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2016: New Year, New Smile!

04 January 2016   Dr. Jason C. Campbell | Partner Content
You have no need to fear your dentist.

Don’t forget or fear your dentist any longer.

Each year, many of our New Year resolutions are health related, however, one area that often gets overlooked is our dental health. Maybe you or a loved one doesn’t go to the dentist because you don’t have any current issues or maybe you are like the estimated 9% to 15% of Americans who avoid seeing the dentist because of anxiety or dental phobia. You are in the company of about 30 million to 40 million people who avoid seeing their dentist because of fear. With a new year brings new beginnings – start it with a new smile!

We are fortunate to live in a day and age when advancements in technology are allowing surgical procedures, which were once involved with long painful recoveries, to be performed in outpatient settings. Patients benefit with shortened recovery times by 50 to 75%. Like medicine, dentistry has made many advancements to reduce pain, as well as, treatment times. Unfortunately, for some people, when it comes to dentistry, there is no way to make a procedure fast enough or painless enough. Certain individuals have deep-seated fear of the dentist that can keep them from getting the care they need. An understanding of this fear by both dental practitioners, as well as, those needing care can have a huge impact in opening doors to care for even the most fearful patient.

Types of Dental Fear

All people will react to the perception of oncoming pain. Our bodies’ reaction to such an
event is the result of feelings of fear: heart rate increases, eyes widen, blood vessels constrict, capillaries in the lungs open and lungs prepare to take in more oxygen. This reaction is part of our “fight or flight” response. In a rational state of mind, we are able to assess the real danger, evaluate just how much pain we might experience and then use coping mechanisms to calm our fear, allowing ourselves to commit to potentially painful, but controlled situations. With dental phobia, we must realize the fear is real, but the mechanisms of coping are somehow absent. In many cases, this is established early on in life and can be traced back to emotionally or physically traumatic experiences, but dental phobias can also develop at any time into adulthood.

Understanding the Causes

Having practiced dentistry for over 15 years, I have seen many new patients who have come to the practice with anxiety or a dental phobia. As dental professionals, we must be careful in the way we treat children between the ages of 3 to 6. It is during these formative years when children become irrationally fearful - noises in the dark, monsters in the closet, the boogeyman etc... Historically, in dentistry, there was a misconception that children did not feel and interpret pain in the same manner as adults. Additionally, the effects of early dental aesthetics were less potent and less understood, especially in small bodies. These two misconceptions often resulted in insufficient, ineffective and, in many cases, completely absent doses of anesthetics in children.

Irrational fear development as a child can also be attributed to traditional behavior control techniques being taught in dentistry. In the past, hand-over-mouth techniques were employed in an attempt to create a relationship of dominance and respect between the child and dental providers, but, also had the potential impact of creating a feeling of physical and emotional fear. Restraints and “papoosing”, while sometimes required in extreme situations, when used too freely, had the potential of leaving children with a sense of helplessness, while their personal space was invaded without permission. Unfortunately, for some, as a result of their childhood dental experiences, or even from negative experiences as an adult, they continue to have dental fear. Adults may also have irrational fear caused by misconceptions of potential pain, for example, regarding root canal and wisdom tooth removal procedures. Today, incorporating advanced technologies and medication in treatment usually eliminates or reduces pain to a manageable level.

At our office, home of Jason C Campbell, DDS, Cosmetic & Family Dentistry and the Advanced Prosthetics Institute, we strive to welcome patients in a warm and friendly manner. We take the time to learn about our patients and whether or not they have fear, and if so, what that level of fear exists. Consequently, we can provide them with the comfort, knowledge, and services appropriate to help diffuse anxiety and fear so they feel at ease while having treatment.

Taking Control – Be Proactive

Once irrational fear has taken root, it can, in some situations, be alleviated. However, it requires many safe and tolerable experiences to overcome this type of fear and requires the help of a knowledgeable and compassionate dental care team.

A few tips to follow in relieving your anxiety include choosing a dentist who:

  • has a casual yet professional, calming environment with a friendly and patient staff

  • gently explains what you will feel during treatment and for what duration

  • will frequently ask you for permission to continue

  • gives the patient the opportunity to stop if necessary (“Raise your hand if you need to stop.”)

  • provides breaks in treatment, if necessary

  • has numerous positive patient reviews. Look at their online reputation by googling the practice and reading reviews from patients who have come to the practice with fear. You will be able to see how well the dentists and staff helped make them feel comfortable and diffused their fear.

Additional steps to take to help overcome your dental fear include:

  • Schedule a tour of a practice you’re considering for your dental care to become familiar with the environment, technology, while meeting the dentists and staff

  • Bring a friend or relative who has no fear of dentists along to the first visit

  • Distract yourself while in the chair with your own music through headphones or seek out a dentist who has the option to watch TV or a movie while in the treatment room

  • Use relaxation techniques, such as, slow breathing (deep inhale, slow exhale) or progressive muscle tensing/relaxing exercises

  • Review appropriate sedation alternatives with your dentist (see chart below)

  • If none of the above relieves your fear, then seek out help from a psychologist or possibly, a hypnotist.

For some people, they may never overcome their fear. For these individuals there is still hope for getting needed dental help through the use of sedation. Many sedation options are available today to help fearful individuals through their dental treatment:

TYPE OF SEDATION

PURPOSE

CONSIDERATIONS

Nitrous Oxide Gas (laughing gas)

In mild conditions, used to help patients feel more relaxed by mildly reducing anxiety.

Enhances effects of dental anesthetics.

Safe and easily reversible.

No driving escort necessary.

Anxiolysis (mild)

A single pill used in small doses just prior to visit to increase effect of anxiety reduction beyond that of nitrous oxide.

Appropriate for most persons with good medical health.

Patient is fully awake and able to communicate.

Not as easily or as quickly reversed as nitrous.

Driving escort required.

Oral Conscious Sedation (mild to moderate)

Combination of medications are used in conjunction with nitrous oxide gas administered to induce a conscious form of sedation.

Patient is fully conscious and able to communicate, likely in a state of twilight sleep.

Optimal for involved procedures, moderate in length.

Appropriate for patients having several treatments in one visit.

Vitals monitored by trained clinician throughout procedure.

Separate fee charged.

Provider should be well versed in handling emergencies, have appropriate life support equipment and reversal drugs available with the knowledge to administer, if necessary.

Requires driving escort and someone to monitor patient until coherency returns.

I.V.Sedation (Moderate)

Form of conscious sedation, in which medications are administered intravenously. Associated with oral surgery and wisdom tooth removal. Most useful in surgical, reconstructive and rehabilitative procedures, which may require greater than four hours of procedure time.

As I.V. Sedation is in the bloodstream, it is fast onset and can be much more easily and quickly reversible.

Because of its ease of control, can be used more safely in forms of moderate sedation.

Provider required to have extensive training and licensing.

Requires involved monitoring of vital signs and heart rhythms.

General Anesthesia

Unconscious form of sedation used primarily for medical surgeries.

Not commonly used in dental settings as it requires intubation and artificial breathing equipment.

Potential complications are best handled in a hospital setting.

The field of dentistry continues to work hard to provide various types of solutions for people to receive adequate care. Fear no longer has to be a limiting factor.

We welcome you to call and schedule a tour of our practice at 139 W. Whipple in Prescott, home of both Jason C Campbell, DDS, Cosmetic & Family Dentistry and the Advanced Prosthetics Institute. If you have any questions about options for reducing your dental fear or would like to schedule a consultation, please call our office 928.776.1208. Further information is also available on our websites at www.MyPrescottDentist.com and www.APIDentalRehab.com.