Allan Schwartz, LCSW, Ph.D. was in private practice for more than thirty years. He is a Licensed Clinical Social Worker in the states
Are you someone who fears going to the dentist and avoids going even if you have a painful toothache? Your are not alone. There are millions of Americans who avoid visits to the dentist’s office out of deadly fear. This is an extremely serious problem because neglect of oral health can lead to things such as: gum disease, cavities, infections, loss of teeth, high blood pressure, heart disease and death. Yes, oral neglect can be deadly and oral care is much more than a cosmetic issue.
Why do so many fear the dentist?
People avoid the dentist for a variety of reasons. Some of these reasons are:
1. General anxiety disorder or panic attacks, so that the individual is fearful about doing much of anything about their health because of their fears.
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2. Fear of pain and discomfort associated with being in the dentist chair.
3. Post traumatic stress disorder (PTSD), such as having been in combat in war or in some other disaster. The result is that the smells and sounds associated with dental treatment set off flashbacks to the original trauma.
4. Terrible past experiences at the dentist that were so painful that the experience was traumatizing.
Experience with Old Fashioned Dentistry:
For many of us older folks, there were some very bad experiences with old fashioned dentistry, before the age of fast drill and anesthesia. The drills were terribly slow, the entire process agonizingly slow and, for most of us, quite painful. I was a fortunate patient in having a very good dentist when I was a child. He took care go give me a sense of control by allowing me to raise my hand when the drilling became painful.
On the other hand, my wife had the misfortune of having a dentist with no concern or care about the emotional well being of the patient regardless of age. The result was that she experience excruciating pain and, very quickly, became phobic. To this day, and we are married forty years, it is difficult to trust a dentist and to motivate herself to go for visits.
Modern Dentistry: Still Fearful:
Modern standards of dentistry make the old days of my childhood seem like barbarism. Today, drills are extremely fast, anesthesias are excellent in preventing any pain and, many dentists offices are equipped with ear phones that allow the patient to listen to relaxing music while the work is being done. Also, dental work, that would takes weeks to finish when I was a child, is now done in one visit unless more complex root canal is involved.
Yet, despite all the modern conveniences those people, like my wife, are still extraordinarily fearful of going to the dentist.
The Nature of Phobias:
The nature of phobias are such that all the facts of ease and convenience make know difference when stacked up against deep fears. People like my wife have now had wonderful experiences at the dentist yet, are still fearful. In the case of my spouse, there is one dentist she trusts completely. However, her good experiences with him have not "generalized" to other dentists and, now that we have moved far away, she is again fearful of starting work with someone new.
Overcoming fear of the dentist:
Based on what I know about phobia, PTSD and my wife, I have a number of suggestions that could help those of you who are extremely fearful of going to the dentist:
1. Find a good dentist, done mostly by the reputation of family and friends. Make an appointment to talk with him, visit the office and become acquainted. If the dentist is unwilling to do this, find another dentist. It is vitally important to find someone who is warm, caring and is familiar with treating fearful patients.
Remember, today, there are dentists who specialize in treating those who are fearful.
2. On that first tour of the dentist’s office ask if he specializes in treating people who are fearful and let him know that you are one of those people. Do not be ashamed, this is a common and serious problem.
3. On this first tour and on subsequent visits, make sure you are accompanied by a family member with whom you are comfortable and in whom you have confidence. I accompanied my wife on all of her visits to the dentist who she came to trust. In fact, I did all the driving and she reported to me that she found this very helpful and comforting.
4. Prior to the visits, practice all of the usual stress reducing techniques. If you do not know them, they can be found here at Mental Help Net.
5. Make certain that you work out, with the dentist, a way for you to feel in control during the procedures. He should know about these but you need to take responsibility because it will further enhance your sense of control. Like my old dentist, be certain you and he have a signalling technique whereby he knows you are in pain or discomfort and he will stop.
6. Put on the ear phones and listen to music.
7. Make sure he has explained to you all he is going to do, how long it will take and what types of anesthesia he will use. The more you know the more in control you will feel.
8. Make certain you are seeing a dentist who is using sedation. I would not recommend general anesthesia in the dental office because it can have serious consequences. In dentistry, general anesthesia is usually reserved for the more serious surgeries and this can be done in the hospital where this is lots of help should anything go wrong with the sedation.
However, most dental procedures do not use general anesthesia. Instead, the sedation is relatively light so that there is no pain but you are fully conscious. I can report that the whole thing can be quite pleasant.
9. Lastly, I would suggest that, if you need extra help in overcoming your fears, that you see a psychotherapist, especially a clinical psychologist, who specializes in training people to over come fears through the use of Cognitive Behavioral Therapy and Behavior Modification.
Your comments are welcome and encouraged
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