Dental nurse Amy Scarbo shares what her own fears have taught her about managing dental phobias, spotting the signs and creating a supportive environment for patients.
‘Amy, we have our dental check ups after school’: the dreaded words I used to hate when I was younger.
I was petrified of going to the dentist, so much so that the dentist would have to perform my examination in the waiting room. This was extremely embarrassing for my mum as she was one of the dental nurses at the practice.
My fear began with needles which resulted in being terrified of dental treatment. I hated the smell, sounds, the clinical look, feeling vulnerable – all of it.
Because of this, I started to hate my teeth, which led to me neglecting my teeth throughout my teenage years. And, of course, because of the neglect I was left in extreme pain and the only way I could get out of the pain was to bite the bullet and get the treatment done.
I promised myself I would never let it get that bad again as I never wanted to step foot through that door again, but here I am, a registered dental nurse!
The risks of dental phobias
As dental professionals, we should be taking dental phobias seriously as they can lead to so many dental problems when sufferers avoid going to the dentist.
Dental phobic patients will have a higher risk of plaque build up, loose teeth, infections and abscesses, and will be in a lot of pain as a result.
I was one of these patients. I waited until I couldn’t take the pain anymore and then had to have three root canal treatments at the age of 21!
I have also had countless fillings, some of which were on my mandible where the anaesthetic in the ID block caused me to have facial paralysis twice! As you can imagine, this grew my fear of dental treatment.
What can cause dental phobias?
Having a dental phobia does not just mean a person has had a bad experience, it can be a number of many things. These are just few of the reasons patients have told me:
- Needles
- Chocking
- Strong gag reflux
- Medical smells and sounds
- The dental drill
- Embarrassment
- Pain
- Powerlessness and vulnerability
- Anxiety disorders
- Trust issues.
Patients who have phobias all show it differently. Here are some of the few symptoms I have witnessed in my patients:
- Nausea
- Tachycardia
- Hypertension
- Hyperventilating
- Urge to gag or vomit
- Urge to urinate
- Feeling of suffocation
- Trembling
- Palpitations
- Fainting.
Spotting the signs
So what can we do to help dental phobic patients? Our first step is spotting the behaviours and knowing what to do.
Talking a lot is a distracting technique. I know this because I do it.
There is so much adrenaline going through me and, as a result, I have so much energy which I release by talking. I also talk a lot because I think it will delay my treatment. I’m sure other sufferers who do this will agree.
Allowing the patient to talk is a good release for them, but it may result in running behind schedule, so using language such as ‘Are you ready to begin?’ or, ‘Okay, now we are going to make a start’ can help encourage the patient to stop.
Many patients will put themselves in a ‘zone’ and therefore not talk. This may come across as rude, but they don’t mean to be. They simply want the treatment over as quickly as possible and don’t want to join in with small talk.
Some dental phobia sufferers will be very emotional. This can be because they’re frustrated, angry, embarrassed or because they want to communicate that they’re genuinely petrified. When I know a patient is in their ‘zone’ I will only talk to them when completely necessary.
Managing dental phobias
Frequently using the toilet could be another method of distraction. But, it could also be a result of the flight or fight response. When stress hormones are circulating around you, your bladder may be affected.
It’s not uncommon to lose voluntary control of your bladder in a stressful situation. Always allow patients to have toilet breaks, and even offer the staff toilet. It shows your patient you are not frustrated with them and understand their needs.
When anxiety hits, it’s hard to stop overthinking – so much so that doing things to your body is the only way to stop the thoughts. Biting lips, biting nails, pinching skin, rocking, pacing and being genuinely fidgety are a few behaviours patients can show as soon as they walk through the door.
If I’m on reception and spot these behaviours, I will offer a drink or even another room for them to sit in. I also sit next to them and will talk through any concerns (if they are up to it).
Having a hand to hold is such an important part of helping a sufferer – it can help prevent the patient from harming themselves.
Sufferers also have a higher tendency to not attended their booking, even if they have paid a deposit.
When I know a patient has the phobia, I suggest they book on a Monday at 9am. Having the earliest appointment of the day encourages them to get up early and come straight to the practice. If it’s later, they have more time to overthink which may cause them to not show or cancel which will cause more problems.
To conclude, as dental professionals, we should be highly educated in this subject and should not neglect the importance of it.
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