How to get over your fear of the dentist

Source: Best Health magazine, October 2014

I’m in a reclining position while infrared heating pads comfort and warm my jaws, and nimble fingers massage my feet. I have declined a paraffin-wax hand treatment, but I will take the fresh carrot juice when we’re done. I’m in a serene, almost dream-like state’until I hear: ‘It looks like you may have a cavity.’

Oh, right. I’m not at a spa. I’m at the dentist’s office for a checkup; the reflexologist masseuse also happens to be a certified dental assistant. Serene, dream-like state’gone! Mild panic begins.

Yes, I admit it: I’m a grown woman with a Fear of Dentistry, not to mention TMJ disorder, which means opening wide is tough on my temporomandibular joints. Although I’ve made small progress over the years’having my teeth cleaned no longer makes me light-headed’the idea of someone in a mask hovering over me with sharp, shiny instruments still makes my cowardly heart palpitate with fear. (Maybe I was once abducted by aliens seeking test subjects?)

Reluctantly, I make an appointment for three weeks later, and then try to forget about my date with the drill. Wait, I think. I’m a freelance writer; maybe writing a story about the process will demystify it, and potentially even desensitize me to the discomfort.

Soon I’m on the phone with Dr. Peter Doig, a Dauphin, Man.-based dentist who until earlier this year was president of the Canadian Dental Association. He says 35 percent of Canadians don’t go to the dentist regularly; what proportion of them avoid the dentist because of fear is not known. ‘It’s difficult to research a group that avoids you.’ Ah, yes. He does know that about 15 percent of people have anxiety about going to the dentist. Common reasons include fear of the freezing needle; noise of the drill; fear of pain (such as a blast of cold air on a sensitive tooth’wince!); previous dental experiences; and issues such as anxiety disorders. That’s me: the anxious, vivid-imagin­ation type. How much blood will there be when the drill, er, slips?

Like anything else, avoidance can make things worse. ‘Anxiety and fear prevent people from seeing a dentist, which increases both the potential for disease and its severity,’ Doig says. In other words, a cavity that you neglect to get filled may worsen and eventually require, say, a root canal. Brushing and flossing daily are musts, as are regular checkups (because even the best brushers reach only 80 percent of tooth surfaces, says Doig).

While dental practices of course remain highly clinical, there have been advances in methods for alleviating anxiety. Some involve less clinical-feeling environments where you can even feel pampered. Some dentists, like Dr. Dana Colson, the one I am at today, offer complimentary spa-like amenities such as reflexology and hand treatments. At Impressions, The Dental Hygiene Spa in Toronto, patients get slippers and hot towel service, too. Some use scents such as essential oils to mask clinical odours and create a more serene setting. TV, heated chairs that vibrate and massage, and music can all help to relax and distract’one study found that classical music significantly reduced the fears of anxious patients. Doig prefers his patients don’t listen to music on headphones. ‘When someone has a headset on, I can’t talk to them. Being able to explain what I’m doing is a huge aid in reducing patients’ anxiety.’

The most important thing is to develop a trusting relationship with your dentist, says Doig. ‘Find someone you’re comfortable with and can talk to.’ Just not while they’re working on you, of course.

Dr. Maud McEvoy, a dentist in Halifax, tells me she puts people at ease with a relaxed, ‘fun’ atmosphere’no white uniforms’and a sign: ‘We cater to cowards.’ She explains, ‘I figure out what bothers people, then work with them on their issues.’ She coaches patients with breathing exercises. ‘Some people think they should just be put under,’ she says, using nitrous oxide, IV sedatives, oral anesthetics or oral anti-anxiety medications. But not dealing with the fear can make it worse. ‘Building up positive experiences helps you get over the fear. I’ve seen it happen.’

Three weeks are up’it’s time for the follow-up appointment to repair my tooth, and I’m feeling bad because Colson doesn’t deserve to be feared. She has a kind and gentle chairside manner; she has even self-published a book about a yoga-based approach to dentistry, and the connection between oral health and overall wellness. Colson once feared dentists, and became one so she could overcome her own fears and help others overcome theirs, too.

‘Think of your dentist as a partner,’ she says. ‘You’re working together to create the outcome, and that’s very empowering.’ Yes, but what if one partner is wielding a drill? Modern dentistry includes lasers, used mostly for gum surgery; new lasers that Colson says ‘can help prepare certain teeth in certain situations’ (e.g., taking out the decay); and air abrasion drills, like mini-sandblasters, for minor decay. But as yet there are no substitutes for the high-pitched, high-speed air-powered turbine drill, known in the industry by the less menacing term ‘handpiece.’ (One Indonesian dentist created a musical version with flashing lights’but when will they invent a silent drill?)

‘So how are you feeling?’ asks Colson, who until now was not aware just how high my anxiety ran’although she may have noticed, during past visits, my sweaty grip on the dental chair armrests, as if hanging on for life.

‘Okay.’ But in truth, I’m nervous. I realize I’m stuck in childhood, feeling I have no control over something being ‘done’ to me, and embarrassed to speak up. I need to think of this as a partnership. Still, I wonder aloud: ‘Do drills ever slip?’ ‘Rarely,’ Colson says. (And a rubber dam, primarily used to isolate the tooth being worked on, can provide a safety barrier.)

Colson suggests we nix the needle. The crack in my molar isn’t a cavity, yet, and isn’t near the nerve; the tooth is located in dense bone that would traditionally require her to inject the anesthetic far back into my mouth, freezing both my tongue and lip and causing me to feel zombie-like for a few hours.

Unfortunately, it turns out we can’t nix the needle. Here’s why: All is going well’or as well as things can go when a device is rotating inside your mouth at 300,000 rpm or so’when I feel a pang of pain. Hello, partner! After some freezing, Colson resumes, then fills the tooth with white composite resin and polishes it. To help my TMJ disorder, Colson ends with some energy healing by cupping her hands around my jaw, which relaxes the muscles.

‘How does that feel?’ she asks. Honestly? It feels wonderful. Later I step outside, organic fresh-squeezed carrot juice in hand, knowing next time will be even easier, and vowing to keep on flossing so that next time doesn’t come too soon.