May 28, 2022
Live Well Club

Dealing with Dental Anxiety

How to fear-proof and pain-proof your dental visits so you can smile again.

One of the biggest reasons that prevents people receiving the dental care they need is fear and anxiety surrounding a visit to the dentist. For many patients over 50, we still remember the traumatic days of the school dental van visiting. And whilst modern technology has come a long way, we still dread the dental drill. In over 30 years of clinical experience, I’ve developed a Fear-Free, Pain-Free Treatment Protocol to help my patients overcome their dental anxiety, and these same 5 steps can help you too, no matter which dentist you visit.

1 – Deal with dental fears before the appointment

For patients with dental anxiety, the first step is a pre-treatment, non-clinical interview and discussion of your fears, concerns and any past dental experiences, both good and bad. Identifying specific areas of concern and assuring patients that these same fearful events will not happen again can go a long way to easing dental anxiety.

2 – Deal with dental pain before the appointment

If you have an infection, anaesthetics will be less effective, and you will feel more pain. That’s why, whenever possible, I recommend patients treat infections first with antibiotics, prior to starting dental work. But that’s not all. You will also experience less pain during and after your dental treatment if you proactively take pain relief medication before your appointment. A pain management program should include taking a non-steroidal anti-inflammatory medicine like Nurofen 1-2hrs before any procedure that is likely to cause inflammation, or where inflammation is already present.

3 – Fear and anxiety may produce an acid-base change in the body called metabolic acidosis

If your gum tissue becomes a different acidity from fear, the numbing anaesthetics don’t work as well and wear off quickly. So, if a patient is still anxious about their treatment, we offer additional relaxation options including Nitrous Oxide (Laughing Gas). Or, depending on your medical history, prescriptions for Valium may be obtained from your GP to help lessen the anxiety you experience about your dental appointment.

4 – Use a gentle local anaesthetic injection protocol

My goal is always to achieve a profound numbing to get your tooth completely asleep during the appointment and keep it asleep until treatment is complete. The secret ingredient to successful numbing of the gums is…time. Unfortunately, some dentists rush through appointments to try to see as many patients in one day as possible. But when it comes to anaesthetic, the more time you have the better. It takes a full three minutes for anaesthetic to penetrate the surface of your gum and provide adequate numbing.

There is a little-known fact that almost all the pain from an injection comes from the pressure of the medicine being forced into the tissues, not from the needle itself! So, the best way a dentist can give practically pain-free injections is to go very, very slowly so that very little pressure is felt. I often place a few drops of anaesthetic under the gums and then wait a while before completing the full sedation. The first few drops have already put the area to sleep and help to ensure a pain-free anaesthetic experience.

5 – Beating the fear and pain after the dental appointment

It wouldn’t really be much good if you have a pain-free procedure, but your teeth hurt like crazy when they wake up! That’s why it’s essential to understand how postoperative pain works. Most postoperative dental pain is caused by inflammation. The most commonly used painkiller is Panadol, however, this only has a short-term anti-inflammatory effect. If your body can tolerate it, Nurofen is much more effective pain relief as it has a long-lasting anti-inflammatory effect. The key thing to remember is that pain is best prevented rather than treated after it begins. You will experience much less pain if you take the appropriate dose of Nurofen by the clock, rather than waiting for the pain to set in… and having to deal with that pain while you wait for the medication to kick in.

In my experience, the reason most people don’t win the war against their dental fears is that they just “wing it” as they go from one frightening dental emergency to the next. They only go to the dentist when they absolutely have to, and they often have very little opportunity to address their fears before treatment is required. The very first step in dealing with your dental anxiety is to choose to take control of your dental health and start being proactive. Don’t wait for a dental emergency – do your research to find a trusted dentist and book an appointment to create a Fear-Proof Dental Treatment Plan so you know exactly what you and your dentist will be doing to reduce your fear and anxiety so you can get the dental treatment you need without any fear or pain.

Courtesy of Dr Darryl Marsh BDSc. Dr Darryl is the author of two books and the Founder of Today’s Dentistry in Chermside.

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