I had a bad experience at a dentist where my heart started racing and I felt like I was going to pass out.
“Basically, I am very scared of the dentist and have been as long as I can remember.
It’s now been a long time since my last dental visit and I now have several teeth that need. Can you tell me about the steps you take with nervous patients and how you achieve ‘no pain’?”
– Question from Jamie of McDowall in Brisbane
I see this quite often and there are a number of possible reasons
A number of dental anaesthetics have adrenaline in them so it's possible that if you are having an injection it could nick a blood vessel and the anaesthetic can get into the blood giving you a spike in adrenaline. Also, the anaesthetic can be absorbed through the tissues into the bloodstream anyway. This can give some patients the feeling that their heart is racing.
In reality, the amount of adrenaline that might be absorbed from the anaesthetic is only a small fraction of what the body can produce. Most of the ‘heart racing’ reaction, while some of it may be triggered by the adrenalin in the injection, is mostly from the patient’s own body as a consequence of their anxiety.
We recently saw a person who was in her thirties and it was their third visit to the dentist. They had been once as a child, once as a teenager to have wisdom teeth removed, and then this appointment in their thirties with a painful toothache.
The longest time between dental visits of all the patients I have seen is 26 years. Unfortunately, a lot of damage can occur in 26 years as pain only comes about once the damage gets very deep whether the tooth is abscessed or decayed.
I have treated a number of patients over the years that have had panic attacks, and it isn’t always at the beginning of the treatment. Sometimes it can be as we are finishing up.
Recently a gentleman told me how much he had to talk himself into not only making the appointment but also to walk in the door. He was so worried that his fear would result in him passing out.
Many times these sorts of fears are anchored in a childhood dental experience, just like you associate some feelings or memories to a smell or sound. As these feelings are ones based on a bad experience they can be extremely deep-seated.
Even my own sister, before she comes and sees me will get a nervous rash on her neck and chest. I have been her dentist for 25 years but she says this all stems back to a bad dental experience she had when she was 10 years old.
The very best thing a patient can do is talk to us and let us know how they feel. In my experience, the biggest help is having someone who is empathetic, listens without judging, and tries to understand how you feel. Then, together you can explore all the options. In many cases, building of trust and confidence of someone can set a patient's mind at ease enough to get past their dental fears.
For some patients, where the thought of the dentist is far worse than the reality, we can prescribe Valium before the appointment to ensure they get a good night's sleep the night. It is amazing the difference a full night of sleep can make before they come and see us and hop in the chair. Sometimes we will suggest Ibuprofen or anti-inflammatory medications before the appointment to reduce discomfort and swelling in the tissues. But remember to always tell your dentist about any medications you may have taken before you see them.
Once they are in the appointment we can use Nitrous oxide (also known as ‘Laughing gas’) during the appointment to really put them at ease.
Now while a lot of this treats the nervous symptoms you have to remember about pain is that it has a very high emotional component. If you are up tossing and turning the night before, worrying about what is going to happen, then you will be in a worse state in the morning.
In reality, we can control 99% of any physical sensations you experience during the appointment using topical anesthetics and the other drugs we mentioned but as dentists, it is important that we treat that emotional component as well.
Any dentist can treat their patients with a near pain-free approach. For us at Today’s Dentistry it comprises of two things:
Ultimately the most important tip I have is to make an appointment with the dentist to discuss your concerns and just check them out. By making a non-clinical appointment, talking with a dentist, you will quickly see if there is a personal connection there, if you trust them and have confidence in them then that will make a big difference to your fear.
I believe dentists have to earn their patient's trust, it isn’t something that we get automatically. We encourage people in this position to just come into our practice, meet our staff and check out the place. I cannot overstress how important it is to be non-judgmental about how long it has been since patients last went to the dentist or what treatments they may have chosen in the past. The dentist’s role is to make them feel as relaxed and comfortable as possible so we help them get the very best out of their dental health.
almost luxurious experience.
I highly recommend this dentist, especially if you suffer with anxiety or a fear of dentistry."
Your first visit at Today’s Dentistry is all about creating a Dental Roadmap so you know exactly what condition your teeth and gums are in, and what your options are for treatment.
Your first appointment includes: