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Dental
Prevention: by
John
Gilbert, DDS |
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FREE! |
Statistics show that between 40 and 50 percent of Americans never visit the dentist unless driven there by severe pain. Although concern about cost keeps some people from seeing the dentist, the overwhelming majority say that fear is the reason they stay away. Now there is help for the dental phobic, and for the average person as well. Psychologists are able to teach people to reliably overcome fearful situations, and modern dental techniques can all but eliminate pain. Why Not Wait Until it Hurts? Many of us put off going to the dentist until we must. The price we pay for doing so is more treatment, increased cost and more pain. A small filling that may cost around $100 will require a crown that costs $600-$700 if treatment is delayed too long. Wait longer and you face a root canal treatment and crown for about $1200-$1500, or an extraction and a bridge for about $2100. With enough time and tooth loss, dentures are required. Most people don't realize that the beginning stages of tooth decay does not cause any pain. Pain only occurs when the problem become more serious and there is infection present. The catch is that dental anesthetic doesn't work well when there is infection present. Few dentists mention this important fact. People just assume that it hurts because they need more anesthetic than average, or that they are harder to make numb. Helpful Hints for Everyone There are a number of things anyone can do to decrease their anxiety and discomfort at the dentist. First, remember to breathe. Many people hold their breath without realizing it whenever, they feel discomfort, and particularly during the injection. Lack of oxygen increased anxiety and magnifies pain. Concentrate on keeping your breathing slow and steady. Another thing most people do is to focus their attention on the area where the dentist is working. Attention amplifies pain! Instead, focus your attention on a part of your body as far away from your mouth as possible. Focusing on the rise and fall of your abdomen as you breathe is a good way to combine these first two techniques. People who are good at visualization will often visualize what is happening in their mouth, even to the point of imagining the needle as it penetrates. No wonder they are anxious! Instead, imagine yourself in a pleasant place such as the beach or lying beside a mountain stream. Take your consciousness elsewhere. If you trust your dentist, there is no reason for you to stick around and supervise. If you don't trust your dentist, find another dentist! Having a dentist who is patient and not in a hurry is very important. Dental injections hurt much less if they are given slowly and carefully. Finally, dental anesthetic contains epinephrine (adrenaline). This substance produces symptoms that feel the same as anxiety, and there is enough in a dental injection to affect sensitive individuals. If you find yourself more anxious after the injection, ask your dentist to use an anesthetic without epinephrine. The anesthetic will wear off a little sooner, but in most cases this is an advantage rather than a problem. One additional item: lack of sleep, lots of caffeine, and high doses of vitamin C taken before a dental appointment seem to prevent the dental anesthetic from working properly. What About Nitrous Oxide or Drugs? Although many people swear by nitrous oxide, other individuals find it makes them feel very uncomfortable. In addition. long-term exposure to small amounts of nitrous oxide has been linked to miscarriages in dental assistants, dentists and the wives of dentists. Nitrous oxide can also cause death if it is not administered properly. Other drugs can have unwanted side effects, including the need to have someone drive you to the dental office. Not only is it dangerous to drive after taking medications to help you relax, your dentist can held liable if you have an accident after leaving the office. I prefer to use natural means to deal with anxiety whenever possible. When More Help is Needed The techniques I have described may not be enough for the truly terrified. Lying awake the night before your appointment compounds the problem. Not only do you feel lousy, but lack of sleep decreases the effectiveness of the dental anesthetic. A high level of anxiety not only amplifies pain, but makes any sensation (pressure, vibration) feel much worse. This is the time when an experienced psychologist can be a tremendous help. "But I'm not crazy," you might say. Today's psychologists do much more than work with "crazy" people. A therapist who is trained to work with phobias will have a number of techniques that can be helpful. These include hypnosis, progressive relaxation and graduated exposure both in imagination and in real life. You do not need years of therapy to get help. If you are thinking that therapy is too expensive, remember the cost of putting off dental treatment. Overcoming your fear of the dentist will not only make you feel better, but will literally save you thousands of dollars on dental treatment. For those of you with children, it is not just your own comfort that is at stake. You will pass your fears on to your children, even if you never mention them. Children almost always grow up with the same attitude toward dentistry as their parents. What to Do: Advice
for the Dentally
Challenged 1.
Get
regular treatment. It's much less painful and less expensive
in the long run. 2.
Find
an understanding dentist who is willing to take the time to
work with you. Overcoming anxiety takes time; don't give up. You may
need to try more than one dentist. 3.
Practice
the techniques outline here before your appointment,
rather than waiting until you are actually at the dental office. It
takes time to learn new behaviors, and no one learns well when they
are under stress. 4.
Don't
be afraid to seek help. Everyone needs help at some time or
other. Consulting a psychologist is nothing to be ashamed of, and
just a few sessions can sometimes make a big difference. 5. Remember, the hardest part is usually just showing up for that first appointment.
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