Sweaty palms and palpitations just at the thought of going to the dentist? Do not worry - you are not alone! A study in 2015 found that almost 60% of those studied were dentally anxious (the study was by Saatchi et al, if you would like to read it). That is a huge percentage of patients in the population, and there are some ways we as clinicians can help you to overcome this.
Now general anaesthetic is something I would like to address first as it is almost always the first suggestion patients who are dental phobic make when they discuss with me their treatment options! General anaesthetic has its own risks, including not waking up at the end of the operation, i.e. dying. Admittedly this is a very low risk (estimated to be around 3 in 1 million!), however if this can be avoided completely then that is much better. Whilst general anaesthetic can certainly be effective in helping to get the job done, it doesn't usually reduce future anxiety, meaning that if further treatment is required you probably wont feel much happier about it. I prefer to get to the bottom of my patients anxiety to help them become fear-free regular attenders. General anaesthetic waiting lists are often very long, meaning that it can be a timely wait. I would only recommend general anaesthetic as a last resort, if the benefits outweigh the risks.
There is more than one way dentists can provide sedation, but usually they will require additional training or qualifications to do this for you. Sedation can be done with a gas (for example through a mask that goes over your face known as inhalation sedation) or by giving you medicine through your veins (intravenous). The main difference between sedation and general anaesthetic is that you remain awake throughout the procedure and can respond to the dentist and team looking after you during your treatment. Whilst the recovery time is sometimes quicker and you can normally go home the same day, you will require an escort (for example family or friend) to take care of you after and you may need to take time off from work depending what you do. Sedation can help you to relax during treatment and if you are considered to be a suitable patient for this it is sometimes provided on the NHS. Some dental practices do this in house, other times you may have to go to a dental hospital for treatment. Another option is to pay privately to be sedated for the procedure to be carried out.
Cognitive Behavioural Therapy (CBT)
Using the explanation provided on www.nhs.net, "CBT is a talking therapy that can help you manage your problems by changing the way you think and behave." In dentistry, this is usually a short-term therapy that lasts around 5 to 10 sessions. Studies have found significant reductions in anxiety for patients who did have CBT compared to those who did not. It is definitely worth considering this approach as it may help you overcome your anxiety once and for all, so have a chat with your dentist about a referral for this. It is important to approach CBT with an open mind in order to achieve the best results.
Pharmacological Interventions (Medicines!)
There are medicines available to help make patients feel more relaxed, which can be given before treatment is begun. A common one prescribed by dentists is called diazepam and helps you to feel calmer before coming for your appointment. As with sedation, if you take diazepam prescribed by your dentist you will require an escort to take care of you whilst the drug is still affecting you. This can last for quite a few hours, and not all patients are suitable for this treatment. It is something which can be used in conjunction with other techniques to manage anxiety, such as CBT and those listed below in the next section.
Finally, there are a few other techniques we can use to help you feel more relaxed about treatment. I personally think trust between myself and my patients is key, so try to find a dentist who you have confidence in. Recommendations from friends who have a good relationship with their dentist are great, as you know a bit more about who you will be going to see. If possible, book a consultation appointment separate to your treatment. This isn't always possible but this way you will get to meet your dentist in advance and talk to them about any concerns you have.
Distractions are also great. I advise my patients who are a little anxious to bring their headphones and then they are welcome to listen to music or videos throughout their treatment. Stop signals help you feel in control, so always agree one of these with your dentist in advance. I personally ask my patients to raise their hand if they would like a break, for example to have a drink, to rest their jaw or to ask me a question. This way, my patients are confident they can stop at any point and even if they are listening to music they can make it clear what they need. Support from family members or friends is another good idea. Ask if you can have someone come with you to your appointment to reassure you and give you a little more confidence - ideally not someone who is afraid themselves as this can certainly add fuel to the fire! My last point is to avoid reading 'horror stories' on the internet. Most people won't write about the times that went well, so try not to worry yourself by reading what has made other people unhappy. If you have any questions or concerns, ask your dentist as they will be best suited to help you understand your treatments.
If you want to learn more about different common dental procedures, have a look at the treatments page on my website. I also regularly post on my Instagram page tips and tricks for dentists and patients, so if you're interested there is a link to my social media pages on the homepage. I really hope you found this post useful! If you want to contact me feel free to use the contact form on the home page of my website.
Dr Bethany Rushworth