Fear of Dentistry FAQ.

Or: How I Learned To Stop Worrying And Love The Dentist

Most people manifest some degree of fear and anxiety when confronted with a dental experience, yet feel that in this regard they are somehow unique. Below are reproduced a few interchanges dealing with this subject, in the hope that knowing that this is both a common and manageable problem will assist those who are so affected.

Q: Hi, I have to get my wisdom teeth out. All four are in, the top two are in straight, bottom two are impacted. I'm really scared of getting put to sleep, also I am scared of novacain. I have anxiety towards getting put to sleep and not waking up. Will I wake up? How do they wake a person up? Will I be drowsy all day? Also if a person does have anxiety about it how can they make a person feel better, I am just very nervous about the whole thing. Will there be much pain afterward? Also one more question, I have an ulcer in my mouth-one of the wisdom teeth rubs it once in a while. Anyway the ulcer has been there for over a month, will it just go away? Should I be scared that it's been there so long? Thanks for taking time out to read this and helping me.

A: We think that in light of your generally high levels of anxiety, that you are a perfect candidate for general anesthesia. Although sleep and general anesthesia are qualitatively different, the depression of higher brain functions are not all that dissimilar. We may be wrong, but you probably don't have such fears of not awakening when you go to sleep at night. Consciousness returns by stopping the administration of the anesthetic agent or by administering a narcotic antagonist drug. If you are of normal health (this will be addressed when the doctor takes your medical history), the anesthetic medications will be normally cleared from your body in a short time. Because drowsiness does persist some time after the procedure, it will be necessary for you to be accompanied by a responsible adult when you go for the procedure. If you are still fearful of general anesthesia after discussing this with your dentist, you may want to consider intravenous sedation as an alternative; in this case, you are never rendered fully unconscious. If you experience severe preoperative anxiety, you may also want to request a tranquilizer from your dentist.

The amount of postoperative pain will depend on the specifics of the procedure; this is a topic more appropriate to ask of your dentist. In any case, analgesic medication and proper care will minimize your difficulties.

As far as the ulcer... it is likely that it is the result of injury from the wisdom tooth, and will resolve after the extractions, but we cannot answer with certainty. Again, this is a question for your dentist.

...And about your dentist... why are you not asking him these questions? Part of his job is communication. Your questions are perfectly legitimate, and he should be accessible for them and any others you may have in the future.

Q: The only thing I remember about my wisdom teeth extraction (done in the dental surgeon's office) was how quickly the anesthesia (administered intravenously) knocked me out. The surgeon's assistant had just injected the stuff in my arm and, not even a second later, I was down.

Was it supposed to kick in that quickly? And what did the assistant use to knock me out so quickly?

A: Usually, anesthesia is induced with an ultra-fast acting barbiturate, such as Brevital. Yes, and it's FAST!

Follow-up question:
Wait...a barbiturate? When I first learned about drugs, barbiturates were a no-no. What do barbiturates do in a medical context?

A: Barbiturates belong to the class of drugs known as sedative-hypnotics; they cause depression of the central nervous system, i.e., sedation or unconsciousness.

Many medications are completely legal for professional use, yet are commonly obtained and used illegally. In the United States, these drugs are strictly regulated by the Drug Enforcement Agency, a division of the U.S. Department of Justice. Drugs in DEA schedule 2, the most restricted group legal for medical use, include morphine, cocaine, barbiturates, and amphetamine. These are perfectly legal and appropriate to use by those properly licensed and trained to use them. Schedule 1 drugs, such as LSD and heroin, are not legal for clinical use, and may only be used in research under special license from the DEA.

Q: Help! Please give me some reassurances if you can: I need to go to the dentist, I know that. I have visible cavities in several of my teeth that I know need serious help. I have not been to the dentist in at least three years. Here is the reason: I hate needles, I hate people leaning over me, I hate the fact that my mouth is so small that my jaws hurt after every dentist visit from stretching too wide, I hate people treating me like I'm stupid, I hate the fact that I am so sensitive to pain that I need three or four shots every time, and I hate the fact that I have bad reactions every time to the pain medications! Last time I went, they gave me Lortab - I spent six months on anti-ulcer medications to counteract what that did to my stomach! Before that, I tried Ultram, I'm not sure which did worse to my stomach! And neither really helped the pain! The only time I actually did well with a dentistry procedure was when I got my wisdom teeth out and they did that under general anesthetic! Help! I don't want to end up with false teeth, but I get upset even thinking about enduring another trip to a dentist!

A: You are not the only one who hates needles, holding your mouth open for long periods of time, who needs multiple anesthetic administration, and who hates situations in which self-control is relinquished to an extent.

What distinguishes you and those like you is that through accumulated past experience and/or your personal temperament, you have developed an aversion sufficiently strong to deter you from treatment you know is necessary.

As dentists, we are unqualified to diagnose or treat phobic behavior. However, unless you are very lucky, you will need to face down demons far worse than these in the course of your life.

We will not sugarcoat dentistry for you, but it is fair to say that objectively, you will perceive it to be far worse than it is due to your heavy psychological overlay. A caring, compassionate dentist will arrange for sufficient time for your appointments, allowing adequate time for sufficient anesthesia, mouth rinsing, resting, whatever you need within reason to get the job done. If this is still not possible, there are dentists who will render treatment under general anesthesia or sedation. There are always options.

If you cannot bring yourself to make that appointment, there is always psychological counseling. Dental phobia is a common affliction. This is partially due to the nature of the treatment itself, and (unfortunately) partially due to the demeanor of some of its practitioners. In any case, you are certainly in good company.

Q: Hello dentists. Out of all the people you see all day long, would you say about half of them are pretty fearful of being there? or what percentage?? Are children better than adults in this area or worse??

A: Psychologists use quantitative psychometric testing to measure things like fear, perceived pain, etc. As dentists, we are unqualified to answer your question in a meaningful way, other than to give you our subjective impression.

We would say that roughly half the patients we see during the day show some signs of anxiety while sitting in the dental chair. The percentage is about the same for children. This, of course, does not include the unknown number of people whose fear is sufficiently strong to prevent them from coming to our office.

We would also say that depending on the patient, the dentist is also fearful;-) For all involved in the dental setting-- patient, dentist, and staff included-- it may be useful to apply Plato's timeless dictum: "Be kind, for everyone you meet is fighting a hard battle." There is no more appropriate course of action when encountering anxiety and fear than for all to use a little empathy and compassion.

left arrow Back to FAQ Contents     Next: Bad Breath, Bad Tastes, and Other Unpleasantness right arrow