How many people can say that their occupation requires them to have an intimate understanding of fear and anxiety? As a dentist with many years of experience, understanding fear is fundamental to my job. The most common sentiment among my patients is that they like me, but hate the dentistry. “No offense!” is a phrase I hear all too often, and truthfully, I don’t blame them. There are many reasons why people are afraid of coming to the dentist and most are legitimate. So why are so many people afraid of the dentist? You might be thinking to yourself that the answer is simple. Generally, and quite obviously, the fear stems from the possibility of dental pain.
However, if we dig deeper, we realize that the reasons for patient fear and/or anxiety are varied. The most common reason for fear is the result of a patient’s recollection of a traumatic experience when the dentist caused him pain or embarrassed him by making light of his fears. Strong, negative memories of the incident can recur whenever the patient needs to see the dentist. On the other hand, a large number of people are afraid of the dentist or certain procedures, but have never personally had a bad experience at the dentist’s office. These are the patients who have heard that dentistry is painful and learned to be fearful. The source of their information is usually friends, family or the popular media. A perfect example of learned fear is the child who is visiting the dentist for the first time. I sometimes hear fearful patients in the waiting room creating a negative impression for their children. The child does not know what to expect from that first visit, but when a parent says, “tell the dentist if he is hurting you,” the child is now expecting pain. In addition to the fear transferred from friends and family, dentistry has taken a beating in the popular media. Can you remember a television show or movie where a dentist is portrayed in a positive light? The likely answer is a resounding “No!” There is even a horror film called The Dentist.
The three most common fears associated with dentistry are:
– The potential for pain during dental treatment – will it hurt?
– Fear of the condition of their mouth – just how bad is it?
– Loss of control during dental treatment – will he stop if it hurts?
Dental treatment always has the potential to produce discomfort as there is no such thing as 100% pain-free dentistry. Trust me, I find absolutely no pleasure in bringing pain to anyone. On the contrary, I truly believe that in addition to good technique and a gentle touch, helping a patient to achieve full anesthesia is a requirement of the job. What I or any other dentist can do to make it a pleasant experience is make sure that the patient is profoundly numb and to be aware of his needs as he is being worked on. When my patient tells me, “that wasn’t bad at all,” I take it as a glowing compliment. Many of my new patients are scared to learn about their oral condition. While it is normal to fear for the worst, it is important for the patients to realize that if there are pre-existing conditions, they will only get worse with time. Tooth decay does not improve on its own. To alleviate the stress, I tell my patients that no matter how bad the results, I will advise and help. Regardless of the outcome, with knowledge and support, we will find solutions that meet their needs and expectations. The last reason for fear is a lack of control.
When meeting a new dentist, you do not know how good he is technically and you are trusting him to take care of you. That is putting a lot faith in someone you just met. You are effectively giving a stranger access and control over a private part of your body. A person in that situation does not know what to expect and the unknown is scary. Upon meeting a new patient, I usually ask him if he has any special concerns, educate him on the procedure I will be performing, and assure him that if he feels even the slightest hint of discomfort, to please let me know. Should he experience any discomfort, I will stop immediately and inquire about what exactly he is feeling. I try to return some of the control back to the patient.
As you can see, there is an overarching theme – the fear of the unknown. Those who are most afraid of the dentist have allowed their imaginations to run wild because they do not know what to expect. When I meet a patient for the first time, I usually perform a new patient interview which serves two purposes:
(1) to get to know the patient and to gauge his expectations; and
(2) for the patient to get to know me and to have any questions answered.
Communication between the dentist and the patient is of utmost importance. I have found that 99% of the time, knowledge resolves their fears. My role as a dentist is to understand a patient’s expectations, improve his dental health, and then to educate him on how to avoid dental problems in the future. I do not expect my patients to ever enjoy dentistry, but as long I can help them understand their needs and make it a relatively pleasant experience, I’ll take that as a successful outcome.