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Thursday, April 9, 2009

Dental Fear - How to Make Dental Visits a Breeze

Dental fear is the name given to a range of uncomfortable feelings associated with a visit to the dentist, or even an imagined visit to the dentist. It may be a mild feeling of anxiety accompanied by muscle tension, anxiety to the point of panic attacks or fainting, or terror so great that the person chooses to live in extreme pain rather than make that dreaded visit.

As a result, people avoid the dentist, or visit less often than they should, and suffer degraded tooth and gum health, pain, loss of teeth and bone loss from the jaw, periodontal disease, abscesses that eat away the bones of the face, and even heart disease as a result of germs entering the blood stream via the gums and then directly targeting the heart.

Other outcomes involve embarrassment or shame about the appearance of the mouth, or about mouth odour. The person often attempts to hide their teeth, avoids smiling, and tends to avoid other people, withdrawing socially and stalling in their career.

This fear is not only severe and of enormous consequence, but it is also widespread around the world.

With a mere 21 percent of the population claiming they feel no anxiety about going to the dentist, dental fear is clearly something experienced by the overwhelming majority of people, ranging from mild anxiety, right through to full-blown distress so severe that the sufferer simply cannot attend a dental clinic.

What causes this dental fear? Most experts believe that it is related to scary dental experiences earlier in life, or to scary stories about dentistry being told to children, or related to abuse or trauma that is re-triggered by the dental experience.

Lots of people can recall particularly awful dental experiences from their youth. In my own case my father, who was a carpenter/builder but I think imagined himself as a dentist, used to pull our loose teeth with nail pliers. These days that seems hilarious to the entire family and now we have great fun teasing him about it at every opportunity. But of course at the time it was traumatic, and the effects were lasting.

Given the "skills" and "technology" and attitude of dentists of years gone by (and unfortunately by some dentists even these days) it is only surprising that more people aren't terrified!

Let's face it, when we're laying back in that chair surrounded by equipment, the dentist, and the dental nurse, our mouth full of stuff and unable to communicate, if we don't trust the professionals who are caring for our teeth and gums, who wouldn't be uncomfortable, to say the least!

We need to know that these people are skilled enough to be entrusted to the task, and that they're aware of and care about our comfort at all times. Dental professionals who don't have those attributes don't deserve to practice.

This article has been written with two aims:

1 To help sufferers understand that they can have total control over the entire dental experience. That they can select skilled dentists worthy of their trust, and that they can manage themselves and their dentist for a great outcome.

2 To tell sufferers how to become ex-sufferers, explaining new techniques which actually switch off those old scared responses so that when they think about dentistry, they actually feel quite relaxed. In some cases, the person will now visit the dentist feeling quite excited instead of nervous, because they know they are safe at their dentist's, they feel deeply OK about it, and they're looking forward to a new, brighter smile!

I probably should re-assure you immediately on that last point, simply because it probably seems such an outrageous statement, to claim that even extreme anxiety (even to the point of full blown panic attacks) can be utterly eliminated.

You need to know that psychology has made huge advances over the last 12 years, and particularly over the last 5 years. However the majority of psychologists today still do not make use of these advances, either because they haven't encountered them and are thus ignorant of them, or because they have briefly reviewed them and discounted them. Many psychologists are very reluctant to give up their current "gold standard" of treatment, which is CBT, even though so many studies show that CBT is no more effective than placebo (a "dummy" or "fake" treatment).

Also, many psychologists are convinced that early trauma needs to be understood in a broader context, that the person needs to develop greater understanding of themselves, needs help to feel empowered, and that talking and understanding are the most important part of therapy. This can certainly be the case (and very often is in my own practice) but NOT for most people when it comes to dental fear.

For most people this stuff can simply be wiped out, in very few visits, with no fuss. Unfortunately the psychologist often thinks they have the right to decide what the client will get, so the client comes along for dental fear, and gets subjected to something they didn't want and didn't need. I consider that to be not only unnecessary, but an invasion of the client's privacy and in some cases an arrogant expression of power over the client.

In my view if the client wants a relatively inexpensive and fast treatment that will simply eliminate the presenting problem, they are entitled to get it. If they have a good experience, and decide they would like to work more in depth for even more benefit, then that will happen at a time of their choosing, not of mine.

The method that I use to help my clients is called BMSA (Brief, Multi-Sensory Activation) but you may not have heard of it. It always takes time before new methods are accepted, and when it comes to BMSA things are no different.

BMSA works by "confusing" the old signals that used to lead to feelings of distress. For example you might have had a thought "I need to get my teeth seen to", immediately followed by a brief imagined "movie" of being in the dental chair, causing you to promptly break out in a cold sweat. BMSA has several different ways of taking the thought, and the movie, and "switching off" the emotional or physical response to it, so that you can think the same thoughts and imagine the same scenario, but feel effortlessly calm and in control.

The beauty of BMSA is that you can actually learn to do it for yourself, and that the effects are usually permanent.

In addition to using methods like BMSA, it's important to realize that your choice of dentist is crucial. No-one can expect to feel calm and in control if they don't know what's going on, or don't know what's going to be happening next, or if they have a deep distrust that their dentist even cares about their level of comfort.

How do you choose a dentist? Certainly not through an advertisement for a dentist, or through Yellow Pages! The best way to choose a dentist is by asking friends and family members whom you trust, and then by calling the dental surgery to ask specific questions about the practice, such as their attitude to anxious clients, how they manage anesthesia, and to get an idea of their level of care and respect for their clients.

With your dental fear behind you, and with a dentist you know you can trust, dental visits will become a breeze, and you can smile with a lot more confidence!

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