With so many people afraid of dentists, I interviewed Dr. Stough about his dental perspective on treating patients with dental fears and phobias.
What are the most common fears and phobias patients experience when going to the dentist?
In my national survey on dental practice stress sent to dentists in 2001, we found the No. 5 cause of practice-induced stress among dentists was dealing with patient anxiety. Therefore a patient's fears and phobias are passed on to the dentist who is going to be treating them.
The most common fears of going to a dentist include:
What can a dentist do to help people with these dental fears?
The dentist should first realize that a fear of the dentist often stems from past experiences, perhaps as a child, and in the case of adults, is difficult (but not impossible) to overcome.
Naturally, fear of injections, reactions to dental office smells and sounds, feelings of lost control and the intimacy of the treatment area are stressors to most all patients in varying degrees. I experience some[thing] similar when I'm in the dental chair. People find that amusing, but I assure them a surgeon no more wants surgery than I want to have a crown done. I know all will work out, but I'm still human. Still, there is so much we can do to minimize fears and anxiety in most cases.
There are a number of medications taken by mouth or intravenously that are safe and effective by trained professionals in extreme anxiety cases. There may be increased cost to the patient but often times it can be worth it. There is always nitrous oxide gas, which is safe and also effective, except in extreme cases of anxiety. I recommend and use these as a last resort, because in most cases, I consider them a crutch and would prefer overcoming dentist fears by methods of trust, touch, reassurance, humor, reminding them that they are in control, providing information and by gentle dental care.
Fear of injections is at the top of the list of fears and phobias for most patients. Once a dentist helps a patient overcome that fear, most of the other things take care of themselves. In truth, 90% (if not more) of the injections should not be painful. If the dentist uses topical anesthesia application properly, goes slowly, uses smaller caliber needles (when possible), infiltration methods that block injections when feasible, mepivacaine (which is less acidic and less painful [when] followed by stronger anesthetics). Also, by speaking in calming and sincere tones, most patients have virtually no discomfort and soon overcome most injection fears. Giving an injection is no time to be in a hurry!
Eliminating distasteful sounds is often a problem, but they be can minimized. Some of the newer hand pieces (drills) are very quiet. We have a TV and a water fountain in the reception area. I've found most patients prefer the TV off and consider the trickling water sounds more soothing.
Televisions in treatment rooms, which can also be used in conjunction with an intraoral camera and video education, are common today. The use of headphones, where patients can listen to music of choice, is also gaining popularity. Calming color combinations, artwork depicting serene scenes and large windows to reduce the feeling of confinement are also important treatment room additions.
