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“I’m afraid to go to the dentist, what can I do?”
Don't put it off. Take that first step and pick up the phone. Talk to your dentist about your fears. By developing a relationship with the dentist, you’re involving yourself in your own treatment plan. Your dentist will discuss options available to you that will help you control your treatment; techniques may be offered that will help you relax and feel more comfortable during your visit.
Common Dental Fears
Fear of dental treatment occurs for a variety of reasons. The following list highlights a few of the more common reasons cited by patients as to why they fear going to the dentist.
Fear of Injections - Many people are terrified of needles, especially when inserted into their mouth. Usually this fear stems from the thought that the needle will break off inside their mouth. Modern disposable dental needles which are used for local anesthetic injections are manufactured to a very high standard of quality. If properly used, patients generally feel very little to no pain.
Fainting - A small percentage of the population will faint at the sight of a needle or syringe or indeed the thought of an injection. Clearly, in known cases of fainting the patient should not be shown either the syringe or the needle. The patient should also be supine while the injection is administered and encouraged to eat an hour or so before treatment to maintain a high blood sugar level (which will help to alleviate some of the symptoms of fainting.)
Fear That the Injection Will Not Work - Local anesthetic is always effective if it is injected in the correct anatomical area and given sufficient time to take effect. It works by blocking the nerve supply to the particular region under treatment.
Fear Due to a Previous Bad Experience, Common Causes Include:
- Negative childhood dental experiences
- Local anesthetic not providing complete anesthesia
- A feeling of being trapped while treated
- Long dental procedures leading to jaw stiffness
- Fear of choking
Fear of Local Anesthetic Side Effects, such as dizziness and fainting. Considering the number of dental injections given, there are remarkably few reports of any side effects. In fact, there have been only a few reports of true allergic reaction to local anesthetics.
Dislike of the Numbness Associated with the Local Anesthetic - This is a common complaint but most people realize the benefits of local anesthetics far out way their dislike of the numbness.
Fear of Unnecessary Treatment - Some patients may question the need for a particular treatment. All dentists should be able to easily show the problem to the patient either by using an x-ray, intra oral camera or patient mirror. An explanation of the treatment plan along with a reasonable estimate of cost should always be given.
Fear of Infection - Modern needles are sterile and designed for single use.
Unspecified Fear of Treatment - Often patients just aren't sure why they're frightened. Frequently, their fear stems from a combination of several of the above-mentioned factors.
Suggestions for the Phobic Patient
Find a sympathetic dentist and discuss the matter with him or her. When booking the appointment be sure to tell the receptionist that you are frightened and that you do not wish for any surgical treatment at the initial visit - just a little chat!
At your first visit, let the dental team know about any concerns or questions you may have. Asking questions about your mouth and the proposed treatment will help remove some of the fear of the unknown and give you an opportunity to become more involved in your dental health. Most importantly, remember that your dental team is eager to work with you, not just on you.
There are many methods available to help you during treatment. These include techniques such as General Anesthesia, Hypnosis, Intravenous Sedation, Inhalation sedation, Oral sedation, Psychotherapy or even just the support of close friends and family.
Types of Sedation
Intravenous Sedation
Intravenous sedation is the administration of a sedative drug into the blood system in order to facilitate dental surgery in the highly anxious patient.
What Effect Does it Have?
The sedative used produces a strong sensation of relaxation and well-being in the vast majority of patients.
Even the most highly anxious patients are routinely treated with this technique.
How is it Given?
The drug is injected into one of the superficial veins of the arm or hand.
Can Anybody have this Sedation?
The vast majority of patients are medically able to have sedation, although some medical conditions, such as severe lung diseases, certain heart conditions, obesity or anorexia are contraindicated.
Is it Safe?
Unlike general anesthesia, the patient remains conscious throughout the procedure. Thus, many of the potential dangers of general anesthesia are avoided.
Oral Sedation
The use of oral sedative drugs (drugs taken by mouth, ie., tablets and syrups) has a long history in dentistry. It is extremely difficult to predict how soon after taking an oral sedative that a patient is at their most sedated state. For this reason, oral sedatives have proven far from ideal. Some patients may take only several minutes to be fully sedated, while others may take much longer.
General Anesthesia
This is the 'ultimate' tool for the dental surgeon in treating phobic patients. In this procedure the patient is completely anaesthetised. Although this may at first sound like the most acceptable way for you to be treated, it should really only be performed as a last resort when other safer techniques have failed. Most dentists are reluctant to use general anesthesia due to the increased risk of treating patients under this treatment modality.
Hypnosis
The dental treatment may be preceded by one or more hypnotherapy sessions. Sometimes the hypnotist can accompany the patient to their appointments.
Although often effective, it’s important to realize that not everyone responds to hypnosis.
Another important consideration is cost.
Psychotherapy
Psychotherapy has been used for many years in the treatment of phobias and anxiety-related disorders.
How is it done?
The first step is usually the identification of the phobia’s origin. The psychologist will then attempt to desensitize the patient by slowly exposing them to the object of their fear. For instance, with the assistance of the psychologist, dental treatment may begin for a dental phobic with the performance of a simple cleaning
Some psychologists suggest that patients with a dental phobia sit in while the dentist treats other patients so that they become accustomed to the environment.
Family Support
Some people may find dental treatment easier to tolerate if it is performed in the presence of a close member of their family. If you think that this would help, please don’t be afraid to discuss this with your dentist.
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