Fear in Dentistry Part 2 of 3

In part one, we talked about how the generalized fear of going to the dentist can really affect your health by causing you to procrastinate until it’s too late. In this part, we’ll talk about the specifics of what is causing that anxiety and what you can do about it.

We’ve identified three separate issues that make going to the dentist an ordeal for some people: the first issue for most people involves pain and pain management; the second involves being able to trust your dentist; and the final issue involves the fear of how much all of this treatment is going to cost. These big three fears are out there and in people’s heads. So, let’s try to break them down, and figure out how we can compartmentalize each fear so they are easier to tackle!

Going to the Dentist Is Going to Hurt!

We provide a wide range of services, from regular cleanings, to full mouth extractions. The more invasive, the more likely there is going to be some kind of potential pain. But fret not, our dental staff has been through situations like yours hundreds of times. We know the relative pain levels that each procedure brings and we know the normal levels of numbing agent usually necessary to make your procedure as painless as possible.

But even with that experience, you as the patient may still have anxiety. This can especially be true for people who are about 40+ as their dental experience as kids was much different than what we have today. A lot of dental offices used to use syringe-based needles which could be re-used instead of disposable ones. The economics of reusing the syringe-based needles made disposable needles kind of a luxury that few practices would pony up for. Because these syringe-based needles could be autoclaved and the needles could get used many, many times over, the actual needle itself had to be pretty thick and big to withstand the cleanings. The thicker the needle, the more it is going to hurt.

Now, as a kid, everything seemed bigger, but these bigger needles really were bigger and they really did hurt more than modern ones. So, what happens if that was your experience and you’re at the dentist now? You never can truly forget what getting poked with one of those large needles felt like. Your brain has memorialized that needles cause pain, and since we want to avoid pain, your brain is telling you to avoid needles because needles cause pain. In a way, that is true, but physical pain is an interesting thing in that you can overcome a lot of it by looking at overcoming it as a challenge. We do this with big hikes, or strenuous workouts. Those activities make our muscles sore the next day but we do them anyways. Have you ever had to block out the pain to do an activity? Could you finish it? And how did it feel knowing you pushed through those boundaries after you did it?

That’s nice, but how do we not give in to it when it is so engrained in our minds?

The first thing when trying to address the fear of pain is that the pain you experienced as a kid may likely be nowhere near the level of pain you have run into in the years since then. One of the most painful things I’ve ever experienced were a series of pinched nerves in my shoulder and back. I went and got some injections to alleviate the pain and the doctor warned me that the injections would hurt. I laughed because nothing I’ve ever experienced had hurt as bad as that shoulder. And lo and behold, the shots were nothing. Now if I had no shoulder injury and I was six, that may be a different story. But, the lesson is that the pain you remember from childhood may be child’s play at this point in your life. If you have real fears of pain at the dentist, think back to experiences in your past to help compartmentalize your current fears better. For instance, let’s take all of you moms out there. Whether you gave birth naturally or via C-section, there is nothing we could almost ever do to you that could top that. Heck, if you’ve ever had a tooth ache, nothing we do could top that either. You don’t have to have some traumatic painful experience to help compartmentalize your fears. A lot of dealing with these issues involves being conscious of how you feel and why you feel that way. That alone begins to give you power over your situation. Don’t let your present be chained to potentially faulty memories!

Now What About Those New Needles?

Oh yes, those new needles. When the dental profession moved to disposable needles, it meant that the needles didn’t have to be so thick since they weren’t going to be used and cleaned again. Modern needles are not just thin, but they’re flexible too. Having had too much dental work done on myself (I like my sweets, be nice!), I would compare the absolute most painful needle pain I have had in this office is like having a rubber band mildly slapping my wrist. Not even a hard slap. It’s almost like a little pinch and it’s over. I’ve had more pain grabbing a bagel that was hot. These super thin and flexible needles have more give so that they absorb some of the movement in the needle themselves and not into you. It takes a very skilled Dentist to know how to use them, but almost all modern dentists are trained on these new needles these days.

Battling the Idea of Potential Pain

With all of that being said, there is another side to the fear of pain. Even if you are not afraid of needles, or can manage it, there is still a baseline fear about what the unknown levels of pain during your procedure could be. Could be. Could be is entirely a mental creation. The fear is that something is really going to hurt while the dentist is performing her tasks. Maybe you felt a little something or maybe you are just imagining something going wrong, but either way, you are creating the idea that a level of pain that you can’t handle may happen at any moment. During the procedure, you’ve got your breath held in and your muscles are all tight in anticipation.  So how do you tackle the fear of anticipated pain?

First thing is be honest with the Dentist. They will ask you if you feel something. We don’t give out awards for pain tolerance, just tell them what you feel and they will give you some more numbing agent. If it’s your second shot or later, the prior numbing agents will make these shots almost imperceptible. Seriously, you don’t have to sit there and take it. Nobody is judging you!

That being said, you may feel vulnerable sitting in the chair with someone working on your mouth. You can’t move much and you can’t talk much. That doesn’t mean you can’t communicate. Our staff will stop whatever they’re doing for you to take a break or say something when you need to. But, this vulnerability you are feeling goes back to one of our primary fears about the dentist, our fear of trust. If you have made it to the chair, you have entrusted your dentist to do what is best for you but that doesn’t mean you trust them not to hurt you. Nobody here wants to cause anybody any unnecessary pain in any way. And this is why it is so important that you communicate that you need to be more numb or that you need a bit of time. We will work with you to make you as comfortable as you can be.

Being able to trust that the dentist and staff are looking out for your best interests and will do whatever they can to prevent unnecessary pain, you can relax a bit and take your mind somewhere else. A strategy that can be effective if you can do it is to dissociate your mind from what is happening to you in the chair. To dissociate your mind requires you to focus your mental energy on a topic that will hold your attention, and keep it there. Once you have created the idea that you are going to latch onto, you can let your mind freely wander a bit, but you’ll have to circle back to your idea from time to time. Doing this is somewhat similar to spacing out while scrolling on your phone but you can’t do that during the procedure. Time sort of passes while you are thinking of this other topic and the whole time you are thinking of this other idea (a reenactment of the Godfather but with lobsters maybe?), you are not worrying about what may come in the chair. If you get snapped out of your fantasy, just gather yourself and try to focus on the topic again.

Your mind can be your hero or your Benedict Arnold. If your mind is betraying you, remember, it is a defense mechanism to what it considers the high likelihood of pain.

Another method you can use is to try to become incredibly present in the moment. Our minds default to thinking about what is to come. Change your view, stop thinking about the future at all, and only concentrate on the present moment. I am reminded of one of my favorite Zen stories about the tiger and the strawberry:

A Zen Master who, while out walking one day, is confronted by a ferocious, man-eating tiger. He slowly backs away from the animal, only to find that he is trapped at the edge of a high cliff; the tiger snarls with hunger, and pursues the Master. His only hope of escape is to suspend himself over the abyss by holding onto a vine that grows at its edge. As the Master dangles from the cliff, two mice – one white and one black – begin to gnaw on the vine he is clutching on. If he climbs back up, the tiger will surely devour him, if he stays then there is the certain death of a long fall onto the jagged rocks. The slender vine begins to give way, and death is imminent. Just then the precariously suspended Zen Master notices a lovely ripe wild strawberry growing along the cliff’s edge. He plucks the succulent berry and pops it into his mouth. He is heard to say: “This lovely strawberry, how sweet it tastes.”

One of the morals of the story is that we should focus on the strawberry (the present) and not the tiger (the past) nor the fall (the future). Focus on the present and only the present while in the chair. It’s hard to be afraid of things you are not thinking about.

Speaking more to the fear of Trust.

Dentistry has a bad reputation for overprescribing treatment. Patients know this and dentists who don’t overprescribe know it too. It is a frustrating aspect of dentistry that good faith actors have to combat the bad faith ones. The problem for the patient, is how do they know who is being honest and who isn’t.

I have a short story about my first dentist I had back in my small town in Kansas. I don’t remember the guy’s name, but I remember his terrible wood-paneled waiting room with old and used Highlights magazines for kids. Every time I went, I had a cavity. I had over 20 cavities in a four-year period! 20! I wasn’t very old, but I felt something was shady and I convinced my mom to switch to a new dentist. After the switch, I magically didn’t have another cavity for fifteen (15) years! Did my first dentist find some cavities? Maybe. But, he got greedy and it became obvious to me that he wasn’t an honest broker

How did I get to that realization?

Being a middle-schooler, maybe I was getting a bit rebellious, but it just seemed to weird to me that I got a cavity every time I saw the guy. But what really made feel something was off was when I asked them about one of the cavities, they were immediately rude and dismissive. I took those as signs of a lack of candor. Nobody really likes to be second guessed, but people who shouldn’t be trusted, REALLY don’t like being second guessed. People with nothing to hide can withstand scrutiny; those who can’t are always suspect.

We don’t mind if you have a million questions for us. We have even set up our appointment times so that you have an extended period of time to ask us questions. We will answer whatever you throw at us, and we’ll show you on the X-rays or cone beams what we’re talking about.

Practically speaking, it is hard to overprescribe treatment as a holistic dentist when our whole goal is to save as much of your tooth structure as possible. The one thing you may see from us that may be different from other offices is that we will prescribe more preventative measures. With the American diet being what it is, there will always be plenty of work for us. We want you to save your teeth and as much of the tooth structure as possible. Our more conservative treatment plans bear that fact out.

But What if I Get a Giant Treatment Plan from Your Office?

Please know, that if you have a large treatment plan, it is because we believe that that work needs to be done and those protective measures need to be taken. Another big reason you may get a giant treatment plan is that we have a legal obligation to you as the patient to describe everything we see that could be an issue. And we mean everything! What you don’t want us to do is keep issues from you, even if they are minor. Fixing minor issues today prevents major issues tomorrow. It is totally up to you and what you can make work both timewise and financially.

Fear of the Cost

Practicing dentistry from the dentist’s perspective is really expensive. Sometimes it is eye watering. But none of that is the patient’s concern. The patient is concerned with whether they can afford the work that needs to be done.

First off, preventative measures are always cheaper. The more effort one makes to getting regular hygiene visits, eating foods and drinking drinks that aren’t bad for your teeth, and taking proper oral healthcare steps at home, you will save yourself more money than you can imagine and you will stay healthier as a result.

But, if you do need the work, our office specifically keeps are prices very mid-level for holistic dentists. We do work with better materials and more types of materials, but we still keep our costs in check. Also, our office prioritizes the work based off of whether there is an infection or whether it is a wait-and-see type of issue. Not everything in the treatment plan is a five-alarm fire (or at least we hope it’s not!). There are also credit options that allow patients to make payments over time.

And, you can always go somewhere else that is cheaper. Usually that means corporate dentistry, and that usually involves a compromise on the patient experience. There are also dental schools that provide cheap work too.

Some people think dentists are fungible (easily replaceable), but that idea is usually held by people who only go to the cheapest practices possible. Those practices work in volume and if you are afraid of being over-diagnosed, well, let’s just say there are reputable and irreputable ways of making up volume.

Managing Your Fears

Simply identifying what makes you afraid gives you some power over those fears. Hopefully some of these stories and techniques make you appreciate that your fears are not unique, and that you can overcome them. Whether you come to our office or go to a different practice, we want you to beat your fear into submission and go get yourself taken care of!

In our final segment, we will talk more about how our actual office, our staff, and our techniques are set up to make your dental experience the most satisfying dental experience you have had. Our space is a comforting retreat from the stark spaces you are used to. Look for our final article on the fear in dentistry soon.