Moving Past Dental Fear
what do a dentist and a spider have in
common
you might think you know the right
answer it’s hairy legs right
well you’re definitely on to something
but today we’ll start off by saying that
they can both cause anxiety
dental phobia is the most common of all
the phobias with 3.7 percent of the
population being affected
the next two most common phobias are
fear of heights and a fear of spiders
arachnophobia now as a dental student i
often see people who are
uncomfortable or uneasy in the dental
chair
just a few months ago i met a young boy
who was playing in his living room when
he fell forward and knocked his front
tooth on the coffee table
now his parents immediately took him to
the dentist and the dentist recommended
a root canal for the traumatized tooth
at the beginning of the procedure he was
very happy and calm
but somewhere along the way he started
to feel uneasy and
he became unable to sit still
the dentist realized that they couldn’t
safely do the procedure
and they decided to refer him to a
specialist for root canals which is
called an endodontist
now this is where i met him i was
actually assisting a resident in the
endodontic program here at my school
when the boy came for his visit he was
very happy
given the history of his referral but as
soon as the resident started to recline
the chair
he started breathing heavily and crying
and saying
i don’t want to do this now luckily she
knew exactly what to do
she stayed completely calm and she asked
him what he was afraid of
and how he was feeling she met all of
his concerns
and his fears with compassion and with
patience
she also started to show him all the
instruments and all the materials which
would be used that day to help fix his
tooth
and finally she asked his parent who’s
in the room with us
to just reach out and hold his hand now
this might seem like something very
simple
or something we’d usually take for
granted but scientists have actually
found that this type of human touch
can induce the release of oxytocin which
reduces stress levels and
increases feelings of trust so gradually
the boy was able to calm down and the
resident was able to save his tooth
fear can so often feel isolating but my
goal today is to reach out a hand
and connect with you so that we can
overcome dental fear and anxiety
together
fear at the dental office can take many
forms but usually it falls along a
spectrum ranging from dental fear
to anxiety and phobia each more severe
and limiting than the last
dental fear is a normal emotional
response to a stimulus that can be
perceived as threatening
now this is somewhat similar to a
feeling you might get when you’re
standing
in front of a line for a big roller
coaster or if you see a spider crawl up
a wall
being afraid of certain things is normal
as long as it’s tied directly to
something that’s happening in that
moment
for example if you’re uncomfortable
around needles and you see one
approaching you
it’s normal to feel a little afraid it’s
when these feelings
start to not match what’s actually
happening in that moment
that it might be a sign of something
more serious
for example dental anxiety can be
described as a persistent apprehension
people with dental anxiety often feel
like something terrible
is about to happen this feeling might
come upon them when they’re
sitting in the waiting room or when
they’re just driving to their
appointment
although nothing is directly happening
to them or around them
they still feel the anxiety that they
associate with being at the dentist
dental phobia is the most severe form of
dental fear
it involves excessive fear out of
proportion to any perceived danger
people with dental phobia will often
have extreme distress if they’re at the
dental office
or we’ll just completely avoid it and
that brings us to our slide on the cycle
of dental fear
where avoiding and delaying dental
visits can lead to painful oral issues
and poor dental health
now these issues will make a lot of
patients feel ashamed or guilty for not
having sought out care
when in reality they were dealing with a
very serious issue which is dental fear
now these feelings of guilt and shame
can then breed more fear and anxiety
and lead to further avoidance and future
dental problems
now studies show that this isn’t
uncommon with about 22 percent of
americans say that they avoid dental
visits because they’re afraid of the
dentist
i believe that by building good
associations in children and by
working through existing cases of dental
fear we can help about a quarter of the
population get the care that they need
so where does dental fear come from well
about 61 percent of people said that
their fear came from a traumatic
experience that happened at the dental
office
now about half of these experiences
happened when they were children
interestingly enough the more checkups
and cleanings that a child has before
their first
invasive procedure so something like
pulling a tooth or getting a filling
the less likely that child was to
develop dental fear
another interesting thing that we’ve
learned is that people but especially
children can learn to be fearful of the
dentist by watching
others experience dental fear themselves
so one study found that a mother’s and a
father’s dental anxiety were both
significant predictors for whether or
not their child would develop that same
fear of the dentist
so what can we do to combat dental fear
you may have already guessed that our
first line of defense is prevention
now many people might say we want to nip
this in the bud but i’m showing a
beautiful picture of a rosebud here
because i believe that instead of
focusing on nipping or cutting off bad
experiences
we should focus on growing good ones so
that a positive relationship can
flourish between our kids
and the dentist the american academy of
pediatrics recommends that kids be taken
to the dentist
before their first birthday and every
six months or so
thereafter not only will this allow for
the identification and the treatment of
any oral issues
but it’ll also build up positive
associations with being at the dental
office
parents should also try to frame
visiting the dentist
in the most positive way possible
avoiding any expressions of their own
dental fear and anxiety
you may be wondering well what if i
already have dental fear
and my suggestion in that case would be
to make a plan
i believe that we can alleviate much of
the fear and uncertainty
surrounding dental visits by borrowing a
strategy which has been used for decades
to help mothers prepare for the birth
process
it’s called a birth plan and i learned
about it from a friend in ob gyn
basically expecting parents will go
through a list of possibilities
and indicate their preferences for
things like support pain management
and elective procedures then they’ll
bring this plan to their doctor and have
a discussion about it
it’s at this point that the plan becomes
a communication tool
which highlights many of that patient’s
fears and worries
now the doctor is able to also walk the
patient through what is likely to happen
what treatment options there are and
also what accommodations might be made
to help alleviate their fear i believe
that we can use many of these same ideas
within dentistry
to help people with dental fear and
anxiety move
past it and get the care that they need
so what would developing a dental plan
look like it would involve working
together with your dentist to address
your questions
concerns and preferences before
treatment actually occurs
now the first thing you’ll need to do is
communicate openly with your dentist
and ask them if they’d be willing to
develop a plan with you to help you
manage your dental fear
believe me you won’t be the first person
or the last to have dental anxiety
and they definitely shouldn’t judge you
for it
ideally during an introductory
appointment you could develop a dental
plan together
to prepare for such a meeting you can
write down any questions or concerns you
have
so that you can guide the discussion to
make sure that you feel comfortable
during future treatment
additionally you and your dentist should
work together to cover your preferences
for example would you like them to
communicate what is going on during each
step of the procedure
this helps some patients feel more in
control but for others they can
introduce an
unnecessary sense of worry many patients
would much rather lay back
shut their eyes and listen to a podcast
if this sounds more like you you’ll want
to make sure to ask your dentist
if you can bring headphones so that you
can listen to music or
book most dentists instruct their
patients to raise their hand if they
become uncomfortable or need a break
during treatment
you should work together to figure out
if this is the best way for you to
communicate with them
another key factor that can help people
with dental fear
work through this is appropriate
sedation
ask your dentist what sedatives are
appropriate for your treatment
they’ll be able to give you the best
recommendations given your unique
treatment plan
and medical history some other things
you can do
to reduce feelings of fear include
texting a loved one for encouragement
while you wait
or even practicing controlled breathing
if you feel anxious life can be filled
with so many
uncertainties and frightening unknowns
but dental
fear doesn’t have to be one of them
dental fear is usually preventable
and even when it already exists it can
be alleviated when the dentist and the
patient work together to develop a plan
by building positive experiences at the
dentist early on
and by communicating your concerns and
preferences with your dentist
you can make sure that you and your
loved ones are getting the care you need
and deserve
i hope that today i have given you some
tools that you can use to tackle dental
fear
but also other fears more broadly take
it one step at a time
and have a plan even if your plan is
just to have courage
thank you very much