Coping with Dental Anxiety
You are not alone
Does the word “dentist” make you shiver? Have you felt butterflies in your stomach before dental treatments? If so, you’re not alone. A survey conducted in Israel revealed that almost 50% of the population suffer from dental anxiety while one in every five even suffer from severe anxiety, called dental phobia.
Sometimes, the fear is of something specific, such as the noise of the drill or the anesthetic injection, while sometimes the fear manifests as a general feeling of powerlessness in the treatment chair. The range of responses is broad, from physical reactions before the treatment (shaking, stomach ache, accelerated pulse, dryness of the mouth) to completely avoiding the treatment itself. Why are we afraid? Sometimes the reason is a single personal experience in the past which involved an unpleasant experience such as pain, the dentist’s attitude or treatment against our will (primarily in children), and sometimes the fear is caused by other people’s experiences which they have described to us.
To all of these factors, we must add the patient’s individual personality, the attitudes of the dentists and the feeling of powerlessness when lying in the treatment chair while the dentist is busy in our mouths. To our joy, modern dentistry offers us a number of solutions which can ease the experience and even serve as a remedial experience.
Here are a few useful tips and methods:
1. The best advice is:
Look for a gentle, considerate dentist who will be conscious of your distress.
Ask friends and acquaintances about the courteousness of the dentist and staff. Visit the clinic before your teeth hurt for a calm visit which will enable you to better examine the suitability of the clinic for you. Ask questions, take a look at the equipment – remember that familiar things are less threatening.
2. Local anesthetic using a WAND
One of the most threatening fears is the fear of the injection. Using the WAND, local anesthetics can be administered at the dental clinic almost without pain at all. The advantage of the WAND is that the rate of injection is very slow, so the numbing process is less painful. In addition, the end of the tool is narrow and delicate in comparison to a regular syringe. Usually, when treating teeth in the lower jaw, it is customary to numb a large area which includes the lower lip and tongue. The “magic wand” allows us to numb only the tooth being treated, thus preventing those unpleasant feelings.
3. Laughing Gas
This is a mixture of nitrous oxide and oxygen which is administered using a small mask to the nose of the patient throughout the entire treatment. The dentist controls the relationship between the two gases – as the concentration of laughing gas in the body increases, calmness, relaxation, euphoria and even analgesic effects spread throughout the body. The gas is received by inhalation and it begins to take effect quickly and can be stopped quickly. The gas is recommended for all types of patients, especially for people with high blood pressure or cardiac diseases. The gas has no side effects and does not cause damage to the environment. It is used in delivery rooms and intensive care ambulances. It is important to remember that when using laughing gas, the patient is completely conscious and therefore in total control, but he is calm and at ease. The patient should avoid eating for three hours before receiving treatment with laughing gas, since it may induce a slight feeling of nausea, which soon passes. Treatment with laughing gas is not recommended for pregnant women and people suffering from Obstructive Pulmonary Disease.
Unlike general anesthesia, under which the patient does not react and is completely disconnected from what is taking place around him, sedation dazes the senses and blurs perception of what is taking place, and can be given on different levels, up to general anesthesia. Deep sedation is a preliminary stage to general anesthesia during the process of which the patient is asleep, but can be woken up with the appropriate stimulus. When administering sedation in the framework of dentistry, very high proficiency is required and the cardiac and respiratory systems must be carefully monitored. This type of treatment can only be administered by a trained anesthesiologist accompanying the dentist performing the required dental treatments. Some dentist have undergone training and are licensed to administer sedation, but in order to ensure successful treatment in case of emergency, two doctors and a nurse or assistant must be present as well.
A patient interested in undergoing dental treatment under general anesthesia or sedation will be directed to the anesthesiologist for a comprehensive investigation of his health and the medical risks, since the doctor is responsible for the functioning of the bodily systems during the surgery and until the person regains consciousness.
Under sedation, the patient lies calm and relaxed and enables the dentist to perform the treatment without any disturbances. The patient’s finger is constantly connected to an oxygen saturation monitor which checks the level of oxygen in the body, as well as measures pulse.
5. General Anesthesia
Some patients can only undergo dental treatments under general anesthesia administered intravenously using medication. The period following general anesthesia is painless, and the person recuperates within a few hours. The anesthetic gases are absorbed by the body lipids and in the bloodstream, and therefore the pain is lessened in comparison to the same procedure when performed not under general anesthesia.
One of the disadvantages of general anesthesia is that when an aesthetic rehabilitation treatment is performed, the patient cannot cooperate. In aesthetic treatments it is easier for the doctor to reach the desired results when the patients is cooperating by opening, closing and moving the jaw and soft tissues surrounding them, and of course by making expressions. Under general anesthesia, the person is passive, the soft tissue fall, and the natural movements of the jaw and soft tissues cannot really be controlled.
To conclude – a few helpful tips:
Describe your fears about the treatment to your dentist; the patient has the right to know and understand the treatment he is about to undergo. If you have a question about a certain procedure, don’t be ashamed to ask! Exhibit involvement in the treatment and take part in making the decisions. Strengthen yourself with the knowledge, and this will lessen your anxiety about the unknown. If the sound of the tools bothers you, bring your favorite music. Utilize relaxation methods like yoga and correct breathing. Remember that the best way is preventative medicine – visit the dentist frequently, and don’t wait for the tooth pain and the situation to deteriorate. It’s easier to be checked and find out that there’s no problem, or to treat a small problem before it becomes a large, complicated one. Finally, a word of advice about the young generation – try not to transmit your fear to them, try to bring them to the dental clinic before the problems begin so that the experience of coming to the dentist will be more pleasant. Don’t use phrases like “don’t be afraid,” “it doesn’t hurt,” “it’s just an injection”; who knows, maybe through them, you’ll have a remedial experience too!