The truth revealed why so many fear the dentist and the hope in a new level of dental care.
By Dr. Robert Antolak, DDS – The Gentle Dentist

There are many common reasons why people avoid coming to the dentist even when they know they need to.  I face new clients in our dental office who have had dental FEAR CONTROL THEM for many years. So if you are one of those people who avoid the dentist at all costs you should know you are in good company. Only about 50% of the population sees the dentist on a regular basis and the major reason they hesitate is because of dental fear. The second most popular reason is because of the cost of dental care. I would like to address dental fear because it is something we can successfully work with.

The truth is that a trip to the dentist in the past has been a very fearful experience. As a modern dentist I feel that I must apologize for those insensitive and mean dentists of the past. They have affected many adults today with their actions.

When interviewing guests in our dental office who decide to become patients they have shared many horrifying events that took place in the dental chair when they were just children. Here are just a couple of confessions that I hear over and over: (In parenthesis I give a short answer what to expect from your dentist in regards to these concerns and fears).

• Their childhood dentist would continue to do a filling or pull a tooth when they could still feel it. They would protest to the dentist and they would be scolded. (They should stop when you raise your hands-IMMEDIATELY)
• The shot hurt so much that they would not subject themselves to it again. (Should inject slowly and use topical anesthesia for 2 minutes)
• They had their teeth pulled because their parents couldn’t afford it. (Financing)
• They had a traumatic accident to the face and won’t allow anyone to come close to their face. (Working with a psychologist to work through the emotional pain and an empathetic dentist)
• The dentist pulled the wrong tooth and didn’t listen to them as they protested. (Should never happen)
• They don’t want to deal with being numb. (I will give the answer in next months column)
• The smell of the dental office triggers the fear of childhood traumas.  (Don’t use these materials that produce those smells and use air purifiers.)
• They hate the sound of the dentist’s drill. (use electric hand pieces and noise canceling headphones)
• They don’t have the money or insurance for the dentist. (interest free financing)
• They believed that the dentist just did the fillings even though they didn’t need them. (digital photography and digital x-rays to show and reason why the dental treatment is needed and justified)

The first is by far the most common reason that the dentist is avoided so much. As I have both studied this and evaluated the patients there seem to be two main underlying causes.

First, is the fact is that as a child, these young patients had to give over all control to someone they really didn’t know and to make matters worse they had to endure the pain without any advocates on their side. All levels of trust had been violated and these children made a pact with themselves that they will never let this happen to them again. And they didn’t even as adults. Many times these adults say they know they should come in but they just can’t. We have seen many adults who have refused to visit a dentist for 20-25 years and all this stems from situations like the aforementioned example.

Second, the fact is as a dentist we invade one’s personal space. It is improperly assumed that we in the dental profession have the right to get into the physical areas that are so intimate and sensitive without creating any relationship with the person. Giving up the control and increasing trust is difficult and takes time. Unfortunately this has not been given much thought in the past resulting in significant emotional trauma. This emotional trauma is difficult to transcend for many people and this becomes a reason to avoid dental checkups.

What to do? Make sure your dentist has empathy and works with you on your fears and concerns. Here I have listed a few of the things we do to make our patients feel more comfortable.

• It is very important to create relationships with strangers before we can assume that it is OK to get close to them. At our office I make a personal call to our new guests to enhance a relationship and to answer any question or concern they have. The new guest is usually quite surprised that I would make the call, but this has been proven to be very helpful with our high fear based patient.
• At their first visit we like to have a simple discussion and chat with our guest to find out what their goals, fears, etc are. We then proceed at the pace they desire. Some of our patients have only made it to our reception area and we considered that a success since they made it past the front door. Eventually we are given permission to complete an exam and finally begin treatment. This may take a couple of visits, but we are patient and as long as there is forward progress, we consider it a success.
• We have recently hired our dental assistant, Tammy, who is also a licensed registered massage therapist. To help our patients, we will provide at no cost a short shoulder and neck massage to loosen and comfort our guests. This is available upon request. This is a real treat!!
• Nitrous Oxide Sedation-This is a great way to provide a very relaxed patient who becomes very apathetic during treatment.
• Oral Sedation”By taking a couple of pills before treatment we can perform oral Sedation (dream dentistry) which eliminates virtually any memory of the procedure and is very relaxing for the patient. We monitor your heart rate, blood pressure and oxygen in your blood to make sure you are breathing well
• Noise canceling Head phones help to reduce the sound of the dental drill and since we use an electric hand piece the whine of the drill is also eliminated. We have an assortment of music or bring in you favorite music.
• By using topical anesthetic for at least 2 minutes before an injection there is nothing felt during the needle insertion. When administering the shot it must be done very slowly. I can remember 24 years ago as a second year dental student my instructor challenged us to numb ourselves under our nose to see what it is like receiving anesthesia and to experience the pain we felt if not done slowly. I will never forget that experience. This has given me the desire to have a light touch to not hurt patients. Having a light touch is very critical because it takes time to regain the high fear patients trust” that means they are giving us one more chance. I appreciate this confidence and don’t take it lightly. I work very hard to ensure that I do not expose them to any discomfort.

This may sound hokey to some, but those whose Fear has controlled them it is the thing the Doctor Ordered.

The most important bridge to recovery is creating a trusting relationship with your dentist and giving feedback if there is something not right with the care. If the dentist you are going to doesn’t acknowledge your intention or believe you really feel it then it may be time to find a new dentist.

Dr. Antolak treats his dental patients in a relaxed, friendly atmosphere where you are treated like a guest in the home. His motto is to relax while we take care of your smile€. He specializes in cosmetic dentistry, implant dentistry and general dentistry using sedation dentistry if necessary for his high fear patients. He has been treating patients for the past 21 years. His dental practice, The Gentle Dentist, is located in Shelby Township, Macomb County, Michigan.