Overcoming Dental Fear & Anxiety
Comfortable Dentistry in the 21st Century
(Continued)
Patient Profile
Jane is 33 years old. She hasn't had any dental treatment in 10 years. She is worried that she has dental problems and should have them taken care of. She has even made some dental appointments in the past decade. She cancelled or just didn't show up to most of them. Twice she did go and have an examination, but didn't go back to have any treatment performed. She changes the channel on the TV if a show has any dental treatment in it and she won't go to movies that show anything about dentistry. Her smile embarrasses her and has led to poor self-esteem. Jane feels bad about herself. She wants to change both the way she feels and reacts to dental treatment but she doesn't know how.
If you are very fearful, how do you have a “good experience” with dental care?
- Tell your dentist you are afraid, even when setting up an appointment and make sure the dentist is prepared to listen. If you can't talk about it you can't get over it.
I am very careful to listen to what Jane says and try to understand her “story.” I ask Jane to tell me about her fear of dental treatment. “I'm glad you asked” she says. “I always felt that dentists didn't really want to know.”
- The dentist must listen carefully to you in an accepting and non-judgmental way.
I avoid telling Jane that things will be different, that there is nothing to worry about, or that there is anything wrong with her being afraid. I also avoid any explanations about dental disease or dental procedures until I'm sure that Jane knows that I understand her fear and am committed to working with her to help her overcome it. I know that the best way for me to convey that I care is to listen, not to provide explanations. Jane should feel confident that she is not being judged.
Of course, some people are better at this than others. If you are afraid, find a dentist who listens to you and who cares about working with you to get over your fear. Some dentists have made themselves quite expert in this area. If you start your work with a psychologist, make a transition from working with the psychologist to working with a dentist who understands and can follow the principles involved in reducing dental fear.
- When working to reduce fear, only do things that you can do with mild or no anxiety.
I reassure Jane that she is in control of the situation at all times. I need Jane to tell me exactly what she is afraid of since it's different for everyone. It's critical that I understand what brings on her particular fear reactions. We will start by having Jane try to do those things that she feels she can do fairly easily. The idea is for her to have the goal of being able to leave each visit saying “that was OK; I could certainly do that again if I needed to.”
- Set up an agreement so you can take whatever time you need to get over your fear and not be rushed to do things you are not ready to do.
Let's stop to emphasize the last point, since this can be a significant shift in expectations. In order to help someone get over their fear of dental procedures, the goal for each visit is for you to have a good experience rather than getting a particular procedure finished. Remember, if you push yourself to do something you are really afraid of, you will remember how unpleasant your fear is and reinforce the fear rather than diminish it.
- If you are afraid, work with your dentist and make a specific plan to reduce your fear. Don't just concentrate on “fixing your teeth!”
It's critical that both the dentist and patient agree that becoming comfortable with dental procedures is something that they are going to work on. Understand that you and your dentist must consider your internal anxiety feelings by working at a pace where you will be more comfortable and trusting. Set up an agreement with your dentist to talk about the time and fees associated with treatment so you can comfortably overcome your fear and not be rushed to do things you are not ready to do. This may result in a procedure taking a little longer than usual to complete or spreading out appointments over the course of time.
Imagine a relationship with your dentist where you feel you have the time you need to go at your own pace, the listening relationship that you need to feel safe, and the sense of control you need to reduce any automatic anxiety responses. It might take some faith in the beginning to realize that this is possible, but you really do have the opportunity to have a “Lifetime of Dental Health.”
