Fear of Painful Dental Treatment

Written by the Dental Fear Central Web Team
Last updated on January 17, 2021

Dentistry is simply too painful, I can’t handle that amount of pain. Going there is not safe.

Reasons for painful dental treatment

If you reckon that dentistry is simply too painful to bear, it’s likely that you’ve had at least one very painful experience in the past. Or maybe someone else told you about a bad experience they’ve had.

There could have been a number of reasons:

And, of course, some dentists are much more gentle than others.

Having dental treatment is not painful if you’re properly numbed up (though if you fear the sensation of numbness, this may not be much of a consolation – see our page on Fear of Feeling Numb).

But what if I fear the injection?

Some dentists have a much better technique than others, so just because you may have had bad experiences with injections in the past doesn’t mean that history will repeat itself.

You can find lots of additional information and tips on our needle phobia page.

Ask a Dentist: Is painless dentistry possible?

What’s the story regarding “painless dentistry”? Some dentists say it’s doable, others say pain is unavoidable?

“Painless dentistry is one of those “it depends” answers. For most procedures, I’d expect the delivery of the local anaesthetic to be totally painless for work in the upper back area and the lower front. For upper front teeth and lower back teeth, there would probably be a slight “jab” when the first drop or 2 of local anaesthetic (LA) went in. Piercing the skin is painless, if topical LA, or “the gel”, is used properly.

The key to minimising pain is in delivering the LA solution as slowly and smoothly as possible. It should take about 2 mins for a 2ml cartridge.

The Wand STA System

There is a gadget called “The Wand” which is basically a computer-controlled syringe which delivers the solution very slowly, although the same effect can be achieved with a good injection technique.

Some dentists when they’re dealing with an apprehensive patient fire in the LA really quickly. It’s the tearing of the tissues which this produces that causes the most pain. Other dentists are just impatient buggers and want the job done as fast as possible. They tend to attract stoical patients to their practice and they do very badly with phobic or nervous patients.

The actual procedure should be painless most of the time, there are some procedures which are likely to be painful and will require extra LA or perhaps an additional LA technique, such as doing a root canal on a very “hot” infected tooth. Anatomical variation can sometimes mean that unusual LA techniques are required. But this is actually quite a rare occurrence.” – answer courtesy of Gordon Laurie, BDS

Does numbing always work?

For the vast majority of people, getting numb is easy – one or two injections in the right spot and they’re numb. Unfortunately, for a small percentage of people, this approach doesn’t work. If dentists have not succeeded in getting you numb in the past, check out the following page: Can’t be numbed? What to do if local anaesthetic doesn’t work.

“How can I overcome my fear of pain?” by Dr. Jerry Gordon, DMD

The first step in overcoming fear of the dentist or dental treatment involves gathering accurate information to help you judge the veracity, or truth, of those fears. Knowledge can be a powerful weapon against fear. In fact, many people fear death because it is “the great unknown.” A comforting component of many religions is the promise of heaven and other rewards in the afterlife. Although I cannot promise you that your dental experiences will be “heavenly,” I can promise that it won’t fall at the other end of the spectrum!

Learning about how dentists deal with people’s fears is a good starting point in alleviating a fear of the dentist. Most people have at least some fear of pain or injury in life – and that’s a good thing. It prevents us from touching a hot stove (more than once) or driving a car into oncoming traffic. Fear is a protective and instinctive emotion that helps keep us safe. It should come as no surprise that when we are confronted with a situation or environment that we believe to be painful, we try to avoid it. Some people who avoid regular dental care do so because they believe that all dental treatment is painful.

So what is the truth about dentistry and pain? I won’t tell you that dental treatment is never painful, on rare occasions, it can be. But I will tell you that most of the time, dental treatment is either completely painless, or only slightly uncomfortable. And be reassured by the fact that most dentists are acutely aware of the impact of pain on their patients. Many dentists pride themselves on being “painless practitioners.” A dentist who causes a patient pain will sometimes lose that person as a patient, and there is a good chance that the person will tell many others about the bad experience they had at Dr. So-and-So’s office. Causing people pain during treatment is no way to build a dental practice and most dentists know that!

Reducing discomfort during dental treatment

Dentists have many ways of reducing discomfort during dental treatment. Strong topical anesthetic gels or patches are used to greatly reduce any discomfort associated with injections. Dentists also use very thin needles and inject the solution slowly to further reduce discomfort.

The most important way a dentist reduces or eliminates discomfort during dental treatment is to make sure that the patient’s mouth is as numb as possible during treatment. The approach I initially take is to begin treating the tooth very slowly. I will ask the patient, “Are you feeling this?” If the answer is yes, I either give them more anesthesia or wait a few minutes and test again. It takes some people’s mouths a little longer to become numb.

What to do if you feel pain

I recommend that you always signal your dentist to stop if you are having pain. If the dentist doesn’t listen, you need to find a new one!

In some instances, you may still feel varying degrees of pain even after everything feels numb. There are a few reasons for this, including inaccurate placement of the anesthesia, not enough time allowed for the anesthetic to work or severe infection in the area interfering with the potency of the anesthesia. The dentist can remedy these situations by redirecting the anesthesia (giving more), waiting longer before beginning treatment or postponing the treatment and prescribing an antibiotic to reduce the infection.

Fearful patients and pain perception

Over the years, I have discovered an interesting irony when treating fearful patients. The vast majority of these patients have a very high pain tolerance. When you think about it, it sort of makes sense. Fearful patients often avoid dental care and endure years of discomfort from their teeth. It seems likely that if they had a poor tolerance for pain, they would visit their dentist the moment a tooth became sensitive. Because of this, once a fearful patient develops trust with their dentist, the fear quickly evaporates. The fearful patient soon learns that dental treatment is not nearly as uncomfortable as the pain they go through every day with infected teeth.

When I have patients who tell me they are afraid of the pain, I make them a promise. I say that I will not perform the procedure (extraction, root canal, etc.) if they are feeling pain – plain and simple. On rare occasions, I will even reschedule the patient for a different day if the treatment cannot be comfortably completed.

Fear of pain following a dental procedure

Some dental procedures can cause discomfort after the anesthesia has worn off. Fearful patients are often concerned that they will be in pain following a dental procedure. These procedures include dental extractions (pulling teeth) and other minor dental surgery, root canal therapy, periodontal (gum) surgery and multiple dental fillings.

Dentists are just as concerned with managing pain after treatment as they are during it. One of the first things dentists do is to make sure that they perform the procedure as gently as possible. A dentist with a forceful technique can put excessive pressure on the teeth and gums, which can cause greater discomfort later on.

Dentists can also use anesthesia that lasts longer or give pain medication like ibuprofen prior to some procedures because these measures have been shown to reduce pain after treatment.

The final step the dentist can take is to call the patient at home after a potentially painful treatment. This is something that I have done for years. I like to see how my patient is doing, if the medication is working, or if the patient has any questions about the treatment. Some dentists do this, and I suspect more will in the future. Aside from being the right thing to do, research has shown that people’s perception of pain is less when the dentist calls them at home to find out how they are doing.

The impact of emotions on pain perception

Most dentists realize that pain is a subjective thing. What this means is that a person’s emotions have a large impact on their perception of pain. For example, if a patient gets the feeling that the dentist is insensitive or lacks compassion, there is a good possibility that other concrete measures the dentist uses to reduce pain will be less than successful. On the other hand, a dentist who makes a worthy effort to reduce all discomfort associated with dental treatment, and empathizes with his or her patients, will have much better results.

This article is © Jerry Gordon DMD, reprinted with permission.

Video: Fear of painful dental treatment

Daniel Finkelman of The Hague Dental Care has made a video about fear of painful dental treatment which you can watch here:

No matter what your fears are regarding the pain factor, they can be overcome. Pain during dental treatment is either entirely avoidable, or avoidable with very rare exceptions. And for potentially unpleasant surgical procedures, there are various sedation options available.

Visit our support forum to get help with this and other fears, or to simply get things off your chest!

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