Doomsday - The First Appointment

Feeling like a lamb being led to its slaughter? Join the club!! This section explains how figure out whether you’ve met Mr or Mrs Right, and how to communicate your needs to him or her.

Your first appointment is a get-to-know-you meeting, where you get a chance to check out your potential dentist. The only possible exception to this rule is an acute emergency.

You’re paying for the pleasure (either directly or indirectly) – what you say goes!

Some of the things on this page may not apply to you – as always, please ignore what doesn’t apply and take from it what you want.

Time of Day

You should schedule the appointment at a time when you feel at your most relaxed (in the normal way, that is :wink:! Nobody feels relaxed on Doomsday).

If you’re a morning person and you dread having to wait all day, your best bet may be the first appointment of the day. This also pretty much guarantees that there’s no hanging around the lounge/waiting room for too long.

If you’re a night-owl who feels cranky in the morning, or someone who feels at their best in the late afternoon, the last appointment of the day might be best for you. The disadvantage of this is that you might have to spend some time waiting, as dentists often run late. The advantage is that the lounge might be emptier (which you may prefer), and that your dentist won’t be looking at their watch too often cos the next patient is waiting to come in!

If you find the “waiting room” bit really hard, but don’t like early mornings either, a good choice is the first appointment after the lunch break.

Bring a Friend

You may find it very helpful to bring a close friend along to your first appointment, to act as an advocate for you and for social support. Bringing a friend is not a problem (we’ve never had anyone on our support forum say that the dentist minded their partner or friend coming along!). Not everyone likes this idea though – you may not want even your nearest and dearest to see you in a panicked state. Or you may want someone to come along, but only as far as the lounge/waiting room. Go with whatever feels right for you!

First impressions – trust your instincts!

The vast majority of people who have overcome a dental phobia will tell you that you will know when you have found the right dentist!

Some things to watch out for:

  • How does your dentist greet you?
  • How does s/he treat the staff? Do they seem comfortable around your dentist?
  • Is the dentist personable and approachable? Or do you feel intimidated by them?
  • Is the place clean? Avoid places that aren’t! Also, instruments should not be laid out in plain sight.
  • What’s the overall atmosphere like? Is it relaxed, happy, and friendly?
  • Is the dentist gentle with you?
  • Most of all, do you feel instinctively comfortable with this dentist?

Hazard Warning: If the treatment room isn’t clean, forget about it – regardless of how “nice” the dentist appears. People with dental phobias often have very low standards when it comes to dentists, and may be “sucked in” just because the dentist isn’t downright horrible. Make sure you feel very comfortable with the dentist!

It is very important that the dentist is personable and approachable. If you feel intimidated by them, then they are not a good fit for you.

Don’t tough it out!

Pretty much the worst mistake you can make! Why act tough if it’s so much easier to get treated with kid gloves if you act scared? You may think “I don’t have to ‘act’ scared, I’m scared to death anyway”, but even so, you may want to try and lay it on a bit thick. This may also take your mind of trying to fight your sense of panic. If you’re scared to death, it’s best to openly show it. Fighting panic only fuels the fire, so go with the flow. Acting brave will most likely add to your sense of panic. Be honest and open about your fears! Your dentist can’t help you if you aren’t.

I’ve come across reports about one and the same dentist who’ll treat fearful clients very differently depending on whether they appear scared or not – take a wild guess who reckons their dentist was wonderful with them? (answer in case you didn’t guess: the person who acts scared).

Be open about your fears – or be prepared

During your first appointment, you will need to voice your fears and concerns.

If you reckon you cannot do this verbally (some people find they’re lost for words or they “freeze”), put it into writing. Write down your fears, or alternatively, what you’d need to know from your dentist in order to be able to let them have a look, undergo treatment, or whatever else. You can then pass on this written information, either on a sheet of paper, or via e-mail. Be aware though that e-mails may get lost or deleted by mistake, so do check beforehand that your dentist has received the information.

The only way your dentist will be able to alleviate your fears is by knowing about them. They’re not mind-readers. You have to do your bit. Be sure to mention even minor concerns – it doesn’t matter if you think they’re “stupid” or “irrational”.

How far should I go?

If you don’t like the dentist, not very far – you should make your excuses and leave. If you think this would be impossible for you to pull off, it’s a good idea to ensure, as far as possible, that you meet the right dentist first time round. Or bring someone you trust with you.

If you reckon you’ve found the right dentist, go as far as you feel comfortable! As a rule-of-thumb, you may want to let your dentist have a quick look (rather than an complete exam) during your first visit – this will get rid of the embarrassment factor, which is a huge hurdle for many people who are terrified of dentists. You may want to have your dentist have a look outside the chair first, without a mirror.

Plus whatever else you can manage without feeling too uncomfortable – your dentist will take the lead on that one to some extent. For example, some people might get as far as x-rays, or sitting in “the chair”, or trying out some of the equipment, but it really depends on the individual. The first appointment should really be used to build rapport with your dentist, and allow him or her to alleviate some of your fears.

BUPA (an international health insurance and healthcare company) have put together the following tips for your first visit:

Specific points that you can raise during this first session include:

Timing: ask your dentist to let you go at your own pace. For example, you might choose to have an X-ray and examination at the next appointment, or you may only feel ready to try sitting in the chair. As you take each step and find that you can cope with it, the level of anxiety will be reduced.

Control: discuss with your dentist that you want to have some control over the amount of dental work that is done. It’s important that you don’t feel pushed further or faster than you can cope with. A useful way of making sure you feel in control is to discuss a signal – such as a raised hand – that lets the dentist know you need to stop for a break.

Specific concerns: make sure you tell your dentist if there are specific areas that make you anxious, or if you have had traumatic experiences with dentistry in the past. Ask questions about anything that worries you, and allow the dentist to reassure you. Dentistry has advanced so much in recent years that treatments can be totally painless.

If, by the end of the session you do not feel comfortable with the first dentist you meet, do not feel obliged to proceed. Instead, arrange to visit another dentist on your shortlist.

(source: BUPA Dental Anxiety Fact Sheet)

Common Doomsday Concerns

The Chair

Your first appointment should always start off with a chat away from the chair. Say that you’d prefer to sit somewhere else, or if you can’t say it, let your dentist know beforehand, in writing or by e-mail. If seats aren’t available in the treatment room or if it’s too crammed, ask if there is another room where you could have a chat first.

The Look

Many people find it easier to have their dentist have a look outside the chair first, without a mirror (only if you feel comfortable with the dentist, of course). Let your dentist know that you are embarrassed over the state of your mouth, and that you are worried about what they will say. Once you can get over the embarrassment of a look outside the chair, it will be much easier to let them have a closer look.

The Numbers

Many people are scared of the dentist calling out numbers to their assistant or nurse. The numbers, on a psychological level, make you feel like you’re a set of teeth, rather than a human being with emotions. They also make the whole situation very clinical, and many people hate this “clinical” feeling. Ask your dentist nicely if they could either not call out the numbers, or else not do it on your first visit, or to explain what the numbers mean as they say them, or listen to an mp3 player while they are doing this “charting” – depending on your preference.

The Poker

Luckily, the days when dentists used the poker (or explorer, in layman’s speak) to randomly prod around are gone. It is now known that sticking in the poker and giving it a good shove (as done in the olden days) can compromise the tooth structure of an early lesion that has the potential to remineralise. It is used much more gently nowadays. Do let your dentist know though if you’ve got a problem with the poker and if you’d rather it wasn’t being used during your first visit!

The X-Ray

X-rays are usually quite easy, but if you’ve got a problem with gagging, make sure you let your dentist know. Also, do let your dentist know if you’re scared of looking at the x-ray pictures and you’d rather not see them (or at least, rather not see them straight away).

The Diagnosis

If you feel that you cannot deal with “hearing the bad news”, let your dentist know that you don’t think you can handle the “bad news” all at once and ask if s/he can break it to you slowly – or during the next appointment. Depending on your prior experiences, you may be the opposite and you may be especially anxious to get an honest and detailed diagnosis – again, let your dentist know!

Give yourself a pat on the back!

If things went well – you’ve just done something incredible, maybe even something you never thought possible! You should feel really proud of yourself (and your dentist)!!

If there’s anything you feel unsure about, or if things for some reason didn’t go according to plan, please don’t hesitate to post on our forum for support and advice. Or if things went great – consider leaving a message on the forum. Your success story will really help others who are trying to work up the courage to get where you are now!

What Next?

That’s really between you and your dentist. Some people feel over the moon and completely trust their dentist immediately, with minimal or no support. Others experience feelings of guilt over the past, and others again have specific questions or concerns about treatments. Please don’t hesitate to post on our forum – that’s what it’s there for!

Red Flags

During the first appointment, you may not get as far as working out a treatment plan together with your dentist. There are some general rules-of-thumb that dentists should follow, which you should know about:


(1) Informed Consent: your dentist should explain to you, in language that you can understand, the available treatment options, what they involve, what the various alternatives are, and what the advantages and disadvantages of each alternative are. You should always ask what they would do themselves if it was their own tooth/mouth. They should also tell you the costs for each option. (Sometimes, it’s difficult to estimate the cost in advance though, in which case both the cheapest and the most expensive scenario should be given).

If a dentist doesn’t present the treatment options, doesn’t give advice, and doesn’t let you decide, this is a red flag!

(2) The usual order of treatment is:

  1. pain relief (if necessary)
  2. cleaning / prevention
  3. deep cleaning (if necessary)
  4. fillings/restorations (if necessary)
  5. tooth removal (if necessary).

A cleaning usually comes first because otherwise you can’t really see what is going on, and also, it’s very important for preventing gum problems and making sure that any other work is built on solid foundations. There can be exceptions to the usual order of treatment.

If you are presented with a treatment plan that deviates from the usual order, your dentist should be able to explain to you why – and the explanation should make sense to you. Unfortunately, there are some unethical dentists who do cosmetic ($$$) treatments first in order to make more money, or who leave the cleaning till last because they want to max out your insurance and don’t care about long-term results. Or they leave out basics like a cleaning because it doesn’t pay well.

It’s actually quite rare for this to happen, but it’s something you should be aware of because it can and does happen occasionally.

“I’d like to say ‘thank you’…”

If you’d like to say “thank you” to that special dentist but don’t know how – apart from saying “thank you” in person (which is always very much appreciated!), you can find some gift ideas for dentists here!