Dental phobia is a severe fear of the dentist that over time causes loss of teeth because of the patients inability to go to the dentist and receive regular care. The heart of the matter is that dental phobia can rob patients of their self esteem as they become embarrassed about the appearance of their teeth and withdraw from friends, coworkers and loved ones.

Why do people hate and fear the dentist so? Fear of the dentist is most commonly something that patients learn from traumatic personal dental experiences. If these experiences occur as a child and are accompanied by a real sense of panic, the resulting reaction to the dentist may become deep seated, visceral and life long. Such patients just don't feel safe in the dental chair. Patients recall of their traumatic childhood experiences often includes being held down against their will, being yelled at, pain and terror.

A recent article in the Journal of the American Medical Association showed that people who suffer abuse as children, may have life long alterations in their response to stress. If a patient suffers from post traumatic stress disorder, the dental office may be just one of many situations where such patients feel unsafe.

Other patients may simply have difficulty getting numb after the dentist gives them an injection. If the patient is extremely anxious the patient may be sensitive to the slightest sensation because of the emotional component of their pain. Many patients may not be particularly anxious but still may feel pain during dental care because of anatomical reasons, the presence of infection or hypersensitivity of the tooth. Newly developed injection techniques may help in these situations.

What can be done to help people who avoid the dentist because of fear of pain or embarrassment?

If you have a severe fear of the dentist, the most important thing is to recognize that there are people ready to help you. Take the time to find the right person. Take the time to communicate your feelings and concerns to your dentist. Make sure the treatment plan that you and your dentist have chosen reflects your cosmetic and long term oral health goals. Choose a quality office that is dedicated to a high level of care and patient satisfaction. Make sure the dentist you've chosen has the tools to care for you comfortably and has the patience and experience to guide you through the complete treatment plan. Consider relaxation and distraction techniques available by the dentist such as deep (diaphragmatic) breathing, or headphones. Oral medications such as a Valium, or something similar, can be used to help you relax and feel more comfortable during long procedures. Intravenous sedation or even general anesthesia may be best for very anxious patients who won't have dental procedures any other way. Patients who have a very sensitive gag reflex, or have a lot of trouble getting numb with dental injections can also benefit from intravenous sedation. Nitrous oxide (sweet air, laughing gas) also provides pain relief and distraction. Nitrous oxide does not relieve anxiety as well as Valium and its related medicines when taken orally or intravenously. All medications should be administered by dentists who are well trained and experienced for the best and safest experience. Most importantly, it is possible for you to have your dental care in comfort.

This article is © Louis Siegelman, D.D.S. - New York City. N.Y.

For more information visit Louis Siegelman's website at: DentalPhobia.com

as of August 17, 2001

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