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September 12, 2010 1:28 PM   Subscribe

I need to go to the dentist. But, I have a phobia of injections. Not going isn't really an option, so what can I do?

Background: it has not always been thus. I've had operations as a child (stitches in scalp, burst appendix, etc). I was on Depo Provera for three years, after which a brief experiment with the Pill got me an injection in my stomach - I was more concerned with getting something to eat than the needle. I had a blood test at 21, which was fine until I fainted what with it being the first time. I've even had a root canal when I was sixteen, and was fine with it too.

I last went to the dentist three years ago. I had an examination, and came back to get something looked at. I was nervous that morning, couldn't eat, drank some juice in case I needed something in my stomach. The dentist got the needle out, got impatient with me, and I panicked and threw up all over the chair. I left vomiting and shaking. I have never reacted like that to anything medical before - the closest was having an IUD fitted but that was very very painful.

Since then, I've had to have a few blood tests. The first one, I lay down on the table and tried to relax, but by the time they decided to draw blood from my hand (I have difficult to find veins, and the more they prodded, the more scared i got) - I was lying on the examination couch sobbing and shaking. I was sent to the local health centre - I fainted. Eventually I went back with MrMippy, and then I learned that if I concentrated on a magazine, it didn't feel so bad - but it's hard to do this when it's in my mouth.

I need to get something looked at so I need to get over this. I know general anaesthetic is one option but it isn't available on the NHS - privately it is very expensive and many dentists aren't keen as it is risky. Also, that would help in the short term but I want to start taking better care of my teeth. I don't know where this came from, I know I need to get things done so it is irrational, and if I can't feel the drill I don't care about that. It seems to be the needle. I keep telling myself that people have been having injections for years, that there is no extra medical risk and the anaesthetic won't travel down my bloodstream and stop my heart, that some people have to inject themselves every day, that the pain of the injection is much better than the pain of dental problems or further medical problems etc, but rationalizing it isn't helping.

I've been trying watching House to see if seeing injections would help but I still get very tense and frightened and also it doesn't seem the same as actually being there.
posted by mippy to Health & Fitness (44 answers total) 2 users marked this as a favorite
What are you having done? Lots of people here just dont get shots, even for drill work.
posted by Iteki at 1:34 PM on September 12, 2010

There are dentists that will use, as an alternative to general anesthesia, gas first, before the injection, or in lieu of. A little nitrous will alleviate you of your phobic reactions.
posted by Cool Papa Bell at 1:34 PM on September 12, 2010

I developed a dentist (not needle) phobia recently and they said they'd prescribe a one time anti-anxiety (Xanax? what's the new Valium?). Ask your dentist!
posted by Pax at 1:34 PM on September 12, 2010 [2 favorites]

A few suggestions:

Find a "painless" dentist. There are many who take great pride in this. Get recommendations from friends, co-workers, etc.

Have an initial consult with the dentist, explain your fears clearly, and the extent to which you react, if you don't get a sense that he/she is in sync and willing to help you with this, find another dentist.

There are a number of things they can do to help. Some valium prior to the appointment, Nitrous Oxide, and a technique that means you don't feel a thing.
posted by HuronBob at 1:35 PM on September 12, 2010

I think maybe you could just take one step at a time - find a really sympathetic dentist who understands your fear. Go and see him or her for the initial appointment, and - if you're ready - see what needs to be done. If you're not ready, that could be saved for the next appointment. These days dentists have lots of options for nervous patients, my friend even saw one who prescribed a light sedative for her to take beforehand. I am not trying to make light of your phobia, but I think you might be moving a bit too fast here in terms of assuming what the dentist will need to do. Definitely the first step is to find one who is very understanding. Perhaps someone in your area could make suggestions?
posted by rubbish bin night at 1:38 PM on September 12, 2010

Valium and nitrous, plus your favorite track on your ipod. Between the anxiolytics, the spaceyness the nitrous gives you, and the distraction of the music, you'll be somewhere else entirely. I have a RIDICULOUS dental phobia, and this is what allows me to get work done.
posted by KathrynT at 1:39 PM on September 12, 2010

A keyword you may want to do a little searching on: "sedation dentistry." You remain conscious, but you just don't care.
posted by kindall at 1:39 PM on September 12, 2010

I'm one of the ones who goes without the shot. Actually Mr. HotToddy tried this first, reported that the discomfort of the drill was dramatically less than the discomfort of the usual injection + hours of numbness, and then I tried it when I went. He was right. Not sure what I'd do for a more extensive procedure, but for ordinary fillings, etc., you might want to give it a try.
posted by HotToddy at 1:41 PM on September 12, 2010

Ask for a Valium. I was given one before my vasectomy and the needle in my *ahem* [not gums] was no problem.
posted by ZenMasterThis at 1:51 PM on September 12, 2010

Find a dentist that uses The Wand, it's amazing.
posted by Mwongozi at 2:00 PM on September 12, 2010 [1 favorite]

Response by poster: I have a hole in a tooth that has had the root canal (chipped on a sweet) and I know from my last exam that I need a couple of fillings.

I don;t think valium is commonly prescribed by dentists here. I take medication for bipolar disorder so I'm not sure what effect a sedative would have on that. I have to have physical examinations at the moment for something else and I do get scared then, but that's based on experience (it HURTS) so I know I don't get scared of actually being looked at - it's needles and/or operations that do it. I have an examination first to determine if something does need doing, so I can ask them.

Sedation dentistry will cost me £250 for that procedure alone, and will probably mean getting my examinations done privately (it's not an NHS procedure) making it at least triple the cost. I don;t think I can run to that sadly.
posted by mippy at 2:01 PM on September 12, 2010

I have a thing with needles, too (mostly they freak me out, but I definitely have a less severe reaction than you). For some reason, though, I never think about it at the dentist. Probably if I saw the needle I would be much more anxious, but I usually lay back in the chair and close my eyes the entire time. The dentist and her assistant chat, give me instruction occasionally (open wider, chin toward me, etc.), and I know I get shots because of the numbness. But I never look at the needle. My dentist also may be skilled in reducing the pain of the shot, I'm not sure. It couldn't hurt to look for a dentist that specializes in anxious patients. But I recommend eyes closed for sure.
posted by JenMarie at 2:02 PM on September 12, 2010

Response by poster: Just lookign at a website about sedation dentistry has started to make me feel panicky, because they mentioned IVs.

Honestly, I had a root canal and didn't feel anything other than a bit bored - I remember the sound of the drill and wishing that they had Radio 1 on rather than Radio 2. This really doesn't make any sense.
posted by mippy at 2:04 PM on September 12, 2010

I agree with Burhanistan about just going anyway. This is why: the longer you put off what needs to be done now, the better chance you have of it hurting WAY more than a needle ever would. I understand that you are scared, but if women can squeeze something the size of a watermelon out of a hole the size of a walnut (some even go for repeats!), you can handle a tiny needle. Guaranteed.
posted by bolognius maximus at 2:26 PM on September 12, 2010

My daughter - when she was 3 - had to undergo some dental work. Because she was so young they opted for conscious sedation. There were no IVs involved. However, her heart, breathing, etc. rates were closely monitored by the use of that finger clippy thing.

Before you start getting freaked out about conscious sedation, check with dentists to see if there is an IV involved (perhaps it's different for adults).

Recently, same daughter - now age 9 - had to have a tooth pulled. She was very nervous. I made sure that nitrous would be involved. The procedure went splendidly. She was a happy camper throughout.

I think you have a lot of options that will make you loopy enough to not care about the needle - medication to take before hand, conscious sedation, nitrous, going without numbing agents, etc.

But, you really need to talk to your dentist and find one that will seriously work with your fears. Like I said, there are a lot of options, but you need to be having conversations with your dental providers regarding this.
posted by Sassyfras at 2:28 PM on September 12, 2010

Not going isn't really an option, so what can I do?


I mean, not to be blunt, but you know yourself what needs to be done.
posted by Biru at 2:31 PM on September 12, 2010

I'll qualify my statement. When I know I have only one option, I don't overthink it, I just do. Thought is pointless as it will not change the outcome.
posted by Biru at 2:33 PM on September 12, 2010

I've never had to deal with it, but I too have heard that just dealing with the drill pain is sometimes not as bad as the Novocaine. So, go, say "no shots" and let them at it.
posted by gjc at 2:44 PM on September 12, 2010

Lots of people are dentist-phobic, so start by commending yourself for trying to deal with this. Talk to your doctor about anti-anxiety meds you can take. Your doc can work with the dentist.
posted by theora55 at 2:46 PM on September 12, 2010

You could do auto-hypnosis. It sounds silly, but my wife gave birth to two kids using it and it works. I used the techniques for MRIs (turns out I'm a bit claustrophobic) with varying degrees of success.

We were taught by someone locally (for a fee of course), but you could probably find tons of books, CDs videos and websites pretty easily.
posted by DrumsIntheDeep at 2:49 PM on September 12, 2010

My dentist prescribes 2mg of Ativan to be taken before each appointment. After an hour or so I don't care about anything.

He also uses a topical anaesthetic before the novocaine shot, and wiggles my lip during the injection, which is surprisingly effective.
posted by elsietheeel at 2:50 PM on September 12, 2010 [1 favorite]

I wish I could offer a specific recommendation, but I know here there are (non-sedation) dentists who put themselves out there as being for people with dental/needle/drill phobias, and going to those has been game-changing for a few of my friends. I'd recommend finding a new dentist, and there must be one out there that's on the NHS and will be keen to work with you to overcome the difficulty.
posted by carbide at 2:59 PM on September 12, 2010

I've had a few fillings done sans anesthetic as well, for pretty much the same reasons at HotToddy. They have ranged on the pain rating scale (0-10 with 0 being "no pain" and 10 being "unbearable, worst pain of my life") from a 0 to about a 6 or so, and the pain has never lasted for more than a few minutes in a session. It's also rather pleasant to be able to leave the dentist without feeling like my mouth is full of cotton for the rest of the day. If you're just having fillings and if you feel like you have a reasonable tolerance for pain, I bet you could handle it no problem.

Also there's nitrous, which many have mentioned for its anxiolytic properties, but which will itself help a lot with the pain even if you still don't feel up for the injections. It's a pretty good anesthetic all by itself, after all.

So maybe what I'd do in your position is ask for the dentist to give me the gas and then to ask me (once it's set in) whether or not I want the injections as well. If I were feeling relaxed enough then I'd have the option, but the procedure could proceed regardless.

Dentists in the past have been pretty good about working with me on this kind of stuff, though I think it's important (just as with any doctor) to have an idea of what you want beforehand, and to be able to articulate it clearly. You're doing the right thing by seeking advice and researching your options. You should definitely feel free (as others have mentioned) to shop around for a dentist who is sensitive to your needs, but once you've found one you can work with you should really get on it. You don't want those fillings to get worse – the longer you wait, the more invasive the repair procedure is likely to get, which obviously would not be good for your chances of having a needleless visit.
posted by Scientist at 3:08 PM on September 12, 2010

Response by poster: I don't understand what people mean here when they say 'gas'. Last time I sat in the chair, they used suction, then the dentist tried to put a needle into my gum (she was going to cut off a tiny flap left over from a wisdom tooth that had got a little bit infected.) No gas involved.
posted by mippy at 3:26 PM on September 12, 2010

I, too, am particularly afraid of needles in my mouth. My dentist uses some kind of numbing agent on cotton swabs before doing the novocaine injections. I was skeptical about them--I figured I'd still feel the initial prick of the needle and braced myself for it--but I literally felt nothing. It was a very pleasant surprise. See if you can find a dentist who will do this for you. Surely it's much cheaper than sedation. Then all you have to do is close your eyes before they bring the needle up to your mouth--out of sight, out of mind.
posted by Fui Non Sum at 3:29 PM on September 12, 2010 [1 favorite]

Mippy, "gas and air" == "nitrous oxide". In the US, nitrous oxide is very, very commonly used in dentists' offices in order to avoid anxiety. My dentist offers it routinely for everything, X-rays and all. My understanding is that in the UK, this is not common. (but they DO use it for labor, which is absolutely unheard of in the States.) I should have checked to see where you were before recommending it, sorry.

When I've had nitrous oxide at the dentist's, it comes in the form of a little mask thing that fits over my nose. Breathe through my mouth? the world gets closer. Breathe through my nose? The world gets further away. Take great galloping breaths through my nose? I'm in a happy little place behind my eyelids, perhaps somewhere past Mars; meanwhile, on some other planet, people are poking me or something, I guess. If I start to dislike being that distant, I just breathe through my mouth instead, and the world comes back into focus inside of about thirty seconds.
posted by KathrynT at 3:32 PM on September 12, 2010

The Wand thing is fantastic -- my dentist uses it, and it's so much less stressful and painful than the usual injection. It doesn't hurt, the Novocaine takes effect much more quickly, and it's nowhere near as awful-looking as the huge syringe. If you can find a dentist that uses it, I highly recommend it.
posted by sarcasticah at 4:01 PM on September 12, 2010

The OP needs a gentle NHS dentist located somewhere in London.

Here are two previous AskMe's about NHS dentist recommendations. One. Two.
posted by elsietheeel at 4:31 PM on September 12, 2010

I have dental phobia - not so much the needles, but the forced passivity - and my dentist would prescribe only a mild sedative. So I called my general practitioner, who prescribed 1 mg tablets of clonazepam, generic for klonopin. He gave me six and advised I take one before each procedure (I'd let dental care go for years and had lots to catch up on). It worked fine. Even a 2 1/2 hour root canal was a breeze. I got everything done within a couple of months, and by the end was taking only half a pill before going in.
posted by goofyfoot at 4:53 PM on September 12, 2010

Ugh I hate those impatient asshole dentists who ruin it for the rest of the profession! (I'm not a dentist but I do have a very nice one who is patient with my TMJ)

Get a prescription for some kind of anti-anxiety/sedating med. I was going to suggest what goofyfoot did - call your GP. Seriously those things are amazing. I forget which one I took after having minor surgery, but it really helped. It wasn't exactly that the pain went *away*...I basically couldn't really feel *anything* bad, period!
posted by radioamy at 5:14 PM on September 12, 2010

A few other people have said this already, but the best thing you can do is find a dentist who knows how to work with anxious patients and who will take a few minutes to talk with you so you can come up with a plan that will make you comfortable.

Nitrous worked very well for me, and I have the same problems with needles that you mention. With the nitrous, by the time they got to the needle, I was already zoned out enough that it didn't cause the same panic. The nice thing with the nitrous for me was that it wore off quickly after the procedure and didn't leave me feeling drugged for hours.

Music and headphones also helped distract me -- you might want to give that a try. Make sure to use a music player that you can operate by touch alone since you won't be able to see it easily.

Good luck!
posted by nalyd at 5:29 PM on September 12, 2010

It sounds like you're having panic attacks. You can go see your doctor about it and see if you can get a scrip for Ativan or Valium. Leading up to my surgery two years ago my gp gave me about a months worth of Ativan to help me deal with my panic attacks, and just last week I got a Valium for a surgical procedure on my head. (I was conscious for that one.) Both take away the uncontrollable anxiety and let you get on with it. Neither will make it a pleasant experience, but it allows your conscious mind to decide how you're going to react. Panic is no small thing, and there's no way to just control it without help. The dentist probably can't prescribe you this stuff, but a compassionate doc will.

Also, in future when you get blood work done, ask if they'll apply heat to your arm first. That works like a charm for my mom.
posted by Hildegarde at 5:45 PM on September 12, 2010

My dentist actually used a local anesthetic (lidocaine?) on the gum before giving the shot. It tasted awful but the needle didn't hurt. He also gave injections very, very slowly, which makes it less likely to hurt, and had the dental assistant rub my shoulders during the shot.

I'm fine with needles as long as I don't look, though. I think that's really important with dental injections: close your eyes and don't look, because while the actual needle is tiny, the shot looks much bigger. It has all kinds of extra apparatus on it so they can manipulate inside your mouth.
posted by Violet Hour at 5:48 PM on September 12, 2010

It sounds like you're trying to find a reason for your reactions and can't find it; this resonates with me. I have found that my weird phobia (fish!) waxes and wanes for no obvious reason. This isn't your fault and I doubt your can really think your way out of it. For whatever reason, your body cannot control your anxiety reaction around injections. That's a medical issue you can help with drugs. I think that's your best bet.

I disagree with those above. You know what's going to happen if you "just go". Listen to your body, go talk to your doctor and get a little help.
posted by Hildegarde at 5:53 PM on September 12, 2010

I take medication for bipolar disorder so I'm not sure what effect a sedative would have on that.

Talk to the doctor who treats your bipolar. They should be able to help you with meds for a dentist visit while taking into account whatever else you're on and the bipolar itself.
posted by galadriel at 6:16 PM on September 12, 2010

Comment on 'conscious sedation' mentioned above- generally this is done with an IV in place for both adults and children. It can be dangerous to do this without an IV in place, because if too much sedation were accidentally given, most of the medications we use have an IV antidote that can be used to reverse their effects, and if any other serious complication occurs, you don't want to be searching for a vein at that point to give IV meds and fluids. All the hospitals I've worked at (which are in the USA) have a protocol that the patient must have a good working IV in place and be on several kinds of monitor before the procedural sedation starts. Honestly, just having the local anesthetic via needle is much much safer and easier. Most dentists use a topical anesthetic gel before putting the needle in and then they rub your cheek during so you can hardly feel it. An oral antianxiety med is definitely a much better/safer/easier move than opting for general anesthesia or procedural sedation in a case like this.
posted by treehorn+bunny at 6:38 PM on September 12, 2010

One thing that calms me down at the dentist, besides a nice xanax, is listening to my ipod. It's somehow better if I can't hear things and have no idea what's to come. I tell them to do what's needed and try to zone out.
I have prayed for you.
posted by littleflowers at 7:04 PM on September 12, 2010

I have a terrible time at the dentist. I metabolize the freezing ridiculously fast. As a result, it wears off long before the dentist is done, and they always, always have to refreeze me several times during even the most simple cavity. It's left me really really anxious about every procedure. The needles don't bother me, but the pain (or the threat of pain) of the freezing wearing off before I can get more just terrifies me now. It's full blown anxiety now whenever I'm faced with anything requiring freezing.

So, now my dentist gives me a pill to take a couple hours before any procedure. It's called Halcion, and it's part of the Valium family I think. I take it, and get someone to drive me to the dentist. I'm sorta sleepy, sorta happy, and really, don't give a shit. The anxiety is GONE. And when it hurts, I just as for more freezing. Simple as pie. When the procedure is done, someone also has to drive me home, and I'm pretty much out of it for the day. This can be a pain, but it's worth it. As an added bonus, a common side effect is temporarily amnesia, so you don't even remember most of what happened. No memory, nothing to fear for next time, and nothing to cause anxiety.

What you need is an understanding dentist willing to work with you to find a solution. Some dentists are awesome this way. Others, on the other hand, just don't get it and are basically asses. You want the former, obviously. Keep searching until you find a dentist who will work with you.
posted by cgg at 7:11 PM on September 12, 2010

Talk to your dentist. My dentist is very good about being sneaky and makes sure you never even see the needle, by bringing his hand up under your chin. Since he uses a topical numbing cream first, you don't feel it much either. Unlike my endodontist who did my root canal... he brought these big-ass needles straight across in front of my face.
posted by IndigoRain at 7:12 PM on September 12, 2010

Response by poster: KathrynT- don't worry! I know US dentistry is different - you don't mock British teeth for nothing!

I don't know how common it is for GPs here to prescribe sedatives, but it is one option. I could save up a bit and look into private dentistry but I don't want to wait a long time to get things looked at - plus this feels like something I need to deal with. I will be seeing this dentist for the first time so I don't know anything about them just yet.
posted by mippy at 1:53 AM on September 13, 2010

I think if I were in your position (I'm in the UK, but have untroublesome teeth and no needle phobia) I'd go and see my GP and explain the problem, and see what they recommend. Even better if said GP is the person who prescribes your bipolar medication.
posted by altolinguistic at 3:03 AM on September 13, 2010

Hey, I'm not mocking British teeth. I can't -- I HAVE British teeth. My father's a UK citizen, and I was born in Manchester. I have lost track of the number of dental professionals here in the States who have looked in my mouth and said ". . . wow, I always thought that business about British teeth was a myth."

I had to have a root canal several years ago, and when I came to after letting the very high-dose nitrous wear off, the endodontist was literally mopping the sweat off his brow and chugging Gatorade. "That is. . ." he said. "That is the MOST interesting root canal I have EVER done."
posted by KathrynT at 2:40 PM on September 13, 2010

Response by poster: OK, probably nobody's reading this now, but...

I went to the dentist today and was so tense during the examination that the dentist (who was lovely) had to stop and tell me to relax. I need a crown on the chipped tooth, which mioght not be a needle job, but I didn't expect to be so scared at the examination (the suction stuff made me gag and I tensed right up).

I also need some fillings, so I have the choice between the NHS metal jobs (which I can afford to have done this month) or the white ones, which are apparently better in the long-run but more costly, and will mean getting maybe one or two things done per month rather than all the treatment in one go. Wondering what the best option is here...
posted by mippy at 3:04 AM on October 1, 2010

Thanks for this post. I feel the same way. I am also trying to figure out how I can do this. I haven't been for a cleanup in 3-4 years and finally have a small intermittent toothache. I don't like injections but they are doable if they are only for a few seconds (blood draw, shot, etc). Dental injections, ugggh. I am feeling dizzy just typing this up.
posted by Earl the Polliwog at 4:47 PM on October 13, 2010

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