Ask The Dentist is a series of columns written by Dr. Mady to answer your questions about dentistry and oral health!
Dear Dr. Mady: I have been avoiding the dentist for the past 19 years due to a great fear I have of dentists. I remember as a child, I had difficulty even entering my dentist’s office. Now I am at a stage where I have had constant pain for three months straight and I know that I need teeth pulled. What do you really think is wrong with me and what can I do? - Anxiety Ridden
Dear Anxious One: Being a current practicing dentist, I can tell you that there is not a day that goes by that I do not observe some form of anxiety in most of the patients that I treat. There is something about dentistry that excites fear in many individuals and this is nothing to be ashamed of. Don’t feel that you are alone.
Having dental anxiety or a dental phobia most of the time is manageable with respect to treatment, but if you find it impossible to cope with, then the problem is more serious. Dental Phobia is a more serious condition than anxiety or fear, but it can be successfully treated.
As far as the reasons behind these intimidating conditions, they are numerous. Most individuals, and maybe yourself, relate their dental fears and phobias to a childhood dental experience. This may not even have been a negative experience at all, but the setting just dictated the start of apprehensive feelings.
As a result of these feelings, most people like yourself evolve into poor attendees when it comes to keeping dental appointments, even if these dental visits are desperately needed. Therefore dental phobics are usually more in need of dental treatment than most others.
Phobia is a different problem than anxiety, and it may be more of a phobia that you are experiencing than anxiety.
The reason I conclude this is because you appear to be demonstrating avoidance behaviour. By this, I mean that you seem to be completely avoiding a threatening situation. This would not be as much of a problem if your phobia were associated with something that you could avoid your entire life without recourse, but teeth always need attention at some point.
A dental phobic usually is well aware that the fear is irrational, but feels unable to do much about it. It could even make you feel faint, nauseated, and even have heart palpitations at certain times. In severe cases, the phobic patient may actually fear the symptoms that are elicited from the phobic situation due to a lack of control.
If you need to combat this problem immediately, get support from friends and relatives who can recommend a sympathetic dentist that you can discuss your problem with before any treatment is initiated. Most dentists will have come across this many times before and will be very used to the problem.
This dentist will be able to offer you (or by referral to specialists) many methods that will assist you, including nitrous-oxide inhalation sedation, intravenous sedation (deep relaxation with full or partial memory loss), or even general anesthesia (total sleep, ultimate sedation). Many anxious and phobic patients also have an option of taking pre-medication with certain calming drugs just prior to their appointments. Included in this list are Valium and Ativan tablets, but still many feel that these type of drugs used for this purpose fall short of adequate sedation. I guess it just depends on the individual.
It sounds like you need to make a phone call now to schedule a meeting “just to talk” at first. Do not be embarrassed because health professionals will understand. You may even contemplate asking your family physician to recommend a good psychotherapist or hypnotist. These skilled and experienced therapists have a reputation for helping people like yourself “extract” the problem, so to speak!
- Dr. David Mady