Sun
19
Apr
Take a bite out of your dental phobia
by Tina Coleman
Pat Nishball of Poughkeepsie, New York, says she is known for rescheduling her six-month dental checkups three or four times before actually going. "I've been fearful for as far back as I can remember," she says.
She's in good company. Nearly half of us are at least a little nervous about visiting the dentist, says Dr. Timothy Smith, a psychologist at the College of Dentistry of the University of Kentucky at Lexington. He adds that 20% of us feel anywhere from moderately afraid to terrified. Many people are ashamed of their fears and reluctant to discuss them with their dentists, further compounding the problem. After all, if the dentist isn't aware of his patient's anxiety, there's little he can do to help.
But times are changing. Advances in dental tools, techniques, anesthetics, and methods of sedation have made trips to the dentist more palatable for many. About a dozen dental schools around the nation now have dental fear clinics, says Smith, and questions about helping fearful patients are now appearing on the national board exams taken by dental students. While Smith says an effective way of dealing with dental phobias has not yet been found, the problem is being addressed. In the meanwhile, there are steps anxious individuals can take to alleviate their fears and receive necessary treatment.
"While there is still some discomfort with certain procedures, generally dentistry is less painful than it used to be."
Dr. Timothy Smith, University of Kentucky College of Dentistry
Pat Nishball of Poughkeepsie, New York, says she is known for rescheduling her six-month dental checkups three or four times before actually going. "I've been fearful for as far back as I can remember," she says.
She's in good company. Nearly half of us are at least a little nervous about visiting the dentist, says Dr. Timothy Smith, a psychologist at the College of Dentistry of the University of Kentucky at Lexington. He adds that 20% of us feel anywhere from moderately afraid to terrified. Many people are ashamed of their fears and reluctant to discuss them with their dentists, further compounding the problem. After all, if the dentist isn't aware of his patient's anxiety, there's little he can do to help.
But times are changing. Advances in dental tools, techniques, anesthetics, and methods of sedation have made trips to the dentist more palatable for many. About a dozen dental schools around the nation now have dental fear clinics, says Smith, and questions about helping fearful patients are now appearing on the national board exams taken by dental students. While Smith says an effective way of dealing with dental phobias has not yet been found, the problem is being addressed. In the meanwhile, there are steps anxious individuals can take to alleviate their fears and receive necessary treatment.
"While there is still some discomfort with certain procedures, generally dentistry is less painful than it used to be."
Dr. Timothy Smith, University of Kentucky College of Dentistry
Getting to the root of the matter
Understanding the reasons behind your fears is the first step to overcoming them. Most phobias are based on previous bad experiences, frequently harking back to childhood.
"It only takes one bad experience," says Smith. But dental anxieties aren't always based on bad experiences in a dentist's office. A traumatic trip to the emergency room could be the culprit. Fear can also be "picked up" from a fearful parent or from the media, Smith adds. For instance, the story several years ago about a Florida woman contracting HIV at her dentist's office created a lot of fear among patients. Those who have been victims of abuse may be particularly sensitive to dental situations as well.
Needles...noise...loss of control...the unknown...the inability to see what your dentist is doing...the invasion of your personal space... There's a lot to fear at the dentist's office. "Tremendous trust is required," says Dr. Matthew Messina, a dentist in private practice in Cleveland, Ohio and a consumer advisor for the American Dental Association (ADA). "The best thing to do," he says, "is talk a lot with your dentist to develop a trusting relationship." Identify your stressors and share the information with your dentist. "Teeth are connected to the person, so the more we know about the person, the more we can do to tailor their treatment," he adds.
"It only takes one bad experience," says Smith. But dental anxieties aren't always based on bad experiences in a dentist's office. A traumatic trip to the emergency room could be the culprit. Fear can also be "picked up" from a fearful parent or from the media, Smith adds. For instance, the story several years ago about a Florida woman contracting HIV at her dentist's office created a lot of fear among patients. Those who have been victims of abuse may be particularly sensitive to dental situations as well.
Needles...noise...loss of control...the unknown...the inability to see what your dentist is doing...the invasion of your personal space... There's a lot to fear at the dentist's office. "Tremendous trust is required," says Dr. Matthew Messina, a dentist in private practice in Cleveland, Ohio and a consumer advisor for the American Dental Association (ADA). "The best thing to do," he says, "is talk a lot with your dentist to develop a trusting relationship." Identify your stressors and share the information with your dentist. "Teeth are connected to the person, so the more we know about the person, the more we can do to tailor their treatment," he adds.
More like your recliner than a dental chair
Here's how some dental offices help you relax:
- Headphones and CDs for patients who can't stand the whine of the drill.
- Virtual reality glasses for video viewing.
- Remote control televisions in treatment rooms for people who are anxious about the perceived loss of control while in the dental chair.
- The option to have a woman dentist. More women practicing dentistry these days may help those who feel a woman may be more empathetic.
Finding the right dentist
It's crucial for fearful patients to find a dentist who has the patience to work with them. "It's a very personal relationship," says Smith. "Shop around." Calling your local dental society or college of dentistry is a good way to start your search, but there is no substitute for personal referrals. Talk to friends, colleagues, and family members. Let them know you are looking for a dentist who is willing to go slow and who communicates well. Perhaps the best source of referrals is someone as phobic as you are, adds Dr. Kim Harms, a dentist in private practice in Farmington, Minnesota, and a consumer advisor for the ADA.
When you find several dentists you are interested in, call their offices, anonymously if you wish, and explain that you are a fearful patient. Ask questions. You can even ask for a consultation so you can see the office, meet the dentist and staff, and ask questions in person. You're better off talking openly about your anxiety before treatment is begun, says Harms. If they don't want to answer your questions or talk to you, or they don't seem supportive and sympathetic, move on to the next name on your list.
Some questions you may want to ask include:
When you find several dentists you are interested in, call their offices, anonymously if you wish, and explain that you are a fearful patient. Ask questions. You can even ask for a consultation so you can see the office, meet the dentist and staff, and ask questions in person. You're better off talking openly about your anxiety before treatment is begun, says Harms. If they don't want to answer your questions or talk to you, or they don't seem supportive and sympathetic, move on to the next name on your list.
Some questions you may want to ask include:
- May I come in just for a consultation?
- What techniques does your office use with fearful patients?
- Can I see the same dentist and hygienist every time I visit?
The tooth, the whole tooth
Smith emphasizes that it's important to know what you're getting into so there are no surprises. If it's been some time since your last checkup or you are experiencing symptoms, don't let your fear of getting bad news keep you from going to the dentist. "No one likes to be chastised or scolded. If this happens, you need to find a new dentist," says Messina. "Fearful patients need the whole truth, but they also need a supportive environment."
If there is a lot of work to be done, collaborate with your dentist to create a treatment plan that works for you: perhaps doing the work all at once if you prefer to get it over with, or spreading it out over several appointments. Often, says Messina, treatment plans are designed to take care of problems in "worst first" order, but plans can often be tailored for patients who are more comfortable starting small and building successes.
If there is a lot of work to be done, collaborate with your dentist to create a treatment plan that works for you: perhaps doing the work all at once if you prefer to get it over with, or spreading it out over several appointments. Often, says Messina, treatment plans are designed to take care of problems in "worst first" order, but plans can often be tailored for patients who are more comfortable starting small and building successes.
It\s been years...
There will always be some catching up to do after years of neglect. The hardest step is making the first call after being out of the system for years, says Messina. "It's never as bad as you think. Your own fears are generally worse than the reality." If you don't see the dentist regularly and only visit when there's a problem, though, your fears can become a self-fulfilling prophecy.
The dentist's office is a different place than it was twenty or thirty years ago. It smells better. Improved anesthetics and sedatives, higher speed, quieter tools, faster-setting impression materials, more comfortable treatments for gum disease, and the changing focus on treating the whole person rather than just his or her teeth, all make modern dentistry much more patient-friendly.
"While there is still some discomfort with certain procedures, generally dentistry is less painful than it used to be. People suffer for years with problems we can fix very easily," says Smith.
Nishball says visiting her dentist hasn't gotten any easier over the years, but as she's matured, she's gained a common sense perspective. "Fearfulness is not a bad thing," she says, "but you can't let it keep you from getting good dental care."
The dentist's office is a different place than it was twenty or thirty years ago. It smells better. Improved anesthetics and sedatives, higher speed, quieter tools, faster-setting impression materials, more comfortable treatments for gum disease, and the changing focus on treating the whole person rather than just his or her teeth, all make modern dentistry much more patient-friendly.
"While there is still some discomfort with certain procedures, generally dentistry is less painful than it used to be. People suffer for years with problems we can fix very easily," says Smith.
Nishball says visiting her dentist hasn't gotten any easier over the years, but as she's matured, she's gained a common sense perspective. "Fearfulness is not a bad thing," she says, "but you can't let it keep you from getting good dental care."