By the nature of our dental name and web site www.TheGentleDentist.com/sedation_dentistry we attract many high fear dental clients who have avoided dental visits for many years. I would like to address some of the most common situations that we encounter in Shelby Township, Michigan. It is my hope that if you identify with one of these scenarios that you make a decision to take action and visit your dentist.
- “Personal space” is the distance in which one has a certain level of comfort with another individual. This is defined by the fact that we are more comfortable with strangers at a distance then up close. The more intimate we are with someone the closer they can encroach on this space. In the health care profession and dentistry more specifically, we encroach on one’s personal space to treat them usually without permission from the patient. I tell my dental patients that it takes time to develop rapport and trust so that we can get close enough to them physically to examine and treat them. We in the medical and dental profession have just assumed that it was OK to jump in the personal space without investing the time necessary to develop trust. This is especially stressful for those who have been in auto accidents, been involved with facial injuries or who have been assaulted.
- These traumatic events have made the victim suspicious and skeptical of most anyone and these dental patients usually require a lot of time so that they can trust us. Eventually permission is granted and we are invited to examine them and enter their personal space. In our office if they need to stop the visit they have plenty of opportunity to do so without pressure. Our goal is to have our high fear patients make small positive steps forward no matter how long it takes. Because dentistry deals with one of the most sensitive areas of the body (the mouth) there are many dental patients who have been hurt by the injection, have been treated in a very rough manner or the dentist did not numb them up adequately that they had pain with everything that was done to them. It was during these times that a decision was made and told themselves that they were NEVER going to put themselves in this compromising situation again and so they continue to avoid the dentist at all cost. We find that these events usually had taken place during a childhood visit and their fear will last their entire life unless something can break the cycle and trust can be restored. I have heard horrible stories of children getting slapped by their childhood dentist because they complained that they were being hurt. Many bad events similar to these took place scarring these people for many, many years.
- Dental treatment requires a patient to lay flat on their back so we have better access to the mouth to perform dentistry. This physical body position leaves many feeling venerable and unprotected. Until they know they are safe, asking a dental patient to lean back may be asking too much out of them.
- Gagging is a real issue for those who have a difficult time breathing through their nose. With a history of gagging there are many patients who are challenged to get back into the dentist for fear that they will be embarrassed from another episode of this.
- The sound of the dental drill makes many nervous and am told is like “nails on the chalk board”.
- When one avoids the dentist for a long period of time there is a strong tendency of self-condemnation and embarrassment. The last thing the high fear patient needs is to be “preached at” and being told “you should have …….”. It is important to show mercy and let them know there is a future and hope.
When we see those who avoided the dentist for many years due to dental fear, a bad experience or other reasons it is vital to not judge them but to let them know that the only thing we can do is learn from the past. We only have control of the present moment and our reactions to the moment. With God’s favor they will have a positive future and we at our office want to work towards their goal of this positive future. I also tell them that it is not my position to judge them because we all have different pasts. I also provide prayer support for those who desire it. Many of our patients find comfort in this act of inviting God into their care.
In summary the solutions to the problem:
- For new dental patients who make dental appointments I like to give them a personal call the day before their first visit to not only welcome them but to start and open the relationship in a non-threatening manner.
- When one arrives to the dental office we like to give them a tour and treat them like they were visiting our own home.
- During the interview it is very helpful to discover the source of what makes one so nervous of the dentist and acknowledge it with no judgment.
- With respect and empathy move forward at the pace the patient feels comfortable doing so.
- Introduce the use of conscious sedation dentistry which allows us to treat the high fear patient without much memory of the visit. This also works well when a lot of dentistry in needed at once.
- Nitrous oxide (laughing gas) is used to take the edge of anxiety off. The benefit is that they can have treatment without requiring a driver to provide transportation.
Movie Glasses and Headphones attached to our i-Pod are used to block the noises that emanate from the dentistry. The use of music in this way provides a great distraction.
- Great techniques used to provide dental anesthesia and numbing is critical to put an end to painful shots and lack of complete numbness.
My hope for you is that your dental provider has an understanding of these principals and uses them to provide compassionate dental care. Modern dentistry should not hurt and if your fear has kept you from getting your oral health taken care of then take action now. 2011 is here and do yourself a favor and get the New Year off on the right foot by taking the first step by calling your dentist. If you do not have a happy dental home then call us at now (586)247-3500. If you prefer to email me directly with questions or concerns about your fear then my email is DrAntolak@TheGentleDentist.com.