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Fear Of Dental Treatment

Thought on my fear of Dental Treatment.

My dear mother used to say “ I would rather have my head cut off and sown back on again…. rather than go to the dentist!”. And she meant it!

I think this is where my fear of dentists began, when I was a little child. It has never gone away even though I am now over 70.

We were a working class family in the western suburbs of Sydney. Along with many other post war families, we were not well off, although we never thought of ourselves as poor. I think we had a reasonable diet for the time, which in retrospect did not have a lot of sugar or sweets.

We never went to the dentist and on the whole we were a pretty healthy family when I was growing up. Going to the dentist was expensive and not a common occurrence for working class people. We went to the doctors when necessary and I had no worries with medical treatment, injections in the arms etc. There was of course no fluoride in drinking water and primary school children were given free milk to drink every school day. We brushed our teeth but I do not recall a regular routine.

My first experience with a dentist when I was in about 8, 9 or 10, was the school dentist and I assume this was a free service. When the dentist came to our school, we were called out of class in a group of about five students at a time and had to line up in the corridor outside the “sewing room” where the dentist had set up a makeshift surgery.

The fear and the apprehension are embedded in my mind to this day. The smell, the noise of the whirring high pitched drill, sucking gurgling noises, the clank of metal bowls and kids crying or trying not to cry are vivid memories. I was a pretty good, well behaved, obedient child as were most of my fellow students. We did as we were told and waited serious fear silently, while we listened and conjured up awful thoughts of what was going on in the sewing room and what would happen once it was your turn.

To the best of my recollection nobody spoke to us about what was going to happen and when they called “next”, we were quickly bundled in full of fear and trepidation. We were sat in a chair, told to hold a metal kidney shaped dish under our chins and open our mouths wide. I always squeezed my eyes shut. The dentist rarely spoke nor did the assistant nurse. Teeth were poked, pulled, filled and otherwise dealt with we were sent back to class biting on blood soaked gauzes, trying not to cry! It was a simply awful. I begged my parents not to send me to school when I knew the dentist was coming.

My next experience was when I was about 16 and had left school and started work. My aunty encouraged me to see a dentist because I had some crooked teeth. I don’t know how but I summoned up the courage to see a local dentist. Like all dentists at the time I think, his surgery was above a shop in the town accessed by a steep staircase without a landing. The room was rudimentary, one window looking out above the shop awning below, with equipment that looked it came out of a B Class horror movie. Again the smell, the kidney shaped metal dishes, the sucking, slurping sounds and worst of all, the noise of the drill as it penetrated by teeth!

These were the days before dentists wore gloves or masks. This particular dentist was obviously a smoker who had badly stained fingers and a smoker’s breathe. I remember even tasting the nicotine on his fingers as he worked on my mouth.

There was no discussion, or chat after the initial courtesies. Probably wouldn’t have been helpful because my mind was always frozen with fear as were my limbs and I clutched to arms of the chair with all the strength I had. The dentist never really commented and I believe he had no idea just how long I had worried about making the visit to him and just how much courage it had taken me to actually walk up the stairs. After these experiences I never went regularly to a dentist for a long, long time and my dental visits were always as “dire emergency” visits when I could no longer bear the pain and discomfort.

My mother, my father and my 18 year old brother had had all their teeth removed and wore dentures. I didn’t want this to happen to me, but, as an adult now in the 1950s, I just couldn’t overcome “the entrenched fear of going to the dentist”.

I consider myself to be reasonably intelligent, articulate and pretty health aware. I knew this fear was irrational, unreasonable and not only spoiling my dental health, but wasting so much energy and time (not to mention pain) while I procrastinated and delayed seeking dental help when I needed it.

I sought treatment only in emergencies, with pain, infection, cracked teeth, cavities and lost fillings. I have had many dentists over the years, often very pleasant, fresh faced, gentle, enthusiastic, probably well- meaning dentists (usually female but not particularly by choice) with pretty faces and perfect teeth. Many smiled condescendingly, nodding and telling me they understood my fear and said, “Oh, things have changed in dentistry………. It is all painless now!”You won’t feel a thing” etc etc!

They were probably right, dentistry has changed, I agree.

However, they really didn’t understand my fear. By this time it could perhaps be described as a “phobia” and it was still very real and persistently stopped me from seeking regular and timely dental treatment.

Recently, through neglect I needed substantial urgent dental work which I had put off for much too long. I was extremely fortunate to become aware of a Special Needs Dental Practice, aptly named Mind Body Teeth while I was an inpatient in the SDAH. I read all I could about this practice and forced myself to make an appointment and told them about my fear.

This time was different and instead of “brushing off” my apprehension and fears Avanti took the time to talk and listen without the usual, platitudes about being afraid. We spent the whole first session talking and listening and actual helping me to understand my fears.

I learnt a lot that first visit and began to understand my fears. I think my “phobia” can best be summarised as follows:

  • Fear of fronting up and exposing my vulnerability to a dentist who had no idea of angst, or

  • if they did acknowledge my fear, thought it was unrealistic and old fashioned;

  • Fear of not being in control of what was going to happen to me;

  • Fear of someone’s hands and equipment in my mouth preventing me from speaking and potentially interfering with my airways;

  • Fear of appearing foolish, childish and a “big sook”.

  • Fear that the dentist would do something wrong they couldn’t fix.

I expect it was also a fear of being hurt was there too, but I now think fear of the “whole dentist experience” was my real concern.

I don’t believe this uncommon and many people probably have similar issues, although I have never discussed this with others because I always felt foolish.

Indeed my Mind and my Body as well as my teeth were involved in my phobia.

My latest experience with Mind Body Teeth was much better and I think some of the reasons I feel this way include:

  • I never felt rushed and being moved along for the next patient.

  • The surgery was light, airy and not overly clinical without a dental surgery smell

  • They listened and took time to draw out my feelings and story

  • Didn’t do anything the first visit except examine me;

  • They weren’t patronising or glib about my fears;

  • Planned my treatment regime with me;

  • Told me what to do if I wanted them to stop;

  • Did what they said they would do with explanations;

Finally I now know that my phobia was never really simply about my teeth, it was about more! It was about my mind and my body as well. How I, as an individual with my bundle of previous experiences, dealt with the drama of having dental work done.

In my view the best way to help someone with my particular problem is to take the time and effort to truly engage with the patient. It is a caring skill that needs to be taught and observed more by all professional people, especially in the medical professions.

Thank you Avanti, your practice is well named Mind Body & Teeth.

Kind Regards

Sally (not actual name)

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