Dentist is Scary. How to get over it?

February 21, 2010 3:08 PM

How can I drag myself back to the dentist when I'm scared of him?

A bit of background: I'm 30, male, in Canada. I'm addicted to sugar and I believe every one of my molars had a filling by the time I was in my early 20s. I didn't take care of my teeth when I was a kid, and I'm paying the price now.

I've got a phobia about body-manipulation. I find massages uncomfortable, needles make me go pale in the face, and I can't visualize accupuncture without getting a little queasy.

The Dentist is about the worst experience I can have. Oh, let me count the ways!

- The dentist/assistants usually have bad breath
- The whine of a drill makes me wince
- The sound and vibration of a drill touching my teeth... well, let's say I'm getting clammy and lightheaded typing this sentence
- They use needles, which are bad enough on their own...
- ... And they don't even kill the pain my teeth feel. Which just results in more needles, or them giving up and drilling anyway.
- They leave me in the chair for ages, all alone without even a ceiling painting to look at
- They chide me relentlessly for my childhood's poor-care.

And, of course, there's just the general feeling of dread and paranoia (Dentists get paid for doing tooth-work, not for preventing future tooth-work).

Last time I went, I had an old filling replaced and it was a very traumatic experience. At the end of it, the dentist non-chalantly mentioned "you might have to come back in next week and get a root canal. I'm not sure if that filling will hold."

The logical part of my brain says "root canals aren't so bad," but to a scared denti-phobist like me, that was about the worst thing you could say. If any mass-media production (cartoons, movies) wanted to conjur up feelings of pain and anxiety, root canals are usually the dental method of choice, and I consumed that media heartily. I haven't been to the dentist since, and that was 4 years ago. The tooth had a bit of an odd feeling to it for about 8 months but it faded and everything feels normal now.

As I get older, I take care of my teeth better and better; but that experience really urged me to kick it up a few more notches. I just got a new medical plan that will make my dentist visits free, but I can't bring myself to visit. It's simply too scary. I'm afraid of what they might do and I know the experience will be incredibly unpleasant.

Current state: My teeth are fine and feel perfectly healthy. I have no urge to visit the dentist until I feel pain, but I know leaving your car until the oil light comes on is a very bad idea.

For the sake of my remaining healthy teeth, how can I motivate myself to get back in the chair?

posted by weasel to health & fitness (20 answers total)

Some dentists specialize in dental anxiety, so I'd start by looking for such a dentist. Also, dental technology has improved in recent years; for instance, my dentist uses some sort of ultrasonic equipment for cleaning/polishing instead of the old rubber-tipped polisher. I barely feel it.
posted by devinemissk at 3:13 PM on February 21, 2010

Probably a good place to start is with finding the right dentist for you. Some (many?) dentists are terrible people, and given the nature of the work, those few seem to give the whole 'going to the dentist' experience a far worse set of cultural baggage than is really necessary. So ask around with friends, and see if you can find a dentist you can trust to treat you well. The city I live in has a wiki with reviews of every dentist in town; it's how I found mine and I've sent about four people to him since then, including one friend who was terrified of dental work. She ended up being allowed to wear an ipod to the filling session to make things go more smoothly. That struck me as a nice gesture, and a way to really say that they cared about how she felt.
posted by kaibutsu at 3:17 PM on February 21, 2010

There are dentists who specialize in anxious patients. There are dentists with a chairside manner that you'll find more tolerable. There are hygienists who pay careful attention to their breath. I promise.

You need to shop for a practice that will be understanding about your anxiety. Get recommendations from your co-workers. Before you make an appointment, drop by the practice and check it out. You'll probably have better luck with small practices than larger ones. Dental anxiety isn't uncommon. I know my dentist would be happy to take two minutes to meet someone and allay their fears. Yeah, sure, this is going to be a little tough for you, because you're going to have to think about the dentist more. But you'll be rewarded with the possibility of getting dental care that doesn't tie you up in knots.
posted by desuetude at 3:18 PM on February 21, 2010

It's definitely important for you to find a dentist you are comfortable with. Chiding you about things you have no current control over is bullshit, and I'd find a new dentist after that.

In addition to finding one that specializes in anxious patients, see about getting laughing gas (might charge you extra) or talking to your GP about getting an anxiety Rx to take to get through dental work.
posted by tastybrains at 3:23 PM on February 21, 2010

New dentist

Gas

If all else fails get someone bossy to drive you to the appointment and back (when you're still a little loopy) to make sure you don't chicken out
posted by internet fraud detective squad, station number 9 at 3:27 PM on February 21, 2010

I had a friend, years ago, who was terrified of dentists, but who needed serious amounts of work done. His dentist's solution was to check him into the hospital and perform what was qualified as ' surgery" - he was anesthetised , so the procedures didn't spark the fear, and the change to a "medical" problerm, instead of dental meant his insurance covered more of the cost. this work-around may be outdated, but you could run it by your dentist to see if that'an option.s
posted by path at 3:37 PM on February 21, 2010

Certainly look into dentists who specialize in treatment of anxious patients (or sedation dentistry), ask your friends a co-workers for recommendations and and google reviews of their recommended dentists. All dentists are not equal. I waited far too long (years) to change dentists after I became aware that my dentist was a bit of a jerk. I've got a swell dentist now.

You may want to bring an mp3 player to appointments in the future. It cuts out unpleasant dental noise during procedures and is a welcome alternative to tired waiting room magazines.
posted by Morrigan at 3:37 PM on February 21, 2010

It sounds like you're very sensitive to sensory impressions, which can make all of that stuff tough to handle. You need a dentist who is trained in handling dental phobias-- they can work with you to make it easier. I would recommend going to a private practice and not a dental school's clinic, as student appointments tend to run longer and involve more people looking at you. (Also, the UBC dental clinic doesn't appear to do phobia work based on their website.)

You should discuss your resistance to local anesthetics with your new dentist, too. This sounds odd, but are you a redhead? Redheads resist dental anesthesia and have lower pain tolerance, which makes them more fearful of dental procedures. This is now Science!, and your dentist should be able to help you with it.

I like headphones and sunglasses for my dental work. I turn up the tunes and the sunglasses handle the annoyingly bright lights. My dentist provides a bite block so my jaw doesn't get sore holding open. Perhaps some of these measures can help you too.

If all else fails, they *can* just knock you out or mostly out and do the work that way-- it's called "sedation dentistry." I used to go to a dental hospital for my work, and they were sedating folks a few rooms over to help them out.
posted by fairytale of los angeles at 3:46 PM on February 21, 2010 [3 favorites]

nthing: Find a dentist who specializes in care for anxious patients and will be liberal with nitrous even for basic procedures like cleaning. they are out there. I hate having my teeth worked on (not as much as you do) and I love the dentist I have now, she makes the experience as minimally unpleasant as can be. there are good ones out there!
posted by supermedusa at 3:50 PM on February 21, 2010

I also used to be afraid of the dentist, not as severely as you but I wouldn't go or I would cancel my appointments. If I did make it there I would be crying in the waiting room. I'm not like that anymore but my body is rigid with tension while in the chair.

I went through many dentists before I found someone awesome. He is understanding that I have had bad experiences and that I am scared of the pain (wasn't fully frozen for my root canal) and he makes sure he over does the freezing so that I am more at ease. The needle for the freezing is barely noticeable, he used to practice on himself and learned some excellent techniques. He also always warns me about noises, or anything that will be out of the ordinary so I am always prepared. For me, all this has helped immensely.

So, you really do have to find the right dentist for you and it may take a few tries. It's probably better to check out dentists when your mouth is healthy and are just going for an easy cleaning rather than waiting for it to be an emergency and being stuck with someone you don't know.

If you are interested in trying someone in Vancouver email me and I can give you my dentists information.
posted by sadtomato at 3:51 PM on February 21, 2010

Getting those biannual checkups is vital to keeping dentally healthy as well as catching anything that can rapidly deteriorate. Your teeth may feel fine but you just don't know unless a dentist is taking a look and cleaning off the plaque that builds up regardless of all the brushing and flossing we may do.

I'm seconding and thirding finding the right dentist. I was also terrified of the dentist and still to this day experience anxiety when going to the dentist. Luckily I found a dental practice with some really great dentists and hygienists. They are really gentle caring people. Unfortunately by that point my dental health had deteriorated somewhat and I had to go through some procedures to regain some of my dental health and retain my teeth. Ask people for recommendations and you yourself might have to shop around a bit to find a dentist you can (tolerate) appreciate.

One note, you mention that one of the things that bothers you is that "They chide me relentlessly for my childhood's poor-care." Chiding relentlessly is never a good thing but at the same time if the dentist doesn't give you a stern talking to at least when you first meet, I would be worried. The dentist is supposed to care about our teeth and that means putting the fear of god (or tooth decay) in us. My dentist gave me this stern talking to when I first started going there but it's gotten much more positive since I've really begun to care for my teeth and keeping my visits. I would hope that this would be the case for any caring dentist. Who wants to be criticized all the time?
Good luck.
posted by crios at 3:53 PM on February 21, 2010

Talk to your general physician about your terrible anxiety. and the fact that you're avoiding the dentist because of it. A lot of people who freak out in certain situations (like on an airplane) take a sedative just on those occasions. I agree with the suggestions above, and it could also be that your heightened anxiety is causing the disturbing thoughts, and not the other way around.
posted by wryly at 3:56 PM on February 21, 2010

One more thing, if you are taking care of your teeth now, (brushing and flossing regularly) the visits are much less scary because there won't be anything wrong with your teeth. If you can work your way up to having your cleaning twice a year you will rarely have any problems. And there are dentists and hygenists out there who won't chide you... I always got that too and I hate it.
posted by sadtomato at 3:58 PM on February 21, 2010

Little things that might help you get through the visit (other than seeing a dentist who specializes in anxiety OR often a family practice dentist--compared to the little kids, you're a joy):

1) Take ibuprofen or another anti-inflammatory, assuming it is not unhealthy for you, an hour before the appointment.

2) Bring an iPod or other music player and listen to it while stuff is going on. It helps with the noise.

3) This sounds so stupid but...bring sunglasses. It helps with the glare.

4) Bring something fun to read while you wait.

I have a very small mouth and the worst gag reflex ever, plus a fear of needles and some bad experiences. And the Novacaine doesn't really work and I have an irrational fear of laughing gas.

These things help me, though YMMV. I have also found that if I talk to the dentist before hand and explain that I have a bad gag reflex and can't deal with the water thingee and am anxious that the good ones will work with me. They may think I'm amusing, but they'll work with me.
posted by eleanna at 4:12 PM on February 21, 2010

Definitely find a new dentist, one with whom you are comfortable sharing your fears and who is willing to help you work through them. I guarantee that most, if not all, of the $20,000 I've had to spend in the last 3 years for extensive and horrible dental surgery, could have been avoided by routine and timely dental care: do not fuck around with your dental health.
posted by elizardbits at 4:14 PM on February 21, 2010 [1 favorite]

Dentists get paid for doing tooth-work, not for preventing future tooth-work
There are dentists that do actually care about prevention a lot. See WCMID.
posted by davar at 4:45 PM on February 21, 2010

I recently started having dental anxiety. I'm 31 and it only took one bad experience to take me over the edge.

But, since then I have had very tolerable, even pleasant dental experiences, both cleanings and fillings.

I notice that you have a somewhat paranoid and, frankly, bad attitude about dentists. Dentists and hygienists aren't out to get you (or me, for that matter). I am not sure if just encouraging you to change your attitude would help (such as a reality check), or whether this is an issue for you and a counselor to deal with. The truth is, there are good dentists and there are bad dentists, just as there are good mechanics and bad mechanics, good chefs and bad chefs. Dentists apply their skill, education, expertise and passion for healthy teeth and tissue to each person with different results. Those results are both in our control (brushing, flossing, etc) and outside of our control (genetics). It's up to you to do your best at taking care of your teeth and mouth--your dentist will do his/her best, in turn. If you don't like your dentist--change practices. Call a dentist up ahead of time and have a chat with the receptionist to find out about the dentist. Ask your friends who they see. In short, be comfortable with who you see, but also make an effort to meet the dentist halfway and don't discount him or her before the fact.

Another thing that has helped me is anti-anxiety medication. I take an Ativan about 30 minutes prior to my procedure, with my dentist's consent. I also use the laughing gas. Not only does this relax me, but the gas helps the anesthetic work better in my body. And it's not an unpleasant feeling, either. Your dentist and/or PCP can prescribe Ativan or Xanax in a low dose to be taken prior to dental work or cleanings.

Taking ibuprofen beforehand, again with the dentist's consent, is another good suggestion, as this will head off inflammation. Check with your dentist about the dose you'll need.

If the anesthetic makes your heart race, check to see if you can get it without the epinepherine. That is what gives you the out-of-control feelings. Once I started getting the anesthetic without epi, it made a world of difference.

You mentioned a lot of reasons that are seemingly out of your control, such as "they leave me" and "they chide me." The best thing for this is preparation. If you're worried about getting bored, bring something to read or otherwise entertain yourself (cell phone, video game, iPod, etc). I've not yet been to a dentist office that isn't full of magazines, and many of them now have TVs in each exam room. If you're worried about them scolding you for bad dental hygiene, all you have to say is "Well, I realize that I didn't take the best care of my teeth earlier in life, but I'm here now and I want to fix things. Do you have any suggestions?" The key is, anticipate what will happen, rehearse it in your mind and have a plan in place. This type of preparation never fails to make me feel more at ease in any situation, be it job interview, tax audit or any other root canal-like process!

I really hope this advice helps you. There are many good responses to your question. Best of luck and I hope you are proactive about this.
posted by FergieBelle at 5:10 PM on February 21, 2010

My dentist prescribes me massive amounts of Ativan for every visit, including cleanings.
posted by elsietheeel at 5:25 PM on February 21, 2010

I've had a ton of dentist's appointments in my (short) lifetime, so I definitely feel your pain. Seconding the music player advice. What got me through my wisdom teeth removal was humming music to myself. I wish that I would have had my iPod with me. Bring music (something happy!) and hum along, it will really help!

When you're at the dentist's chair, keep reminding yourself that whatever happens, the appointment will end soon and you will get on with your day. You will not be sitting there forever.

Reward yourself with something you enjoy when the appointment is over.
posted by carmel at 6:31 PM on February 21, 2010

As far as the anaesthetic not working, ask your dentist about the possibility of divergent neuroanatomy. The nerve that deals with your teeth ordinarily has two branches, but in some people -- myself included -- it has three. Hit two and miss the third, and you can still feel everything. I also have nerves that cross sub-lingually, so everything they do on one side of my jaw I can feel on the other side.

Yeah, dental work is a fuckin' picnic, let me tell you.

anyway. My solution is 1) nitrous 2) valium 3) they just shoot my entire face full of so much novocaine that I can barely drool. They do the nitrous and the valium even for cleanings, if I need it -- it's been ages since I did, but damn, it was sure nice to have at first, when I was terrified after years of high-pain dental work. The last time I had a filling done, I could still feel the drilling, and I told them so. They re-shot me with novocaine and cranked the nitrous up to full, and when they came back ten minutes later and said "How do you feel now?" and I tried to say "Grateful to live in a time and place where the standard of care with regards to patient comfort is to ensure that no pain is felt whatsoever" but what came out was "Graaaaaaaaaah." So, yeah. Anxiolytics, nitrous, and tell them that you might need more shots than you thought. Trust me, with enough valium on board, you won't even care.
posted by KathrynT at 6:35 PM on February 21, 2010