| |
| Some
people don't look forward to dental appointments
any more than they look forward to visits
to a physician. Most dental procedures
aren't painful, but just being examined can
make people feel stressed. |
|
| Some anxiety about
going to the dentist can be considered acceptable. |
| For those with dental
phobia, however, the thought idea of going
to the dentist is terrifying. They may be
so frightened, in fact, that they'll do just
about anything to avoid a dental appointment.
A phobia is an intense, unreasonable fear
of a specific activity, object or situation. |
| People with dental
phobia routinely put off routine care for
years or even decades. Rather than make an
appointment, they'll put up with gum infections
(periodontal disease) , pain, or even broken
and unsightly teeth. |
| Dental anxiety and
phobia are extremely common. It has been estimated
that 9 to 15 percent of Americans ? about
30 to 40 million people ? avoid seeing the
dentist because of anxiety and fear. A survey
commissioned by the British Dental Health
Foundation found that 36 percent of those
who don't see a dentist regularly cite fear
as the main reason. |
| People often use
the words "anxiety" and "phobia"
interchangeably, but they aren't the same
thing. Those with dental anxiety will have
a sense of uneasiness when it's time for their
appointments. They'll have exaggerated or
unfounded worries or fears. |
| Dental phobia is
a more serious condition. It's characterized
by objectively morbid fear or dread. People
with dental phobia aren't merely anxious,
but terrified or panic-stricken. |
| People with dental
phobia have a higher risk of periodontal disease
and premature tooth loss. Apart from the physical
consequences of avoiding the dentist, there
may be emotional costs as well. Discolored
or damaged teeth can make people self-conscious
and insecure. They may smile less or keep
their mouths partly closed when they speak.
Some people can become so embarrassed about
the cosmetic qualities of their teeth that
their personal and professional lives begin
to suffer. There may be a serious loss of
self-esteem. |
| Sedation Dentistry
is very helpful for any patient
that has a dental phobia or anxiety. |
| Read
more... |
|
There are varying degrees of dental
anxiety and phobia. At the extreme,
a person with dental phobia may never
see a dentist. Others may force themselves
to go, but they may not sleep the night
before. It's not uncommon for people
to feel sick? Or, in some cases, to
actually get sick ? while they're in
the waiting room. |
|
| Dental phobia, like
other mental disorders, can be treated. Without
treatment, dental phobia is likely to get
worse over time, in part because emotional
stress can make dental visits more uncomfortable
than they need to be. People who are unusually
tense tend to have a lower pain threshold,
which means they may experience pain at lower
levels than other people. They may need additional
anesthetic or other pain treatments. They
may even develop stress-related problems in
other parts of the body, such as headaches
or muscle stiffness in the neck or back. |
 |
Pain
is among the main reasons people go
to the dentist. It's also what keeps
them away: Some
35 million Americans are so afraid of
pain that they won't go anywhere near
a dentist's chair until a toothache
gives them no other choice.
"I was probably 10 or 11 years
old when I had a tooth pulled and it
was excruciating," recalls Jim,
56, an account executive "After
that, I never went to a dentist unless
I was in pain."
It took Jim more than four decades —
and a push from his daughter, who wanted
to see him smiling in her wedding photos
— to get some long-needed dental
work done. Most people don't wait that
long to have cavities filled or their
teeth repaired, but the anxiety they
experience is no less severe. More and
more dentists have begun offering some
form of sedation to make the experience
a little easier.
People
who have had painful experiences in
the past will understandably be dubious
when they're told that most dental procedures
today are nearly pain-free. A
shot or two of novocaine will make your
jaw or teeth numb, but there's no getting
around the fact that it's an uncomfortable
experience. And the more apprehensive
people feel, the more uncomfortable
the procedure is likely to be. |
| There are
many reasons why some people develop
dental anxieties and phobias.
A few common themes emerge. Pain.
In a survey of people who had
not seen a dentist for 12 months,
6 percent reported fear of pain
as the main reason. The fear
of pain is most common in adults
24 years and older, probably
because their early dental experiences
predated many of the advances
in "pain-free" dentistry.
Feelings
of helplessness and loss of
control. Many people develop
phobias about situations —
like flying in an airplane —
in which they feel they have
no control. When they're in
the dental chair, they have
to stay still. They may feel
they can't see what's going
on or predict what's going to
hurt. It's common for people
to feel helplessness and a loss
of control.
Embarrassment.
The mouth is an intimate part
of the body. People may feel
ashamed or embarrassed to have
a stranger looking inside, especially
if they're self-conscious about
the appearance of their teeth.
Also, the physical closeness
that occurs during dental treatments
— the dentist's face may
be just a few inches away —
often makes people anxious and
uncomfortable.
Negative
past experiences.
Anyone who has had pain or discomfort
during previous dental procedures
is likely to be more anxious
the next time around, as is
someone who has been told how
painful dental procedures are.
|
|
|
| Sedation can make
a difference. Apart from the fact that sedating
drugs have some analgesic (pain-killing) effects,
they also reduce fear and anxiety. It's an
option for people who are too afraid to go
to the dentist any other way. |
| Getting
sedated doesn't necessarily mean that you'll
be "out" for the duration of the
procedure. This is certainly an option,
but most dentists prefer “conscious
sedation,” in which patients are awake,
but relaxed or drowsy. |
| Some
people have no anxiety undergoing treatment.
Others find it difficult to even enter the
dentist's office. If you are nervous or fearful
about dental treatment, sedation can help
relax you, making your experience easier and
more pleasant. |
| Although your dentist
may explain the procedures to you and ask
if you have questions, he or she may not perceive
or understand your fears. Also, if your dentist
doesn't know you are anxious, he or she may
not suggest sedation as an option. Talk to
your dentist about your anxiety. That may
be enough to relax you. If not, there are
many anti-anxiety drugs that can be used during
dental treatment. Your dentist can even give
you one before your appointment, to use if
you have trouble sleeping the night before.
If you are given an antianxiety drug to take
the night before, you should arrange to be
driven to and from the office. Also, avoid
alcohol and over-the-counter sleep aids, because
they can react with sedating medications. |
| Nitrous oxide is
a common inhaled anti-anxiety drug given just
before treatment starts. Diazepam (given in
pill form) and other similar drugs can be
given 30 minutes to an hour before treatment
or the preceding night. Diazepam and other
oral sedatives do not provide pain relief.
You also will receive a local anesthetic injection.
Children often receive antihistamine-type
sedatives (such as hydroxyzine), which can
cause significant dry mouth. |
There isn't
a clear boundary that separates
"normal" anxiety from
phobia. Everyone experiences various
fears and concerns and copes with
them in different ways. However,
the prospect of dental work shouldn't
fill you with terror. If it does,
then you may need some help overcoming
the fears.
Some
of the signs of dental phobia
include:
- You feel tense or have trouble
sleeping the night before
a dental exam.
- You get increasingly nervous
while you're in the waiting
room.
- You feel like crying when
you think of going to the
dentist. The sight of dental
instruments — or of
white-coated personnel in
the dentist's office —
increases your anxiety.
- The thought of a dental
visit makes you feel physically
ill.
- You panic when objects
are placed in your mouth during
a dental appointment or you
suddenly find it difficult
to breathe.
|
|
Depending
on the doses and types of sedatives
used, different levels of sedation are
achieved. Dr Perry might consider deeper
levels of sedation for complex procedures
or if you are more anxious.
Anxiolysis. Very light sedation, usually
induced by nitrous oxide. It provides
a feeling of having no worries.
Conscious sedation. Medium sedation
induced by nitrous oxide or intravenous
drugs. Your gag reflexes still work
and you can respond to commands.
Deep sedation. You are somewhere between
conscious and unconscious, but closer
to unconscious. You experience a partial
loss of your gag reflex and you cannot
respond consistently to stimulation
or commands. You may also be unable
to keep your airway open for breathing
independently under deep sedation.
General anesthesia. You are unconscious
and cannot keep your airway open for
breathing or respond to commands or
stimuli. Usually, an endotrachial tube
will be used to assist with breathing.
|
|
| If you will be receiving
nitrous oxide, eat lightly before and after
your appointment. After your dental procedure
is over, you will receive oxygen for several
minutes to clear the nitrous oxide from your
system. If your dentist just takes off the
mask without giving you oxygen, you can experience
headache or other side effects. These are
rare, however, with the 25 to 40 percent concentration
of nitrous oxide typically used by dentists.
|
| If you are taking
medication for psychiatric conditions, talk
to your dentist before receiving any sedative. |
|
