If you hate going to the dentist because you are terrified, this column is written specifically for you.
Most people avoid going to the dentist because it’s a hassle, time-consuming, costs money and teeth are not a high priority. High-fear patients are in a completely different category; they break out into a cold sweat just thinking about anything that has to do with a dentist. Picking up the phone to make an appointment is close to impossible. Their fear is real, and they cannot just wish it away no matter what friends or family tell them. “Just suck it up, be like me, do it and get it over with” just doesn’t work, ever.
A big percentage of high-fear patients have had a horrible dental experience in the past and are terrified it will happen again. The most common bad experience is having pain while being worked on. When the patient tells the dentist that they can feel what he or she is doing, the dentist says that’s not possible because they are numb and, unfortunately, keep on working. Not only is this extremely painful and scary it creates panic with a feeling of not being in control, not being believed and not being respected.
Dentists who are guilty of not listening to their patients have not learned that people are attached to the teeth. Unless they learn this fact, they will not last long in the profession unless they work in some kind of free clinic where the patient doesn’t have a choice. The military is an example; as some of you vets know.
To work with the high-fear patient, dentistry has three different techniques to help patient reach a relaxed state: nitrous oxide (laughing gas), oral sedation and IV sedation. All three are heavily regulated by the state as they should be. No matter the technique used, all dentists who are experienced with the high-fear patient know that the most important goal is to start with a trusting relationship.
I have been successfully doing sedation dentistry for more than 20 years, and here is what I have found to work best not only for me but other dentists as well. We start with a face-to-face meeting to just talk. I want to hear your story. I want you to trust that I will treat you with respect and understanding. Most of all, I want you to know that you are in control at all times. At this beginning stage, the person is much more important than the needed dental work.
This interview takes time. Once the anxiety is addressed and the person starts to feel comfortable, the sedation protocol is explained. Even though sedation is controlled by the state, every dentist has different protocols for consultations. Mine start with an X-ray of the upper and lower jaw for education purposes. This particular X-ray is call a pantograph and is taken outside the mouth. This allows an overview of your dental status without anyone poking things in your mouth. It is not fully diagnostic, but it allows dialogue with zero invasive procedures that may create anxiety.
The goal of oral sedation is for the patient to be in a sedated state throughout the procedure, even if it is a few hours long. Most high-fear patients want to get as much done as possible in the fewest appointments possible. The bonus of sedation dentistry is the product used is not only a sleeping pill, it is a hypnotic, which means the odds are very high the patient will remember little to none of the appointment. Yes, a great dental experience to boot.
Since the first appointment is to just talk, is there any reason not to pick up the phone and call a qualified sedation dentist before pain forces you to?