“My teeth are the worst the dentist has ever seen; I feel guilty, ashamed, and scared of ‘The Lecture’. I’m worried that the dentist will berate me, humiliate me, or judge me.”
Research has confirmed what we’ve known all along: that “intense embarrassment due to poor dental status or perceived neglect, often with fear of negative social evaluation as chief complaint”, is extremely common among people suffering with dental phobia (Moore et al, 2004).
This is the vicious circle of dental phobia: whatever caused the phobia initially (be it painful or traumatic experiences, hurtful remarks, or something else) leads to avoidance, which in turn means no access to professional dental care, usually resulting in poorer oral health, and at some stage the results of this “neglect” are perceived to be so embarrassing that it’s totally impossible to see a dentist, even when in pain. If shame, embarrassment and guilt are keeping you away from seeing a dentist, you’ve got plenty of company!
First of all – it’s highly unlikely that any dentist hasn’t seen teeth which aren’t as bad as or worse than yours – if you don’t mind graphic photos, check out this page: “My teeth are the worst the dentist has ever seen!”
Embarrassment is perhaps THE most common concern voiced by people who haven’t been to a dentist in a very long time. It may come as a surprise to some that the days when “the lecture” was part-and-parcel of a visit to the dentist are gone. Dentistry has evolved into an industry which supplies a service to the potential customer – you!
This development mirrors trends seen throughout society. The authoritarian parenting model which used to be so popular has fallen out of favour, to be replaced by tender loving care and open communication. It used to be common for medical doctors to behave in a paternalistic fashion (“doctor knows best”), but nowadays, we expect to be given choices and make autonomous decisions. The rise of the Internet and search engines helped to accelerate these changes, and today, medical doctors have come to expect that their patients will have done their own research and will want to discuss diagnoses and treatment options in partnership with them. As a result, professional distance and dominance has decreased, and mutual participation has increased. Similarly, most dentists nowadays realise that that people want to be actively involved in their own care, and that admonishing people is a sure-fire way of keeping them away. Many now endeavour to make dental appointments a positive experience, not only for those whose teeth are in great shape!
As always, beware – there may still be some old-school dentists around who see lecturing and negative remarks as a good way of frightening people into compliance. But this has become increasingly rare.
The psychology of embarrassment is pretty interesting. Studies, for example by sociologist Andre Modigliani, have shown that shy people with high levels of empathy – the ability to imagine how others may be feeling – can be more easily embarrassed. Easy-to-embarrass people also have a tendency to believe that others see them as somehow inadequate.
The good news is that the mortification is mostly in your own mind. Research has shown that most onlookers are actually very sympathetic when others embarrass themselves – and that people who are embarrassed and simply admit to it are tremendously well liked.
Other factors which make a sense of shame and embarrassment so common when it comes to dental fear and phobia may include an emphasis on beauty and perfection in modern Western society and the fact that the mouth is an erogenous zone.
It may help to know that from the operator’s (that is, the dentist’s) perspective, the situation looks very different. They’ve been trained to help people who are experiencing problems with their teeth and gums – it’s their job to fix these problems. And a lot of dentists view their job as a caring profession – which is what it should be.
You might find it more reassuring to hear all this “from the horse’s mouth”, so to speak.
If you don’t want repeat business…
… insensitive remarks are the way to go!
❓ “I’m not really scared or phobic of dentists as such, and I suspect that there have been massive improvements in dentistry over the years, but after a pretty painful experience, I haven’t been to a dentist for years (25 years to be exact)… Everyone else seems to have regular check-ups, I’m the only person I know who hasn’t been for decades… I’m scared s***less of what a dentist is going to say… can you tell me what awaits me? Am I in for a lecture? Surely, a dentist will never have seen someone who hasn’t been to a dentist in such a long time? I’m pretty certain that the dentist will be horrified when s/he finds out, and totally disgusted by the state of my teeth… I’m very frightened of the dentist’s reaction, please help!” – Frightened
❗ Great question Frightened, and one that comes up all the time. We see people like you everyday… really. It’s no big shock to us, all we care about is fixing you up, reducing/preventing future pain, maintaining/increasing function and esthetics. As professionals we know you don’t come here for the lecture, it won’t help anything or anyone… we are only there to help and serve so feel free to talk to us.
Please don’t be embarassed… sounds silly but it’s what we do. We have seen it all before, and there is no reason why we should judge you for it. We are there as learned practitioners. You’re not embarrassed to take your car to the mechanic even though your oil is very dirty are you? You take in your car, they change your oil and you’re good to go again. As dentists, we have chosen to see and treat patients within this specialized area of medicine.
I hope this helps and it all works out for you.”
In case you think that this was a carefully selected answer (it actually did come from a dental phobia discussion group), think again! What follows are the dentists’ responses to a question which appeared on a dentistry discussion group while writing this page way back in 2004. The person who asked the question was not phobic of dentists, so the answers weren’t even tailored to suit an anxious person:
❓ “This is a very embarrassing situation. I have some “root remnants” – one lower right middle, one upper right middle, one lower left middle, and two upper left – all molars that had once had root canals. Here’s the rub… I was going through a trying time a few years back, money was tight, and when the first one of these fractured, well, I didn’t do anything about it. Fear of discomfort at the dentist, the money, etc. Then another fractured a while later, same deal with this one. By the time the third one happened, I was simply overwhelmed. The crazy thing is this I am a normal looking professional guy….educated….good family background, etc. And NO one knows about these problems except me.
Now, I feel totally stupid about presenting to a dentist, and I cannot even imagine how much all this will cost. So, here I am, with these rotten teeth gone to the gum level, and feeling like a total idiot. I wish I had addressed the first tooth when it happened but I didn’t.
Now, is there anything you can say that will encourage me to get treatment without feeling like a total moron in front of the dentist and his staff?”
❗ “You should not worry what the dentist will think this stuff happens all the time. Your teeth will tell the whole story. The dentist should not make you feel bad because you could not afford to have things done and then were afraid to come in. I imagine there was a period of denial “oh it does not hurt maybe it will not get any worse” but that is a normal feeling and the dentist understands this. You should not feel bad. The fact that you are interested in correcting the past will be a good fresh start for you.”
❗ “We see patients like you all the time. Personally, I’ve been around long enough not to judge. You’ve neglected yourself before. Now you want to help yourself. Anyone will see that this is a good thing. Worrying about what others won’t be thinking anyway should be the last thing on your mind.”
❗ “Yeah, the dentist is used to it and will welcome you into the practice!”
❗ “We see this type of thing quite often and should be no cause for embarrassment on your part. Treating dental problems is what dentists do. Get an appointment for an examination. Most caring professionals are there to treat their patients’ problems; and offer restorative solutions, of which there are many in cases such as yours. If a dentist berates you for the condition of these teeth, get up and walk out.”
And if even a dentist tells you to get up and walk out…
The next Q&A comes courtesy of Jerry Gordon, DMD – it’s an excerpt from his article “How Dental Fears Work“:
❓ “What If I’m Afraid My Dentist Will Scold or Embarrass Me?”
❗ “Some patients fear being chastised by the dentist for neglecting their mouths. They might nervously comment that “I know I should have come earlier” or “Is this the worst mouth you ever saw?”, expecting the dentist to reprimand them like a disapproving father or a marine drill sergeant. It is no wonder that people with these preconceived notions fear going to the dentist.
This fear seems to have originated years ago when some dentists thought they could “help” their patients by lecturing and/or insulting them. Most dentists today realize that this is a poor approach that ultimately backfires by either driving people away or building up a barrier of resentment. I look at it this way: the patient is coming to me for help. He or she has likely had bad dental experiences in the past, has been out of work and/or lost his/her insurance, hasn’t been educated about modern dental treatment, or is not particularly concerned about the comfort or appearance of their teeth.
Whatever the reason, the important thing is that the person is coming in for dental care now.
The bottom line is that most dentists do not browbeat their patients about the condition of their teeth. That may have been common years ago, but is not nearly as prevalent today. If you are worried about how a dentist will react to the condition of your mouth, try to remember that a dentist has seen everything from black and broken teeth to no teeth at all. Your teeth won’t shock the dentist. If it does, or if your dentist insults you, find a new dentist. There are plenty of dentists out there who do care about helping their patients!”
Still not convinced? Here are some excerpts from threads which have appeared on our message board:
❓ “My teeth are terrible.. probably the worst on here.. Ive considered meds to make me go.. even just for a check up.. but i make myself panic at the thought of even contacting someone. I need help.. so badly.. im so scared.. and its ruining me.. this is not the way i want to be living.. but i physically cannot go.. and i cant take anyone comforting with me.. because im so ashamed of the neglect.
My teeth dont hurt at all.. but i can feel massive holes with my tongue and it makes me feel sick.. ive practically stopped eating because im so scared.. i cant sleep either.. im a wreck .. a nervous one.. and in need of some serious help… before i do something stupid..
Ive thought terrible things.. killing myself even.. i sound so stupid to think such terrible things about a dentist.. but i cant help it and i cant go to one.. no matter how hard i try..
Please someone hear this plea and give me some advice.. i feel so alone and so ashamed.. please…. someone
I need to find someone who has seen appalling teeth.. really bad.. so i dont feel so bad
At the moment i feel like dirt, scum…”
❗ “Embarrassment is perhaps THE most common concern voiced by people who haven’t been to a dentist in a very long time. The fact of the matter is that as dentists we really do see a lot of bad teeth all the time. Although it sounds like your teeth need a lot of work, this would be nothing new or unusual to any dentist you saw. We see people who need multiple fillings/extractions/root treatments etc etc all the time – literally every day. Some people aren’t lucky like you with good front teeth. For some people all that can be done is to remove ALL of their teeth. But even then it’s not the end of the world – we can make lovely, natural dentures so that they can eat, and smile again! The fact that you need a lot of work should not be an issue. The actual dentistry would not be a big problem and your teeth can be easily fixed no matter how bad they are (even if some of them do need to be removed.) The problem isn’t with fixing your teeth – any dentist could help you with that regardless of how bad they are. It’s how you feel about it all that’s the problem.
It is important that you remember that you are much more than your past. Of course, you cannot change the past- not even one second of it. Some things can’t be changed. However luckily some things can! You can change (either quickly or gradually) how what has happened to you in the past makes you feel now. You can then get the treatment you want, and deserve to have. Then all of this will just be a problem you used to have! You will have a healthy mouth and you can feel proud of yourself that you have overcome something which once seemed impossible.”
What are you embarrassed about?
Giving away some trade secrets here, but dentists don’t really give a damn about how decayed people’s teeth are. We don’t get angry and we won’t “get you into trouble about it”!
Seriously, you’ve got 24 broken teeth? Great news, I get to fix them and you get to pay me!
We spend years of our life learning to fix damaged teeth, so why should we get upset when we get busted teeth to fix?
So go and see a dentist, no matter what’s wrong with you, it won’t be half as bad as what your imagination is telling you right now
Embarrassment and feelings of guilt often go hand-in-hand. It might help to bear in mind what dentists have to say on this topic:
“I can understand why some may be embarrassed with the state of their oral health but would it help to know it may not be your fault. In my practice, I honestly have patients that brush 5 times a day…. damn 5 times in the morning, after each meal and at bed and they have decay WOW! That kicks the crap out of my own oral hygiene program. On the other hand, I have patients that don’t even own a toothbrush and they seem to have minimal to no decay… WHY? This comes down to many things, technique, crowding, bacteria present, diet, genetics etc. We should never judge or make rude comments; one it’s just plain stupid that doesn’t help anyone and two it’s counter productive.”
If you’re pretty sure you’re in for dentures, you may be thinking “yeah, great, this is all about people who’ve got some teeth to be saved, but there’s nothing there to be saved in my case…” It’s pretty much impossible to offer consolation for the loss that anyone would feel at losing what is essentially a part of their body, unless one has actually been there. There are a lot of support groups for denture wearers on the internet. Groups like this are great if you find yourself with a problem that’s not really dinner-party material. Here you’ll find support from people who’ve actually “been there and done that”, including many younger people. Over the last decade, massive strides have been made in the field of implant-supported dentures and bridges, which are permanently attached and function almost the same as “real teeth”. Although more expensive than “traditional” dentures, these have become increasingly commonplace.
It might also be helpful to know how dentists feel about dentures:
“Do you judge people with glasses? or one with a artificial hip? You would never say Oh My GOd look at that freak in the glasses what a loser? Why are glasses an acceptable prosthesis and dentures are not? Both serve the person in a beneficial way. Glasses let you see better and look good, dentures let you eat better and look good. Would you be surprized if I said many of the beautiful smiles you see around you, and ones you envy, saying I wish I had nice teeth like that …. well, they are dentures too.”
Anyway, the moral of all of the above is: don’t let your embarrassment get in the way of getting the help you need and deserve. There are ways of ensuring that the dentist you choose views their job as a caring profession and realises that there’s a person behind the teeth.
“I have many missing/broken teeth and am terrified of having a dentist look in my mouth. It’s taken me months to work up the courage, but I’m now in the process of selecting an empathetic dentist.
Thank goodness for the internet – I used to think I was alone in my fear. I was too embarrassed to talk about it with anyone. Now I realize that it’s not uncommon at all. I’ve also come to the conclusion that there are lots of understanding dentists – ones who won’t “freak” at the sight of bad teeth. Message boards are full of such accounts.”
If you suffer with dental phobia, it is possible that you’ll interpret remarks which others might simply regard as helpful advice or fair commentary as negative – and pretty devastating. Let your dentist know right from the start that you are very embarrassed about the state of your mouth and cannot cope with any negative remarks. This should eliminate any insensitive comments.