Dr. Robert Rose recently saw a new patient who hadn’t been in a dentist’s chair in more than 40 years. “The last time he was at a dentist, he wasn’t given novocaine before they started his dental procedure,” says Rose, of Devon Dental Associates in Wayne.
Now in his 50s, the patient described the pain he felt all those years ago as nothing less than excruciating. This was prior to the emergence of “pain-free” dentistry.
“Dental phobia is a very real phobia,” says Rose. “It’s not to be taken lightly; it’s a real fear, and patients shouldn’t be ashamed to have that fear.”
And while the fear seems to dissipate with each generation, dental phobia continues to be an ongoing problem. And it’s much more than the common nerves more than a few of us feel at our semiannual dentist visit. While as many as four out of five Americans report being afraid of the dentist, it’s estimated that one in seven Americans ignore getting dental treatment at all because of dental phobia. Call it an extreme version of the common dental anxiety that most people experience, preventing any interaction with a dentist.
People with dental phobia have a higher risk of gum disease and early tooth loss. They may also have to live with stained or chipped teeth, pain and undiagnosed periodontal disease. The latter has been connected to heart disease, diabetes and kidney disease.
People develop this condition for a variety of reasons. Aside from negative past experiences, a common cause is the fear of not being in control, of being unable to see what’s happening in their mouths, of not knowing when and if they’re going to feel pain. “It’s crucial that the patient knows they’re in control,” says Dr. Barry Cohen, who’s treated many patients with dental phobia during his 30-year career.
He tells those he sees at his Drexel Hill practice to raise their hands during a treatment if they want him to stop. “A person sitting in a dental chair is extremely vulnerable,” he says. “It takes a lot of time and work to deal with patients who have dental phobia. It’s the dentist’s job, as well as the rest of the dental staff, to make sure the patient feels comfortable.”
The best way for patients to feel at ease is by the dentist communicating with them and letting them know what is going to happen during the visit. “As dentists, we have to gain the patient’s trust,” says Rose. “You want them to trust that you’re not going to hurt them.”
A patient should ask for a step-by-step description of the procedure. “I’m always up-front with a patient,” says Rose. “I’ll tell them when they’ll feel pressure or a pinch. A patient needs to know what to expect.”
It’s possible to overcome dental phobia with proper treatment. Avoiding and dismissing the fear is not the answer. In some cases, it may be appropriate to administer local anesthetics, nitrous oxide or oral sedatives to alleviate some of the anxiety. For the most extreme cases, Rose recommends his Single Day Dentistry program at Bryn Mawr Hospital. It provides comprehensive multidisciplinary care in a hospital setting for the mentally or physically challenged, severely phobic, or medically compromised.
Rose’s brother, Louis, started the program in 1974 at the Medical College of Pennsylvania. It evolved and continued until 2003, when the college closed. In 2004, Rose’s brother re-established the program, which allows patients to receive multiple treatments from various specialists in a single day. “We take every precaution during this process,” says Rose. “In many cases, after the program, the patient can come in for follow-up visits.”
Dentists also realize that it’s never too early to make a good impression on future clients. Cohen opens his office to preschoolers and kindergarteners for tours. “We let the kids ride in chairs and let them hold the instruments,” he says. “We let them know that the dentist’s office is not a scary place.”
Most times, kids are less anxious and afraid than adults. “I recommend that parents get their kids in when they’re young,” says Cohen. “Around 3 years old is the ideal time.”
Parents should be positive when talking to their children about the dentist, avoiding words like “pain,” “scared” or “hurt.” Cohen even has televisions in the examination room to help distract his young patients. “Putting on SpongeBob for the kids is sometimes as effective as using novocaine on adults,” says Cohen.
And there’s nothing scary about SpongeBob—or the dentist.
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