painful experience and recall how awful it was. Then we may go on one occasion and have to have a filling or a tooth extraction and it could be painful or uncomfortable and then we start to fear going back as we don't want to go through it again.

Even the thought of going just for a check-up can make people panic and become very anxious. They then end up cancelling the appointment thinking that they will feel better about it next time – but they never go.

For some people a trip to the the dentist was never an issue until the one time they went and they had some dental work done and it was possibly painful and uncomfortable and then they have that thought to remind them when it is time to go again.

Sometimes it is not a fear of the actual Dentist but a fear of being trapped in the chair whilst the teeth are examined, a filling is done or even a tooth extracted. If you are a panic/anxiety sufferer then you will probably be thinking that you will get panicky and will want to run out of the surgery as soon as you get in there. Let's face it no-one likes being pinned in a chair, unable to move with someone telling you to "keep still"!

Around 50% of people experience some anxiety whilst going to the dentist and debilitating levels are experienced by 5-10%, so you are not alone. Dental phobia is classed as a "simple" phobia but it is complex in its nature.

Let's face it nobody likes going to the dentist! Unfortunately for some this turns into a real phobia that makes it impossible to go. Unfortunately these are the people that are most likely to need treatment as their teeth have been neglected for many years. It is a fact that neglected teeth are harder to treat and repair; there could be several problems that need addressing and then of course there is the issue of cost.

Let's address some important issues.

What are you scared of?

  • Loss of control – Whilst in the dentist surgery it is not possible to move around, fidget or easily get up and walk out. You tend to be laying down on the chair – almost horizontal and that is not comfortable for all people.
  • Painful experience – Listening to horror stories from other people, possibly including your parents, who had a painful experience and recall how awful it was. You may have been to the dentist in the past and had some painful treatment and don't want to face that again.
  • Trust – Do you have to go? How do you know that you really need the work doing? Is it really necessary? How do I know I am getting a "good" dentist?
  • Embarrassment – What if the dentist tells you to "stop being so silly"; "of course it doesn't hurt"; "even the kids are not as bad as you" etc
  • Medical Fears – A general dislike of someone/something medical including doctor's and hospitals. Usually called "White coat syndrome".
  • Denial – You don't want to be told that you have bad teeth and you are not looking after them properly. You don't want to hear that you should stop smoking; cut down on drinks like red wine and coffee and stop eating sweets and snacking between meals.

What do you think of when someone mentions the dentist?

  • Drilling
  • Pain
  • Injections
  • Numbness
  • Choking
  • Scaling
  • Extractions
  • Fillings

Does it get better or worse?

  • Some people make a spontaneous improvement after going and their fear is completely removed.
  • For those that overcome their fear and visit the dentist then they will improve if they continue to go regularly.
  • Continued avoidance maintains the fear
  • Keep going back!
  • In general it was found that people with dental fear do not look after their teeth as well as they could. They don't take much pride in regular brushing and flossing so the teeth end up even worse. Dental phobics tend to clean their teeth far less than those who do go and this of course exacerbates the problem.

Why do we continue to be scared?

Thoughts – I can't stop them doing what they want to; I am at their mercy; I will need a lot of work doing; It will be painful; The more work I need doing the longer I will have to be there; It will cost me so much money to get my teeth fixed.

Intrusion – It is an invasion of our personal body space. Medical procedures like injections, vaccinations, blood tests, blood pressure etc are all done on external parts of the body. Dental work involves allowing someone access to a very personal area of the body.

Injections – When having an injection in the arm, for example, you can turn your head away and not look. Having an injection in the mouth is something more up-close and personal and you can't easily distract yourself from it.

Feelings & Emotions

You may experience all or some of these symptoms:

  • Nausea
  • Heart racing
  • Hyperventilation
  • Hot/Sweaty
  • Dry mouth
  • Muscles Tensing
  • Headache
  • Dizziness
  • Visual Disturbances

All of these feelings come from the fight or flight response that many panic/anxiety sufferers are already very used to.

What about these feelings?

  • Useless
  • Fear
  • Vulnerable
  • Embarrassed
  • Panic

What can you do to help you cope?

  • Explain to the dentist that you are very nervous and have dental phobia. An understanding dentist will take this into account and treat you accordingly. If you don't tell him how terrified you are then he won't know and will assumethat you are quite happy with any dental procedures he does
  • If you have had a previous bad experience then tell the dentist so that he appreciates and understands your worries
  • Ask the dentist as many questions as you need to about what will happen during the procedure – even if this is a simple check-up and scale or polish. Ask him to tell you what he is looking for and what does all the jargon like "occlusion" mean
  • Try to have balanced thoughts about what is happening. For example some people think that they are in pain when it is in fact just the vibration of the drill. The noise of the drill can be another factor to consider. The memory of the pain in this case is short-lived and is soon forgotten once treatment has ended. One thing you could do to is ask the dentist to show you that the pain you think you are feeling is just from the vibration by using the drill on both sides of the mouth – the one that has been numbed and the other one (obviously he should take the drill bit off). You may then realise that it is not pain you are feeling but just the vibration.
  • Ask if you will be able to use something like a Walkman and listen to some music to distract you.
  • Relax whilst in the chair. Don't tense muscles or grip the arms of the chair as this will just make you more tense and anxious
  • Ask questions about the anaesthetic that can be used. How much do you really need and if possible will you be able to get some more if you still experience pain.
  • Agree a stop signal. This could be the simple raising of your hand to signify that you want the dentist to stop for whatever reason. This could be to say that you are in pain, you just need to stop for a few minutes or you want to ask a question
  • Try to relax before going to the dentist using a relaxation CD or doing some slow breathing
  • Some dentists offer hypnosis in the chair or you could go and see a hypnotherapist for a few sessions prior to going to the appointment
  • Will the dentist offer any sedation ? Sedation will relax you but this could be an problem if you have an issue with trust or need to be in control at all times
  • Your Doctor may prescribe a sedative to help you but don't rely on this as they may not feel it is appropriate for you. It is unlikely that the Dentist will give you a sedative as he is not medically qualified to assess your medical background etc. If you are really nervous then you can asked to be referred to a Dental Hospital for larger procedures such as tooth extraction and asked to have a general anaesthetic. Not everyone will be suitable for this procedure though
  • Consider CBT treatment

Finding a Dentist

The best way to find a dentist will be from a recommendation by friends, family or work colleagues.

You can usually find dentists on-line by searching for "dentist" and the area you live in.

Be aware that not all dentists offer treatment on the NHS so you may have to pay for private care and this is obviously more expensive.

Links

British Dental Association

British Dental Health Foundation

The British Society of Medical and Dental Hypnosis

Dental Fear Central  (Dental Fear Central is a non-profit, non-commercial site aimed at anyone suffering with dental phobia or dental fears. Various dental fears are discussed, and methods of overcoming them (both psychological and pharmacological sedation) are described. Includes tips for finding a sympathetic dentist and advice for abuse survivors and their dentists).