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