The root of all dental fear

Dentist chatting to patient

Journalist Grace Vaughan talks about her experiences with dentistry and how she managed to face her fears of the dentist’s chair

Fear of anything can have a serious and negative impact on a person’s quality of life. When we develop a phobia we do one of two things, confront or avoid. Some phobias can be avoided, like the fear of flying (if you’re happy to spend your life solely travelling by boat and train) but others are not so easy to avoid, like the fear of the dentist, which is an all too common phobia. Granted, you can dodge the needle and drill in the short term but one painful gum abscess and raw nerve later and you’ll be screaming out for a dental appointment.

Dental phobia like any phobia often has its roots (excuse the pun) and, for some people, that can derive from a previous bad experience in the dental chair or, as in my case, it is brought on by something much more complex.

When you’re a child, everything appears bigger

My dental phobia began with my first trip to the dentist when I was six years old. Back in the 1970s, routine visits to the dentist were unheard of and people only tended to go out of necessity – for example, tooth pain that became intolerable. The cavity in my tooth had gotten bigger and was causing pain so a teacher advised a visit to the dentist.

Even though I’d never been to a dentist before, I’d heard stories about people going and how they dreaded it because there was pain involved. So already I had other people’s fear of needles and drills projected onto me – but in the end it wasn’t the injection that proved most traumatic, it was the dentist himself and the fact that he had an artificial eye.

When you’re a child everything appears bigger and I can still recall it, the memory of this big shiny glass eye peering into my mouth and the panic I felt, thinking the dentist is going to take the wrong teeth out because he’s half blind.

He didn’t, of course, and the decayed tooth travelled home with me in a little plastic cup to show off to my friends at school the next day. But the trauma quickly turned to fear and it was a very long time before I went back to a dentist again – and only when I had to, if I had a gum abscess, say, and the whiskey-soaked cloves in cotton wasn’t cutting it in the painkilling stakes.

The fear was so great I tried to pull out my own teeth

Some people will go to any extremes in order to avoid their fear. You often hear stories of people with a fear of dogs, germs or open spaces, never leaving their house. In my case I resorted to using a knife to try to extract my own teeth. However, all I succeeded in doing was breaking said teeth down to the roots and developing mouth ulcers from the shards that cut into my tongue and cheek. Eventually the broken roots needed to go too but not before I did my research, found people who suffered with dental phobia but conquered it with the aid of a good dentist with a real understanding of dental anxiety or odontophobia, to give it its technical name.

In the end, I did find a kind and gentle dentist who extracted the remainder of my broken teeth. However, the residual fear remained and I didn’t make the regular six-monthly check-ups like I promised myself I would. The next visit to the dentist was post-pregnancy with a broken filling and after that a couple of sporadic visits to have my teeth cleaned. The fear might have lessened dramatically but I hadn’t quite conquered it.

The fallout

The old adage “you don’t know what you have until it’s gone,” is very fitting when it comes to teeth, and losing them. It turns out our back teeth are more important than we give credit for as chewing food is not their only function. I discovered that posterior teeth act like scaffolding, a support system for the jaw muscles and, when they are taken out, the jaw muscles start to collapse causing cheeks to become sunken and the face to appear aged.

And that’s just the aesthetics. The remaining teeth that are overcompensating for the missing teeth start shifting to bridge the gaps and from that TMJD (Temporomandibular Joint Disorder) can develop, with symptoms ranging from jaw pain, headaches to ringing in ears.

If like me, you work at a computer all day long, you are at greater risk of developing TMJD – as sitting at length in front of a screen unconsciously clenching the jaw to aid concentration stresses out the facial muscles and that’s how pain occurs. Had I known that the fall-out of a dental fear would result in having to wear an uncomfortable mouth guard at night, albeit with little success, I would have confronted my fear a lot sooner. Because now only implants would fix the problem but it would be an invasive procedure, not to mention expensive.

Evolution in dentistry

Having heard horror stories about people seeking dental treatment abroad I opted to stay local and book consultation for dental implant procedure. Thankfully, from the moment I walked into Boyne Dental, in Navan, Co. Meath, I realised how far dentistry had come. It was a far cry the practice where my dental journey began at the age of six with its pokey waiting room, grey plastic chairs and two miserable magazines to share among a roomful of glum patients.

The reception area of Boyne Dental was like stepping into a stylish café clad with modern round tables and funky chairs. Staff freely floated around welcoming and reassuring people that their appointment would be soon. Instead of picking up one of the array of magazines as I sat down, I surveyed the spacious reception its bright walls tastefully decorated in artwork celebrating the local heritage. Instantly I relaxed because with modern décor comes modern medicine. And modern medicine in dentistry means minimal pain during any procedure.

One to greet his patients personally, Dr David Murnaghan descended the stairs and introduced himself with a warm handshake. We chatted as we made our way up to his office which I was surprised to find was equally as spacious. Having been to a few dental surgeries over the years, although many things had improved, surgery sizes remained the same in that they were all small. While I sat on a couch chatting about the possibility of dental implants, an assistant worked quietly at two computer imaging screens displaying 3D X-rays.

I realised that every sensory reminder of that first bad trip to the dentist were absent – the sound of the drill, the smell of antiseptic, the sight of people with bloodied cotton wedged in their mouths. In its place was light-hearted banter between David and his assistant and a TV in the background with low volume nature sounds. Everything felt different. Looked different. Even the dreaded dental chair looked more inviting with its soft leather.

Nobody relishes the thought of a stranger rummaging around inside their mouth but I was soon soothed when I reclined back and watched the flat screen overhead of polar bears playing in icy water. I found myself biting back a tear, not of pain or fear but of relief at how different things were now compared to that of my childhood. It made me think of my own children and how going to the dentist will be a much more pleasant experience for them and they’ll go so often it will be like… brushing teeth.

Know the drill

After scans of my teeth and jaw, it transpired that I was not a candidate for dental implants, well not for the standard, straightforward procedure anyway. The recommended time for getting that type of implant is within six months of the tooth being extracted. After that, bone loss starts and you’re quickly in the realms of more invasive and expensive surgery involving bone grafts.

But, it wasn’t all bad news. I was in good health generally. Apparently dentists can detect more than just gum disease – the mouth being the gateway to deeper parts of the body – can display signs of heart disease, diabetes and oral cancer.

If I’ve learned anything about my journey through dental fear it is this. Control. Or lack of. As a patient you are not in control, the dentist is. And you put your trust in their hands, literally. Education is a great thing but too often text books are about the body, the condition and not enough about the person.

When it comes to dental anxiety treating the whole person instead of just the problematic truth can make a world of difference. A simple question like asking how the patient feels can help a dentist gauge the psyche of that patient. Some adults don’t like to show fear as they feel they’ll be judged as weak – but the reality is that for many, once they step through that surgery door, whether it be a GP’s or a dentist’s, they regress into that vulnerable child who feels afraid and less in control. A good dentist will already know this.

If we don’t feel empathy for patients then we’ve no business treating them.

About the author

Grace Vaughan is a writer with an MA in Scriptwriting from the Dún Laoghaire Institute of Art, Design and Technology. Her work has been featured regularly in national news site publications – Independent.ie and Journal.ie – and on online parenting sites both here in Ireland and the UK – MummyPages, Eumom.ie, HerFamily.ie, and Mumsnet.com