Ask the Experts

Good News for Anxious and Fearful Patients



Edward J. Prus, DDS
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Disliking a dental experience can be commonplace but is accommodated by most patients to some degree. Just another part of life we endure. Extreme dental fears and phobias are entirely different.

 

What is dental fear (phobia)? How does it differ from ‘disliking’ a dental experience?

DISLIKE: Since most dental treatment involves an anesthetic injection, it is fair to say most patients don’t look forward to the ‘shot’ except, perhaps, as a mechanism to avoid something worse. That is a typical example of disliking a dental event. It can happen at many levels and we teach ourselves to deal with it best as we can.

FEARS AND PHOBIAS: Dislike, however, does not come close to the emotional turmoil that highly fearful people have at the mere thought of being at a dental office. For those individuals who experience it, it is paralyzing. They impulsively avoid all things dental. As a result, their dental health suffers, often greatly.

Why are such patients so paralyzed at the thought of going to the dentist?

 

The Source of Dental Fear

Over time everyone will forget many of the details of an unpleasant event, but not as easily how they felt about it. Fear is an emotional reaction and it wins over logic for dental phobics. They fear things which they feel (emotions), not know (logic), can harm them in some way and that they don’t have control over. Experience has shown this fact drives the emotional reaction and they then relive their emotional event as they perceive it, and fear it can happen again. For fearful patients, I have found a traumatic event was almost always accompanied by their inability to influence it. The lack of having any say or influence in the event during their dental experience is the primary cause of their dental fear. It was not the just the pain or suffering. Emotional trauma is the result.

 

What are the Ways to Counter Dental Phobia?

1. The most common way in today’s dentistry is to use sedation dentistry. It can allow a person to receive all the needed dental care without the challenge of emotional stresses. There are several options:

a. Nitrous Oxide, called ‘laughing gas’, for the obvious reasons 

b. IV sedation which uses an intravenous injection of any of several sedative solutions

c. Combinations of both

The choice of which approach is best is determined by the training of the doctor and the requirements of the procedure. Even patients without phobias can benefit from this when a procedure is expected to be difficult, such as a difficult extraction or any extensive surgery. It removes the possibility of developing a fear.

The phobic patient will, however, still retain their fears after the procedure. Their only recourse is to continue with the sedative approach for most dental care. There are always costs and potential problems with any form of sedation and they must always be considered and properly explained to a patient.

 

2. The second choice involves learning how to overcome and move past your fears. It involves patient-dentist teamwork and it is not as difficult as it may seem. Here is how it is done.

There are three important patient-doctor interactions you want to develop to make it work:

a. The most important factor in overcoming your dental fears is to gain a sense of control over your environment. The dentist’s job is to support that. Tell them what you want and do not want. Speak your mind.

b. The second most important factor is to have the dental team understand what caused your fear (your trigger point) and tell them to avoid it if at all possible.  

c. The third vital factor is to develop a trusting relationship between you and your doctor through repetitive successes so you can work together better. This is the cornerstone of your success. This is an extension of (a).

 

How does a dental patient gain control over their environment and bypass their fears?

When visiting a dental office there are several key steps you should be mindful of. These steps, when supported by your dentist, create your sense of control and you want to focus on them:

1. Be Informed as to what they are going to do. If you are uncertain, ask for a clarification. Non-dental examples work well. Dentistry is often confusing.

2. Don’t allow treatment until you give permission to do it. Be engaged in the decision making process. This will help you understand and accept the process and put you more in control of them. If you express resistance, the dentist should reduce his/her expectations and try for a smaller accomplishment. Only proceed if you give permission.

3. In the midst of the approved procedure, be willing to pause, reaffirm the process and repeat the approval to continue. This reinforces your involvement in having a say in your dental experience and starts to lessen the fears you have held for years. When you give approval all along you will more easily accept the consequences.  That changes your reaction from emotional to logical.

4. Applaud your positive results however minimal. Speak it out. This builds trust, not just between you and the doctor but within yourself by reaffirming that you can handle it.

Over time I have found most phobic patients learn to move past their fears with proper guidance and, as a result, they approach the dental environment with greater appeal, self-confidence and even enthusiasm. What they lived and relived for years is gone.


To learn more about Dental Fears click here… http://www.drprusdds.com/why-choose-cde/caring-for-the-fearful-patient/



Read Past Topics from Dr. Prus: 
‚ÄčHow to Regain 20 Years of Youthful Beauty in Your Life
Why Should Dental Patients Consider Implants?


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