Approximately 80 percent of North Americans are afraid of the dentist. This isn’t surprising considering that procedures rely on needles and burs, and produce sounds and smells that we usually associate with a bad experience during our childhood.
Fear of the dentist usually divides into one of the following categories:
1. Fear of pain; 2. Fear of needles and burs; 3. Fear of sounds and smells (dental surroundings); 4. Fear of the unknown; 5. Embarrassment or guilt; and 6. True phobia to anything regarding dentistry.
A well-prepared dental professional who is committed and sensitive enough for patients’ needs can usually address each of the concerns.
Having been a professor for many years, I can see how each new generation is more eager than the last to reduce and eventually eliminate dental fear. The dental industry finally understands this, and today we are blessed with different technologies to allay those fears. Â
Fear of the pain: With today’s technology and anesthetic agents, about 99 percent of procedures involve little or no pain. Only in very rare situations would a dentist be unable to numb a patient. The use of topical anesthesia before a needle is inserted prevents patients from actually feeling the needle.
Fear of needles: Computerized local anesthesia is now available. We use a computerized micro-motor with a much smaller and less threatening needle to numb our patients. A much more comfortable procedure uses a computer to induce the rate at which anesthesia is programmed.
Pain is usually felt as tissue expands. While the volume of the anesthetic agent is being injected, the machine prevents more volume from being applied at the same time, so that pain is not felt while being injected. A few steady-handed and well-trained professionals can also achieve this without a computer.
Fear of drills and burs: New techniques such as air abrasion help avoid the use of a dental drill. Air abrasion uses very tiny aluminum oxide particles with pressurized air to remove decay and plaque. A white composite filling can then be placed without the need for anesthesia or a drill. Air abrasion can usually only be used on new cavities, and has limitations, such as the inability to remove older silver fillings.
Laser dentistry is also an option, although these techniques are still limited and usually much more expensive.
Distraction therapy can help a patient address fear of sounds, smells and dental instruments. Patients can wear virtual reality LCD glasses and watch movies and TV shows while a dentist works. This is a good tactic because it helps distract the patient.
LCD glasses function as if there were a movie screen in front of a patient’s eyes. Noise-cancelling headphones are also available for audio therapy, which allows patients to control the volume of music and therefore block external sounds.
Electric blankets and massagers can also help a patient feel comfortable by creating an atmosphere that resembles a spa.
Nitrous Oxide sedation is helpful in achieving conscious sedation. A patient will feel sleepy and relaxed, but still remain conscious.
Traditionally, the most common smell in a dentist’s office was clove oil, a product that was widely used. Today, however, dentists use different materials that do not produce a bad smell. Dentists also incorporate aromatherapy, such as lavender, which produces a nice, clean smell and is proven to soothe and calm nerves.
Fear of the unknown: Communication with your dentist is essential. A committed professional with technological tools, such as digital X-rays, 3D imaging and computerized 3D, will explain the procedures and processes that the patient is about to endure. It has been proven that the more the patient is explained about the process the more comfortable the treatment will be.
Embarrassment or guilt: Lots of people avoid their dentist because of fear they are going to be scolded for one or another reason. This is why empathy and communication is so important with your dental professional. Something else to remember is that no matter how bad your mouth may become, a dentist has probably seen worse. Today’s technologies and techniques can even help correct rare defects and diseases. So don’t let guilt get in the way of a healthy smile.
True phobia of dental treatment: These are the hardest cases to address. Psychological professional therapy may be needed. Options such as complete general anesthesia are available, though not always advisable. Desensitization therapy and conscious sedation (nitrous oxide) are preferable approaches.
Every day more options exist that facilitate a comfortable dentist visit. Do your research and find the dental professional that best fits your needs.
Dr. Federico Rubinstein is a lecturer on cosmetic dentistry and phobic patient treatment. He is a member of the American Dental Association, a fellow of cosmetic dentistry at the University of Costa Rica and a graduate in aesthetic dentistry at the University of Minnesota, in the United States.
