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In my view, the sense of not being in control over proceedings almost always begins outside the chair. For example, the thought
that I could simply walk out if I didn't like and trust the dentist completely had never occurred to me (then again, it had
never occurred to me that there might be some extremely nice dentists around, either). Realizing this helped me a lot in making
an appointment. It seems totally obvious in retrospect, but most dental phobics I've talked to feel the same. We tend to assume
that "the dentist" is an authority figure who has full control and power over you once you walk through that surgery
door. The fact of the matter is that, once you view the situation rationally, it becomes perfectly obvious that you're in
charge.
In my (limited =)) experience, a lot of people with dental phobia fail to realize that dental treatment is elective - in other
words, you can decide which treatment (if any!) you'd like to have done. A dentist cannot force you to consent to treatment.
You are the customer, what you say goes and you're in charge! I'd advise anyone with dental phobia not to even go near "the
chair" unless you're perfectly happy that you like and trust your dentist. It's totally up to you if you even want to
have a dentist have a look! More about this in "Doomsday - The First Appointment".
| Realizing that you're the customer can help... |
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| ... but please treat your dentist the way you would like to be treated yourself! |
Dentists provide a service to you, the customer, which you can accept or decline. Dental phobics have a tendency to assume
that dentistry is something that is done TO them, that they have no choice in the matter, and that they're at the mercy of
the dentist. However, the truth is that it's entirely up to you to decide what you'd like your dentist to do - much like walking
into a shop and deciding what products to buy (or not to buy). Today, many dentists view their patients as partners in their
care, and will endeavour to come up with a treatment plan that takes their clients' needs into account. If you suffer from
dental fear or phobia, this includes only carrying out treatment that you feel happy with.
However, if your demands are unreasonable and would amount to neglect on behalf of the dentist (for which you could then sue
them), they have every right to refuse to treat you. Let's hope that's not the case, though - usually, there are several treatment
options available and you should be able to work out a treatment plan you're happy with.
If you've had bad experiences in the past where a dentist wouldn't stop even though you were in obvious distress, or a dentist
holding or pinning you down, it's very likely that you'll be terrified of losing control in a dental situation. If this has
been your experience, it's important that your next dentist is one whom you can trust completely.
There are many ways of ensuring that you don't feel out of control, for example by starting off with real easy things and
gradually building up your confidence and trust in dentists and dentistry. There are a lot of simple techniques available
which can help you feel in charge. These include being talked through procedures, the use of stop-signals, a method called
tell-show-do, and taking frequent breaks (especially at the start, that might mean every few seconds, until you feel sure
that you feel comfortable with a procedure). You can read more about these and other techniques in the "Overcoming Dental Phobia - Psychological Methods" and Tips & Tricks pages of this website.
"What if I'm afraid of losing control during treatment?" by Jerry Gordon, DMD
Some people who fear dental treatment are those who are used to being in control at home, work and in personal and professional
relationships. In today's lingo, these people are sometimes referred to as "control freaks." Despite this negative
label, these controlling people are often highly intelligent and very successful. For instance, you may have heard the statement
that "doctors make the worst patients," but other professionals, including lawyers, teachers, engineers, high level
business executives, etc. could just as easily be put into this category.
Although that statement is a generalization, it is accurate to say that some of these high-powered people can be difficult
patients because they are accustomed to controlling their environment.
When people who are used to being in a position of power are put into a situation where they must relinquish that power
to their dentist, anxiety, confrontation and avoidance are the most common reactions.
The first step in overcoming this fear is to tell the dentist that you want to know what he or she is doing and why. Ask
your dentist to explain X-rays, show you your mouth with an intra-oral camera, give you handouts or in-office presentations,
or any other information to help you have a more active role in your dental care. When you know what the dentist is doing
and why, you will have a greater sense of control during the procedure. It is also important to ask the dentist how you should
signal if you are having pain or any other uncomfortable sensation.
Many dentists tell the patient to raise their hand if they are having pain, and the dentist will stop. I have had patients
tell me that they had a dentist continue working on them even after they repeatedly raised their hands. This is not a dentist
that you want treating you. It's a good idea to test your dentist -- even if you're not having pain -- to see if he or she
will indeed stop. The dentist who follows through with that promise is what we call a "keeper."
One technique I like to use is to let the patient have some input as to what procedure they want done first. Many times,
there is no urgent need to have cavities on the left side of the mouth treated before those on the right side, or one crown
(cap) done before another. I believe that it is perfectly appropriate for you to ask your dentist if you can have a particular
procedure done first or last. If there is no urgent need, the dentist may comply with your wishes.
Allowing you to help "call the shots" can be an effective way to reduce tension if a loss of control is your
main source of anxiety. (Please note that some dental procedures must be done before others for your benefit. Your dentist
should give you a good, jargon-free explanation to help you understand why).
� Jerry Gordon, reprinted with permission
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| � Mark Parisi - www.offthemark.com |
If you're particularly worried about not being able to communicate with your dentist once you're numb (cos you can't speak
properly), an easy solution is to bring a writing pad and pen along (keep it on your person though - it might be a tad inconvenient
to rush off looking for your handbag... ;)).
Also, some people find it highly annoying if their dentist asks them questions while they're numb or have instruments
in their mouths and can't speak properly, because it makes them feel like morons. The reason why dentists may ask questions
when they know you can't answer is to distract and calm you - but if this technique has the opposite effect on you, don't
feel shy to let your dentist know!
It is very common for people who have been sexually abused to suffer from dental phobia, as the dental treatment situation,
in many ways, can resemble past traumatic events. If you belong to this group of phobics, you can read this page on dental phobia in survivors of sexual, emotional or physical abuse,which was written by a survivor of childhood abuse (warning: may trigger). I would also like to urge dentists to read this
section.
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