Fear, Anxiety and Pain Control

Question:

Why do some people have a fear of dentistry?

Answer:

People are not born fearful. Fear and anxiety develop out of socialization, personal experience, and the mass media (movies, television, news stories, etc). Newspaper and magazine cartoons, along with comedy sketches also are guilty of misinformation, and create inaccurate perceptions that contribute to one’s anxiety. The right dentist, with understanding, patience, compassion, and a gentle touch should be able to convert an anxious, scared patient into a loyal, non-fearful patient. The wrong dentist may say negative remarks or perform certain actions that contribute to the patient’s fears. Fear can come from an individual’s own personal perception of the situation, which is usually based on past experiences coupled with their interpretation of the present situation.

A sizable portion of the general population who could benefit from dental care does not receive treatment because of their fear. What produces the most fear is the sound of the “drill” and the “needle”. They may be terrified when they sit in that big chair, but as soon as the dentist makes them numb, they are so relieved, that they sometimes fall asleep. They discover almost immediately that the dental injections are not very painful. It’s just that there is a tendency for patients to concentrate on the stimulus of the injection, and by doing that they magnify that stimulus into something much more unpleasant than it should be.

Question:

What is the difference between fear, phobia and anxiety?

Answer:

Fear is the individual’s emotional response to a perceived threat or danger.
Anxiety denotes an emotional experience similar to fear, but where the source of threat is ill-defined, ambiguous, or not immediately present. Phobia is a special form of intense fear recognized by that individual as excessive or unreasonable in proportion to the actual level of danger.

Question:

How can a patient overcome their fear of dentistry?

Answer:

Numerous studies have shown that the critical element is that the patient believes he or she has some sort of control over the potential threat. Therefore, if the dentist can convince the patient through words or actions that he or she can terminate the procedure if the feel the need (raising the hand), then less fear and less pain will likely be experienced. If the patient feels that they have no means of influencing treatment, then they may develop a perception of helplessness and lack of control, which fuels their fear.

Some apprehensive patients need to be told everything that is going to be done, so they know what to expect. (i.e. warnings when they may feel pressure or vibration, what they are likely to experience next, etc.) A lack of information may result in fear. By developing a sense of trust with their dentist, a once fearful patient can become the most dedicated and loyal patient.

Question:

How can one cope with their fear and anxiety once they are in the dental chair?

Answer:

Coping skills include learning to relax and breathe properly, utilizing distraction techniques, and asking questions to gain control. Sometimes candles, waterfalls, relaxation music, headphones, TV, movies, etc, will enable the patient to relax more. Additional ways of controlling fear and anxiety is by administering Nitrous Oxide (laughing gas), Oral Premedications (i.e. Valium, ambien, and xanax), IV sedation, and giving pain free injections after using a strong topical numbing agent. Of course, having a dentist and staff that is patient, understanding and comforting is the most important factor in helping to cope with one’s fears and anxieties.

Question:

How can you prevent a child from developing a fear of dentistry as they grow older?

Answer:

Factors contributing to a positive outlook on dentistry involve early encouragement and positive communication by parents, and a relatively pain-free experience with a dentist who communicates with the patient, treats them with respect, and allows the patient to have some say in their treatment if they desire. Starting kids early, by 2 years old, and making the visits fun with magic tricks, balloon animals, toys, counting teeth, brushing the teeth models, seeing their teeth on the TV screen, playing fun music or having their favorite shows or movies on can really make a difference. These kids will develop a positive association with the dentist and look forward to future visits. Never use the dentist as a threat if they don’t brush or if they eat too much candy. If you make the dentist out to be the bad guy, they will carry that thought with them throughout their adult life.

Question:

What can happen as a result of avoiding dental care?

Answer:

What starts as a small cavity can become very serious if left untreated. Some people wait until the pain they have is enough to exceed their avoidance tendency. This fear of pain is one of the major reasons why patients fail to seek help from a dentist until their emergency becomes too severe. At that point, what should have been a simple cavity now becomes a more involved root canal or extraction. Additionally, a patient who avoids routine dental cleanings and gum maintenance can wind up with severe gum disease (Periodontal Disease), which causes gum recession, bone loss, tooth mobility and the eventual loss of teeth. Swellings and infections may result from neglecting these cavities and gum issues, and what would have been unnecessary costs and procedures will now be necessary to restore the mouth back to a better state of health and function.