By Dr. Roderick Stewart DDS
The office is pleasantly decorated and the receptionist is cheerful and friendly. The music is relaxing and there is a good selection of magazines in the reception area. But you’re not thinking about those things. Instead you sit uncomfortably in your chair, your heart is pounding and your breathing is rapid. You haven’t slept in two nights and you’re hungry because you haven’t eaten. You just want to get up and leave except the constant pain in your jaw makes you stay. You wonder how much more you can take and the idea of someone touching your sore tooth terrifies you.
This scenario may sound extreme, but for some it’s very real. Fear of going to the dentist is a common condition. It has been reported that between 6 % and 14% of the population voluntarily avoid seeking dental care because of their fear of dentistry. They delay treatment until they are in such pain that home remedies are no longer effective. At this stage, their dental condition is compromised to the point of requiring complex treatment that further increases the person’s anxiety. However, if a dentist properly addresses a person’s fear, this cycle of fear and avoidance can be broken.
Fear and anxiety of dental treatment can vary in intensity. It’s usually a learned response acquired from personal experience or through the experience of others. Sometimes, this response can be “unlearned” through subsequent positive experiences. Other times, the response is so deeply embedded in the person’s emotions, it cannot be rationalized away.
Management of a fearful patient requires a dentist to acknowledge the patient’s fears as being real (which they are) and incorporating a variety of methods to eliminate the reaction. All dentists are taught basic understanding and management of the fearful patient in their dental training. Some dentists have recognized the importance of managing patient fear and need for increased comfort and have taken additional training in more advanced techniques.
The basis for effective management of a patient’s anxiety starts with a simple consultation, in a non-clinical setting. The dentist can learn about the patient’s concerns and allow the patient an opportunity to fully express their needs and desires in obtaining dental care. As well, this allows the patient to start to get to know the dentist and their support team. A good rapport between the patient and the dentist based on trust and understanding is essential for a good outcome. This is not a difficult step, it just takes time.
Dental anxiety can be reduced with sedative medications, hypnosis or acupuncture. In Canada, the use of sedation medications has become the standard for dentists who focus on managing patient anxiety. These can be administered orally (with a tablet or liquid), injection or as a gas (“laughing gas”). Each option has its advantages and limitations, meaning each patient’s requirements need to be assessed individually.
Modern medications are safe and effective. Some medications will produce a light sedation that wears off quickly afterwards. They can allow the patient to drive home and carry on a regular routine. Heavier sedation requires that the person be escorted afterwards and takes several hours to wear off.
Yes, it’s possible to relax at the dentist’s office. When you talk to your dentist about your fears they’ll be able to work with you to alleviate many of your doubts and concerns. Talking to your dentist about your fears is your first step to getting appropriate dental care.
Dr. Rod Stewart and Dr. Opie Chari practice at Mount Joy Dental on Main Street, Markham. For further information contact 905.294.9905 or www.mountjoydental.com
2600 John Street, Unit 207, Markham, ON L3R 3W3 T: 905.475.5222 F: 905.475.6369
