FEAR OF THE DENTIST

							                                                        great deal to make dental
FEAR OF THE                                             treatment an acceptable, normal
                                                        part of life.
DENTIST
                                                        And nearly everyone would feel a
Q           I have been scared of the                   lot better about dentistry if they
            dentist for a while – what is it            knew for certain that they would
            like now?                                   always be treated kindly and
                                                        considerately.
A           Dental techniques have improved
            so much over the last few years,        Q   How do I choose a dentist?
            that modern dental treatment can
            now be completely painless.             A   The first fear to deal with is the
            Despite this, most people still feel        fear of admitting to other people
            a little nervous at the thought of          that you are afraid of dental
            going to the dentist.                       treatment. If you can discuss it
                                                        with your friends or colleagues
            If you have not been to see a               you are likely to find someone else
            dentist for some time, you will             who has similar problems, and
            probably find that things have              who may be able to recommend a
            improved a lot since your last visit.       dentist to you. A dentist who is
            The general attitude is likely to be        personally recommended by
            more relaxed, the dental                    another nervous person is usually
            techniques and safety procedures            a very good choice. It can also be
            will be much better, and the                a good idea to look in the Yellow
            equipment will be more up to date.          Pages for practices that mention
                                                        treatment for nervous patients.
Q           Why am I afraid of the dentist?
                                                    Q   Do some practices specialise in
A           Being ‘afraid of the dentist’ may           treating nervous patients?
            mean different things to different
            people. It will probably help if you    A   Don’t be afraid to contact several
            work out just what it is that worries       practices before you decide which
            you most.                                   one is right for you. It may be
                                                        easier for you if a friend makes
            Some people have specific fears             some preliminary phone calls.
            about actual areas of treatment –           Ask to speak to the practice
            for example, they are scared that           manager, and find out if they
            having a filling will hurt. Others          make any special arrangements
            hate the whole idea. Some                   for nervous patients. If they don’t
            people don’t like the thought of            sound right for you, don’t make an
            being out of control, and others            appointment but go on until you
            worry about being treated as                find a practice you really like the
            though they were on a production            sound of.
            line.
                                                        As someone who is nervous about
            Some people find the sounds and             dental treatment, you need to be
            smells bring back memories of               looked after by a dental practice
            bad experiences as a child.                 that will take special care of you –
            Others worry about stories they             it’s just a matter of finding the right
            have heard about other people’s             one for you. You may need to
            bad experiences.                            travel some distance, but it will be
                                                        worth the effort when you are no
            A smaller number of people are              longer afraid.
            genuinely afraid of dental
            treatment. The good news is that            Often people find their fears
            more and more dentists now                  change. After finally finding a
            understand their patients’ fears,           dentist they like, they may still
            and with a combination of                   dislike dentists in general, but they
            kindness and gentleness can do a


Courtesy of the BDHF
            have complete confidence in their            be easy sessions for checking and
            ‘own’ dentist.                               cleaning.

Q           Who can I talk to?                       Q   How do I start?

A           There are many organisations that        A   It may be helpful for you to see the
            help people suffering from                   practice before you arrange an
            phobias. Most of them also offer             appointment. Call in to speak to
            help to people nervous of the                the receptionist, and see what the
            dentist because it is a very                 atmosphere is like. Do the other
            common problem. Contact the                  people there look cheerful and
            British Dental Health Foundation’s           happy? Does it give you a feeling
            helpline ‘Word of Mouth’ on 0870             of confidence? Perhaps you could
            333 11 88 to discuss your fears              meet the dentist and have a look
            and find out about other                     around the practice as a visitor.
            organisations to contact.
                                                     Q   What will happen at the first
Q           I haven’t been to the dentist in a           appointment?
            long time – will I need a lot of
            treatment?                               A   Your first appointment should just
                                                         be for a consultation. See it as an
A           Years ago it was normal for                  opportunity for you to ‘interview’
            people to need fillings every time           the dentist, receptionist and dental
            they went to their dentist, but              nurse. Is the receptionist
            things have changed for the better           welcoming and helpful? Is the
            now. Fluoride toothpastes have               dentist interested in you? Is the
            made a large impact on tooth                 nurse kind and understanding?
            decay and you may be surprised
            at how little treatment you need.            If you like what you see and hear,
                                                         you may want to arrange another
            The aim now is for healthy mouths            appointment for a short treatment
            that stay healthy. Teeth are for             session, perhaps with the
            life and can last a lifetime if they         hygienist. Allow yourself to take
            are looked after properly. If you            things at your own speed, and
            can get your mouth into good                 don’t be pressured into anything
            shape, with the help of the dentist          you are not happy about.
            and dental hygienist, you should
            need less treatment and there will       Q   What type of treatment should I
            be less for the dentist to do in the         choose?
            future.
                                                     A   Most dentists today offer some
            Using a fluoride toothpaste will             form of treatment for nervous
            help to strengthen your teeth and            patients, whether they work in the
            prevent decay. Look for products             National Health Service or
            carrying the British Dental Health           privately. The NHS covers most
            Foundation logo on the packet.               treatments necessary to treat
            These products have been                     nervous patients. The main
            clinically and scientifically tested,        advantage of private practice is
            and a panel of dental experts have           that more time can be spent with
            decided whether the packaging                you to help you feel relaxed.
            claims are correct before awarding
            their accreditation badge.               Q   Should I tell the dental team
                                                         that I am nervous?
            It is important to keep up your
            regular visits to the dentist, not
            only to monitor tooth decay, but         A   Make sure that the practice knows
            also to help prevent gum disease.            you are nervous, so that they can
            Once your mouth is healthy, your             help you.
            visits to the practice will often just



Courtesy of the BDHF
            Tell the receptionist when you first    Q   I have gone for a check-up,
            make the appointment so that she            what do I do next?
            can make a note on your records.
            Tell your dentist what it is that you   A   Take things one step at a time.
            particularly dislike about dental           Discuss any proposed treatment
            treatment. If you think you know            with your dentist, and decide what
            the reason, tell your dentist what          you feel you can cope with. This
            may have caused your fear. Was              may be no more than an
            it a bad experience as a child? A           examination with a dental mirror
            recent dental experience? Or is it          first. If you succeed with that, you
            a more general feeling of worry             may feel you could have your
            and fear?                                   teeth polished next, probably by
                                                        the dental hygienist. Don’t be
Q           I am afraid of injections – what            afraid to say when you have had
            can I do?                                   enough - there is usually no
                                                        reason to hurry through the dental
A           Many people are scared of the               treatment.
            local anaesthetic injection needed
            to numb the tooth. Again, be sure       Q   Can I take anything with me?
            to tell the dentist that this is
            something that bothers you.             A   Listening to music is a good way
            There are anaesthetic gels that             to help you relax. Some practices
            can be applied to the area of the           have it playing in the treatment
            gum to be injected. This gel                rooms, but the best way is to take
            numbs the gum so that you cannot            a personal stereo so that you can
            feel the needle.                            have your own choice of music. In
                                                        this way you can concentrate on
Q           What is the best time of day to             your music – or anything else you
            visit the dentist?                          like to listen to – and will not hear
                                                        the sounds of the treatment. You
A           Book appointments at a time of              will be able to distance yourself
            day when you feel at your best,             from the dental treatment as the
            and when you do not have any                sounds in your ears take all your
            other commitments to worry                  attention.
            about. Allow plenty of time so that
            you can get to the practice in a        Q   What else can I do to help me
            relaxed frame of mind – arriving in         relax during treatment?
            a rush will only make you feel
            more nervous.                           A   Thinking hard about something
                                                        other than the treatment is a good
Q           Should I eat before going to the            distraction. Try to solve a puzzle
            dentist?                                    in your mind, or perhaps work out
                                                        a plan for each day of next year’s
A           It is usually best to have                  holiday. Or give yourself
            something to eat before you go,             something tricky to do - try to
            so there is no chance of you                wiggle each toe in turn, without
            feeling faint while you are in the          moving any of the others.
            chair. If you are going to have a
            treatment, where you cannot eat         Q   How can the dental team help
            beforehand, the dentist or nurse            me?
            will give you full instructions.
                                                    A   Your dentist should be happy to
Q           Can I take a friend with me?                both talk to you and listen to you.
                                                        Just talking about your fears can
A           People often feel better if a friend        help lessen them. He or she
            comes with them to the practice.            should tell you what treatment you
            Think about what would suit you             need, why you need it and what
            best. A reassuring and capable              the fee will be.
            friend is often a great help.


Courtesy of the BDHF
Q           Can I ask the dentist to stop if I        teachers or at home and can be
            need to?                                  very useful in controlling anxiety.

A           Agree with your dentist a sign that       Many practices offer several types
            means ‘stop now - I need a break’         of sedation, including inhalation
            before the treatment is started.          (‘gas and air’) and intravenous (by
            Usually you can just raise your           injection).
            hand, and the treatment can be
            stopped for a few minutes until           Other practices offer hypnosis and
            you are ready to start again. Once        relaxation techniques. You would
            you know that you can control the         learn these techniques, which
            situation you will feel more              would allow you to gain control
            confident.                                over your feelings of distress or
                                                      fear.
Q           How can I feel more
            comfortable about treatment?              Counselling is another way of
                                                      dealing with feelings of anxiety.
                                                      This is usually carried out by a
A           Is there some way that the dentist
                                                      member of the practice team, in a
            or assistant could help you during        room away from the surgery. You
            the treatment? Would you like             would be encouraged to discuss
            them to talk to you, have
                                                      your fears so that they may be
            background music playing, or              dealt with and overcome.
            describe exactly what they are
            doing while they are working? Let
                                                      The British Dental Health
            them know what would help to              Foundation has a telephone
            distract you.                             helpline ‘Word of Mouth’ which
                                                      you can call Monday to Friday,
Q           How can I reduce the amount of            9am to 5pm on 0870 333 11 88.
            treatment needed?
                                                  Q   What about sedation?
A           Your dentist and hygienist can
            work with you and tell you what to    A   Patients who feel they need some
            do to keep your mouth healthy.            extra help can be given a sedative
            The healthier your mouth is, the          medication, often called
            less treatment you will need in the       intravenous sedation or IV. This
            future.
                                                      makes them feel sleepy and very
                                                      relaxed. Treatment with this type
            You will probably be given advice         of sedation often works well,
            about ways your diet can
                                                      particularly for long treatment
            safeguard your teeth and gums,            sessions, as you are very relaxed
            and the best way of brushing and          but still awake.
            flossing. Looking after your teeth
            at home can be the most
                                                  Q   Will I still know what is
            important part of all.
                                                      happening?
Q           What other techniques are
            available to help?                    A   Your dentist can still talk to you,
                                                      but time passes more quickly and
                                                      you are usually unaware of the
A           Let the practice manager or the
                                                      treatment being carried out.
            dentist tell you about the                Because the sedative takes some
            relaxation or sedation techniques         hours to completely wear off, you
            that the practice may offer. There
                                                      must have someone to help you
            are various methods available,            get home and to keep a careful
            and it will depend which methods          eye on you for some time
            the practice is experienced with          afterwards.
            and which you feel would help you
            most. Relaxation techniques can
                                                  Q   Can I have Gas and Air?
            often be learned from specialist



Courtesy of the BDHF
A           Gas and Air or ‘Relative
            Analgesia’ is a mixture of 25%
            nitrous oxide, 25% oxygen, and
            50% air. You breathe it through a
            nosepiece and it is easily
            controlled by the dentist. You stay
            awake, but are unconcerned
            about the treatment or the
            surroundings. Recovery time is
            quick. The mixture leaves the
            body after just one or two deep
            breaths of oxygen.

Q           Can I go to sleep for treatment?

A           General anaesthetics are now not
            generally available for routine
            treatment. When a general
            anaesthetic is needed, patients
            are referred to hospitals or
            specialist clinics where the
            necessary safety equipment is
            available.

Q           Will things get better with time?

A           As you get to know and trust your
            dentist, hygienist and other
            members of the practice you will
            find your fears begin to lessen. In
            time you will gain control over your
            fears, and dental care can
            become a normal part of your life.

Q           What will it cost me?

A           The charge will be the same as for
            normal treatment, but if you are
            having sedation there will be an
            extra charge. It is always
            recommended that you get a
            written estimate before starting
            treatment.




Courtesy of the BDHF