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Dental phobia

Many people worry about going to the dentist. You may be very nervous and may actually feel sick to your stomach.
Some people become so nervous that they just don’t go to the dentist. However, this can lead to serious problems, including infected gums and teeth, difficulty chewing, and lack of self-confidence because of bad teeth or bad breath.

To help get over being nervous about the dentist, it is helpful to first understand why you may be nervous. Reasons include:

  • Having had a painful or bad experience at the dentist, including insensitive comments made during your visit.
    The smell of the office or seeing or hearing the dental tools (such as the sound of a drill) may bring this back.
  • Feeling helpless or out of control. Being confined to the chair and not being able to speak and communicate may cause this.
    The precautions your dentist takes, such as wearing a mask and gloves, may add to this feeling.
  • Being embarrassed about the condition of your teeth.
  • Hearing about others’ bad experiences at the dentist or being influenced by how TV, newspapers, or magazines portray them.
  • A fear of the unknown, including the procedures your dentist uses.

To help feel less nervous about a dental visit, try the following:

  • Talk about your fears. Tell your dentist that you are nervous, and try to explain why. This way your dentist can do everything possible to put you at ease.
  • Ask your dentist about what is going to happen and why. If you understand the steps of getting a filling, for example, you may feel less nervous about it. Ask your dentist to tell you when he or she is moving from one step in a procedure to another step.
  • Make your dental visit at a time when you are not rushed or under pressure. An early morning, late afternoon, or Saturday may be the best time, as you may not have to worry about missing school or work.
  • If the sound of a drill bothers you, ask your dentist if he or she has music and headphones. If not, bring your own audio player and headphones.
  • Agree on hand signals to communicate pain, discomfort, or that you need a break.
  • Use relaxation techniques. As you sit in the chair, try deep breathing or thinking about a favorite activity or place.

Don’t be afraid to switch dentists. If you talk to your dentist and feel that he or she is not listening or not making an effort to help you feel at ease, try another dentist. Tell your friends about your fears, and ask them about their dentists.

What Causes Dental Phobia and Anxiety?

There are many reasons why some people have dental phobia and anxiety. Some of the common reasons include:

  • Fear of pain. Fear of pain is a very common reason for avoiding the dentist. This fear usually stems from an early dental experience that was unpleasant or painful or from dental “pain and horror” stories told by others. Thanks to the many advances in dentistry made over the years, most of today’s dental procedures are considerably less painful or even pain free.
  • Fear of injections or fear the injection won’t work. Many people are terrified of needles, especially when inserted into their mouth. Beyond this fear, others fear that the anesthesia hasn’t yet taken effect or wasn’t a large enough dose to knock out any pain before the dental procedure begins.

  • Fear of anesthetic side effects. Some people fear the potential side effects of anesthesia such as dizziness, feeling faint, or nausea. Others don’t like the numbness or “fat lip” associated with local anesthetics.

  • Feelings of helplessness and loss of control.
    It’s common for people to feel these emotions considering the situation sitting in a dental chair with your mouth wide open, unable to see what’s going on.

Embarrassment and loss of personal space. Many people feel uncomfortable about the physical closeness of the dentist or hygienist to their face. Others may feel self-conscious about the appearance of their teeth or possible mouth odors

Fainting Before the Needle

Although some medical procedures may make us nervous, fear of needles can evoke intense reactions. Fear of needles is a recognized phobia, listed in the American Psychiatric Association’s DSM-IV manual within the category of blood-injection-injury phobia, according to a 1995 study in the Journal of Family Practice.

Needle-phobes experience panic attacks, lightheadedness, or fainting when exposed to a needle, according to the author, James G. Hamilton, MD. (Hamilton says that 80% of patients with needle phobia also report the fear in a close relative, suggesting the phobia has a genetic component.)

A 2006 study showed that 15 million adults and 5 million children reported high discomfort or phobic behavior when faced with a needle. Nearly a quarter of those 15 million adults said they refused a blood draw or recommended injection because of fear. (The study, which extrapolated from a survey of 11,460 people, was commissioned by Vyteris, Inc., a company that makes a patch, called LidoSite, designed to relieve needle pain.) Hamilton estimates that needle phobia “affects at least 10% of the population.”

“Blood tests are one of the most important diagnostic tools modern medicine has at its disposal,” Mark Dursztman, MD, a physician at New York Presbyterian Hospital, said in a news release announcing the study findings. Fear of needles, therefore, is “an important public health issue.”

Hamilton says needle-phobic patients deserve to be recognized as suffering from an involuntary condition rather than being made to feel like “wimps” or “oddballs

How to Cope

Here are some tips experts suggest to cope with fear of doctors or medical procedures:

1. Identify what worries you. Or as Consedine puts it, deconstruct your anxiety. “Anxiety tends to be diffuse; people are not sure what they’re really anxious about. But if you identify what it is, that makes it much easier to manage because you can evaluate your coping potential.”

2. Confront anxieties and deal with them rationally. This could be a useful way to overcome fear of screening tests, Consedine says. For example, the digital rectal exam can be important for detecting prostate cancer, and the colorectal exam is important for early detection of colorectal cancers. Studies show that many men avoid these tests because of a perceived threat to their sexuality, Consedine says.

Other screenings such as the mammogram may be uncomfortable, but they are brief and can be life-saving. Surveys show that people anticipate screenings to be more painful than they actually are, Consedine says. And rationally, those brief moments of discomfort are far outweighed by the chance of having your life saved by early detection of a disease.

3. Ask for sedatives or anesthetics. These can be helpful for people with needle phobia.

4. Ask for a preview of what pain you might feel and how long it will last. Leventhal has found that patients are more relaxed if the doctor or nurse prepares them with a reasonable description of what they are going to feel — for example, by comparing a needle stick to a mosquito bite — as well as clear indication of how long the feeling will last. If you’re worried about pain from a procedure, you may want to ask for a preview of what you are about to feel, Leventhal suggests.

5. Seek a new doctor. If you’re afraid of your doctor, you might want to seek out a new one who evokes a more calming reaction, Lack advises.

6. Try cognitive behavioral therapy. By reframing a patient’s state of mind and teaching coping techniques, this form of therapy has been shown to relieve anxiety in as little as two or three sessions, Lack says.

7. Take someone with you. Once you’ve recognized your fear, talk about it to someone who is unthreatening, Hay says. Many anxious people rely on a spouse, relative, or close friend to get them to an appointment and even sit with them in the examining room. Your greatest resource could prove to be someone who cares deeply enough about your health to help you overcome your fears.

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