Appointment tomorrow - quite worried

[Cactus]

I have managed to contact a local NHS dentist who "welcomes anxious patients." They offered me an appointment tomorrow morning for registration. I am a bit stressed, unsurprisingly. What actually happens at registration?
I asked the receptionist to note that I am very anxious, but I am worried that I am so phobic they will be taken aback. I am likely to do the following:
- cry, possibly in the waiting room
- need to take my time speaking
- cry more
- shake
- did I mention crying?
- breathe rapidly
How abnormal is this? I once had a panic attack because people just wouldn't stop talking about dentistry around me. I can probably manage to not have one tomorrow, but my distress is going to be visible.

I think I'm likely to request a referral for sedation treatment, but can I actually do that? Can I say straight-up that I think I need referred? Will it annoy them?

 

[vicki]

When you register as a patient at an NHS dental practice, they usually ask you to fill in a few forms; these usually consist of a personal/contact details form, an NHS form that you sign to confirm that you're entitled to NHS treatment (so you usually need some proof of ID and your address - utility bills are usually OK) and they will probably ask you to fill in a medical history questionnaire, just to make sure that they know about any medical conditions you've got and any medications you might be taking. Once you've filled the forms in, they usually ask you to give them back to the receptionist (apart from the medical history form - sometimes you have to give that to the dentist). You might want to get there a few minutes early, so you've got time to fill in any forms before your appointment.

When you phoned up to make your appointment, they will have started a new record for you on the computer system, probably including a note that you're very anxious. When you see the dentist, they may have already been told that you're anxious, but whether they have or they haven't, it's a good idea to let them know anyway. Very few people actually enjoy going to the dentist, some people just dislike it, some people are really worried about it and some people are absolutely terrified by it. Most dentists are used to seeing patients who are nervous, so it shouldn't be that much of a surprise for them... especially if someone has put a note on the system beforehand .

At the NHS practice I used to go to, I would sit like a coiled spring in their waiting room and I would be absolutely shaking like a leaf. Sometimes I even broke out into a cold sweat. When my name was called, my legs would turn to jelly and I could hardly speak during my appointments because I was that terrified. I saw several dentists during the time I was a patient there and generally, they never reacted badly when I sat there trembling like mad and trying not to panic.

Not all dentists are great with nervous people because it does take time and patience and since they're only human (believe it or not!!), not everyone has the communication and people skills needed, but most of them will try and help you to feel at ease. If you find that you don't feel comfortable with them for whatever reason, it just means that you need to find somewhere you do feel more comfortable. If they pro-actively advertise that they welcome nervous patients, then that's often a good sign . You will know if it's the right place for you.

Dentists can usually refer you for sedation if you need it, but I think the NHS waiting times and facilities vary from area to area. If it turns out that you need any treatment and after trying without sedation, you decide that it's what you want, then I think they should be able to refer you. The thing about sedation though, is that it's great if you just need to get through a course of treatment and not remember much (or anything) about it, but it doesn't really help you to overcome your fears in the long term. In order to start overcoming your fears and the feelings of panic, you need learn a new way of responding and feeling when in that situation and that means being aware and participating in a positive dental appointment with a dentist who will take the time to make sure you have a positive experience.

You could also ask your GP to prescribe something like Diazepam or Temazepam. It wouldn't knock you out, but what it would do, is help you to feel more relaxed and calm and so more able to cope with any treatment. It's not for everyone - some people do prefer to be unaware of what's happening, but I've found it helpful over the past few months whilst I've been having root canal treatment on a few teeth. I was still awake and able to walk and talk, but I was a lot calmer than I would've been without.

 

[Cactus]

Posting from the waiting room. It's not that stressful being here after all!

 

[Cactus]

I only need a few fillings so it's not nearly as bad as I thought. The tooth I thought was very bad actually has a filling in it which is the black I saw. I had so many fillingsvas a child I don't know where they are! I had some trouble with the x ray as it made me gag.

 

[rabidstoat]

Yay, sounds like you did great! I had an emergency root canal my second day on vacation (broken tooth, extreme pain, and it was a solo vacation so all on my own!) but luckily found a great, albeit extremely expensive, dentist dealing with dental phobia. I did a consultation in his office. I hardly ever cry at, well, anything, but all the stress and anxiety (I hadn't been to a dentist in 6 years, things were a mess!) had my blubbering like a baby. He was real understanding and sympathetic and had tissues on hand, so though I felt like an idiotic baby at the time, it was probably not uncommon. He seemed prepared and unfazed.

 

[Cactus]

I am not sure this dentist was experienced with phobic people. However, the he was actually quite good for me - he was confused by me suddenly panicking that he was going to pull out all my teeth, but the matter of fact way he had actually kept me quite calm. I expected much worse than some fillings.
I get a filling a week on Monday. He wants to see how I go with a single filling first, as I was very nervous (but not as much as I expected - he had to tell me to relax a few times, but I didn't lose control at any point) and see how I go with that. The injection won't be much fun for me, but it's only a few seconds of fear.
I am going to try to do without requesting sedation, because as Vicki says, it's not great for properly overcoming fear and I would rather deal with the underlying phobia problem if I can. It probably wouldn't kill me to look at hypnotherapy, but so far I think I am doing well on my own - I have been known to have a full-on panic attack and nearly pass out because people were talking about dental treatment, so going to have a checkup is a very big jump from that.

 

[Cactus]

I had the first filling today - I cried at the bus stop, I cried at the reception desk when they asked my name, and I cried a LOT when I sat down in the dental chair. But it was actually not that bad! The dentist asked if it was the injection worrying me, and I said yes - he gave me a very small and quick one which I barely felt, which numbed my gum enough that the proper injection was barely noticeable. I felt something from it at one point and whimpered, so he stopped and waited before giving me the rest of the anaesthetic. After that, it was easy. I had some fear of the drill - I was scared that the numbness would suddenly wear off, but it obviously doesn't work that way. After a while I actually relaxed and it was all fine - totally painless, very little gag reflex etc. Apparently it was a complicated filling and it took a while - he had to fill two things instead of one. It all felt fine though. It was the only tooth in the upper jaw that had been giving me any pain at all, and having it sorted out is a massive weight off my mind. Next Monday I am getting the lower jaw done - I think there's 3 or 4 in total but i doubt he's going to do that much at once!
I had initially thought I would need a sedation referral, but apparently not. Hooray! i feel almost cured - I think it's highly likely I will have a phobic reaction to the needle again next time, but this is a big improvement from how I was.

 

[vicki]

That's fantastic news - well done !!

I had the first filling today - I cried at the bus stop, I cried at the reception desk when they asked my name, and I cried a LOT when I sat down in the dental chair.

That's what I quite often do as well; it's better off out than in, though - if nothing else, it lets them know how scared you are . Having said that, I've gone from being very tearful during routine stuff like fillings, to being quite laid back (for me anyway!) about having had 6 root canals over the past few months... although I think the Diazepam I took for those appointments may have had something to do with it .

I had some fear of the drill - I was scared that the numbness would suddenly wear off, but it obviously doesn't work that way.

The numbness doesn't usually suddenly wear off, the feeling in your teeth and mouth tends to gradually come back rather than being numb one minute and not the next. It depends on what type of injections you've had, the type of local anaesthetic used and the number of injections you've had. Whenever I've had fillings, my mouth has been still fairly numb for a couple of hours after the appointment has finished and then the feeling gradually comes back.

Lots of people fear the drill and discovering that they suddenly feel pain half way through treatment. This was one of my biggest fears too; especially as I've had problems with getting numb in the past as well as a few dentists who have just carried on, even though I've been in obvious pain. Usually, if the local anaesthetic is wearing off a bit too early or maybe it hasn't worked as well as it should, then it starts off by being a bit sore or uncomfortable first, before proceeding to actual pain. The important thing is that you tell your dentist as soon as it feels uncomfortable or sore and then that way they can give you more anaesthetic and you shouldn't feel anything after that. Having a pre-arranged 'stop signal' or letting your dentist know that you're worried about not being numb, can help you to feel more in control of what's happening as well.

Next Monday I am getting the lower jaw done - I think there's 3 or 4 in total but i doubt he's going to do that much at once!

It depends on how you feel and how much you can cope with. You might decide that you're ready for 3 or 4 fillings; especially if they're in the same part of your mouth because you'll have already had the injections to make it numb . It's surprising what you can cope with if you're feeling confident and you can trust the dentist doing the treatment. I had an appointment about 2 or 3 weeks ago with the endodontist who's done all my root canals and he did the 3 permanent fillings in the last of the root canals, in preparation for crowns in six months' time. I've never ever had more than 1 filling during an appointment before, so I was quite surprised that I found myself laid there, quite chilled out and listening to the radio instead of stressing out. I think part of me just thought, "Oh well, whatever... I've already had 6 root canals, so if I can cope with that, I can cope with fillings!".

I had initially thought I would need a sedation referral, but apparently not. Hooray! i feel almost cured - I think it's highly likely I will have a phobic reaction to the needle again next time, but this is a big improvement from how I was.

Hooray indeed!!!

If you *think* it's highly likely that you will have a phobic reaction to the needle again next time, then it's highly likely that you will; it almost becomes a self fulfilling prophecy because you can convince yourself that it will happen... and so it does. You coped and were able to have a filling this time, so you can do it again .

For some people, fear does magically disappear when they've had a positive appointment and realised that they coped a lot better than they thought they would. But, usually what happens, is that with each appointment, although you might still feel nervous or scared, over time it does get less and less, especially if you've found a dentist that you trust and feel comfortable with. Then one day, you go to an appointment and you suddenly realise that you're sat there having treatment and you're not really all that bothered about it anymore. Different people make progress at different rates, but with each appointment, it does get better .

 

[Cactus]

Well, you were right. I decided to just see if I had a phobic reaction to the needle instead of treating it as a foregone conclusion. I didn't enjoy the injection and I yelped partway through, but I didn't have a full on phobic reaction. I didn't cry at any point.
I had a harder time with the drill this time. The filling was in my lower jaw and the vibration was far more intense than last time. I found that quite disturbing and wriggled quite a lot. There was still no actual pain, although I had a tough time remembering that the anaesthetic doesn't suddenly wear off. I felt myself panicking at the idea that the drill would suddenly hit a non anaesthetised part in my tooth. That's not possible but it was difficult to control the reaction. Also, I moved my tongue and knocked a cotton swab down my throat. Still, not breaking down was a good step. I am back next Monday and then it's only one more filling session.

 

[Deejay]

Well done you!! Bet you feel like you could conquer the world?
your major issue seems to be the injection?
just ask if they have the numbing gel, they used that on me and said most dentists should have it, they put it on a little block and hold it against your gum for a while it smells and tastes of bubblegum so in itself the smell and taste is a distraction as it's so out of context un clinical but it really numbs super good and the injection is not painful and my dentist still then goes back round and doubles up on the injections once I am mega numb, experience will now tell you that the numbing wears off, but I have found it really amazing stuff to have pre injection, good luck with your future treatment, you have done so well xx
D.J

 

[Cactus]

I do feel pretty good. It has all been much easier than I expected and I am really hopeful that I can stop th phobia.
I don't think my dentist has gl. He does one short injection to numb the gum before the main one and any discomfort I feel is so minimal that i don't think gel would make a difference. My yelping is reflexive.

 

[Cactus]

So I am back for a filling on Monday and I have been pretty good with not stressing between appointments. I am basically not letting myself think too hard about it and also I am focusing on the massive relief of getting myself sorted. I have noticed, though, that I am feeling very tired quite a lot of the time and also really over emotional, irritable and anxious. Is tuat probably coincidence? I was wondering if it's connected to dental fear because it's an effort to be going through this, even if it's not the complete devastating nightmare I imagined.

 

[kitkat]

So I am back for a filling on Monday and I have been pretty good with not stressing between appointments. I am basically not letting myself think too hard about it and also I am focusing on the massive relief of getting myself sorted. I have noticed, though, that I am feeling very tired quite a lot of the time and also really over emotional, irritable and anxious. Is tuat probably coincidence? I was wondering if it's connected to dental fear because it's an effort to be going through this, even if it's not the complete devastating nightmare I imagined.

Sounds normal to me. I think even though you are feeling less anxious overall, we can still harbor stress and anxiety in our subconscious that eventually manifests one way or another. Some people, even though they feel 'okay' about impending appointments, experience bad dreams before appointments, lose their appetites, become irritable and lash out at others, etc. I remember when I first started coming to terms with my dental anxiety and had lots of filling appointments, I would get absolutely sick to my stomach a day or 2 before appointments and was unable to keep down any food but with lots of time and persistence that stopped eventually (thank goodness!). I also used to physically shake a lot during appointments even when I did not feel particularly anxious about what was happening...that also improved with time and lots and lots of "chair time." For me, things actually got much MUCH worse just before they got a lot better (no idea why maybe it just opened Pandora's box and all of my repressed emotions were set free). I began to worry a bit that I might not be in the right place but I stuck it out and it paid off. Persistence is half the battle; finding the right dentist is the other half. It gets better you just need to be patient and go with the flow. Good luck with your appointment on monday!

 

[sincitysoul]

Cactus, I think that's all normal. I'm so much happier with my current dentist, but I do still feel the initial "OHMYLAWDWHATAMIDOING" feeling at the thought of going for a cleaning or any other procedure. For a few days before the appointment, I do seem to be more tired or (as my mom puts it) nit-picky about things, but when I stop and remind myself that it is just the anxiety kicking in, it seems to calm down. I've found that getting a decent night's sleep before the appointment really seems to help - even though it's a struggle to sleep when your nerves are going. Like kitkat, I also get the jittery feeling in the chair, even though I trust this dentist 100%.

I think that the more dental work you have done at this office (even if it's just a routine 6-month checkup), you'll begin to feel more at ease. Make a routine out of appointment days - wake up at a certain time, do things like brushing your teeth or dressing in a certain order, have a set time when you want to be out of your house. Maintaining a schedule will give you something to think about besides the dentist. For example, I too have a dentist appointment on Monday. I know that with the appointment being at 1, my dad will want to leave by about noon, so I'll need to be ready to go by 11:30 (we're a family that takes forever to get out of the house ). Like I said, the routine will get your mind off of being in the chair.

Good luck - and I am so proud of you going to the dentist even though you find it frightening!

 

[vicki]

You did really well . Feeling irritable or anxious in the run up to appointments is entirely normal; as the others have said. Anxiety manifests itself in different ways in different people. I'm a lot better now than I used to be, but a few years ago, when I was a patient at a different practice, there were a whole load of things that I used to have to do to cope with my upcoming appointments. I would get so anxious and stressed out that I would be sick before and after the appointment and on several occasions, I actually threw up in the drain at the side of the road as soon as I got out of the building. In an attempt to avoid this, I used to have to starve myself and limit the amount of fluid I had to drink as well (like when you starve before surgery so you have an empty stomach)!! My skin would go really blotchy when I was in the chair and it was really obvious that I was having an adrenaline surge, so I used to wear long sleeves and cover up as much as possible - even in summer when it was hot . People could tell when I had a dental appointment coming up because I would get really edgy and irritable and would bite anyone's head off if they spoke to me.

During the root canal treatment I've had over the past few months, particularly during the first few appointments, I was shaking really badly, had skin so blotchy that I looked like a snake and had an adrenaline surge so bad that the dentist thought I was having an allergic reaction. But, instead of feeling embarrassed about it and doing everything possible to hide it, I just let it happen and after a little while, the fear eventually subsided as though it had burnt itself out. I felt comfortable with the dentist and knew that he wouldn't react badly, so I just thought, "What's the worst that's going to happen if it's obvious that I'm panicking?" I can remember being sat in the chair at one appointment and immediately after he'd done the first injection, I started shaking really badly (and really obviously !) so I tried to make a joke of it by saying that I had enough adrenaline to run a marathon. The dentist rubbed his hands together and said "Well we can go for a run if you want!". After that, I realised that it didn't matter if I started panicking because nothing bad would happen and it wouldn't last forever anyway.

It's a lot easier said than done (and I should know because it's taken years for it to sink into my brain!) but don't be worried about what happens if you become anxious or scared during an appointment. The dentist shouldn't react badly and if they do, then it just means that maybe it's not the place for you.

I also tend to yelp during injections; sometimes it can't be helped . I'm fairly sure they must be used to it because I can't think that many people just lay there in total silence and enjoy having an injection. The numbing gel does help a bit, but usually I find that it's the speed of the injection that makes a difference. Even though you want it over with as quickly as possible, the slower it is, the more comfortable it usually is. If my own dentist is doing an injection a bit too fast, I usually end up making a few feeble yelping noises . It works though - he slows down straightaway and starts apologising and telling me how well I'm doing (which is even better because he has a really nice voice, so a few yelps are worth it for the amount of soothing and praising that follows )!!

 

[Cactus]

Thanks for all the helpful responses and encouragement. I am kind of relieved to hear it's not just me who gets like this. I have been feeling quite proud of myself overall and I have had such a huge burden of stress lifted by finding out that my avoidance of treatment hasn't caused more damage that it came as a surprise that I am feeling like I am. I start crying a bit whenever I think about another filling, so I am now quite sure that my general not feeling good is related. I know that the treatment isn't so awful, but even so... I guess that it's actually pretty reasonable to experience a backlash when you go from refusing to go near a dentist to three filling appointments in as many weeks.

 

[kitkat]

Sometimes my own reactions surprise me (and probably surprise my dentist too ) even after 10 years with the same dentist. During my last appointment for a filling about a year and a half ago (after many, many positive appointments) I had this anxiety that just kept building through the appointment that I could not quell. My dentist stopped probably 5 times just to check that she wasn't hurting me because I seemed so uncomfortable and shaky. My dentist offered me a break but I declined because I just wanted it done and wasn't actually having any pain. A little more than halfway through I started just burning up and broke out into a full blown sweat! Adrenaline is a real nuisance sometimes! My dentist ended up giving me a stress ball to try to work out some adrenaline and distract myself which she's never done before! There was nothing out of the ordinary about the appointment although I had a lot of stress from other situations going on (mom was hospitalized at the time) so it's not always about the appointment specifically...it can be an accumulation of factors that aren't even directly related to dentistry. Sometimes you just never know what's going to happen so it's best to just accept it for what it is and go with it. The more you try to fight it or hide it, the more stressed you feel and it only exacerbates the anxiety.

 

[Cactus]

I survived again. I cried really hard in the chair before the injection though. It was painless but I just lost it. I calmed down during the filling itself, but I wasn't happy about having a bracket thing put around a tooth or having a file used between them. That was abit ppainful for my gums.
I am not going back until the 4th now so I can have a break.

 

[kitkat]

I survived again. I cried really hard in the chair before the injection though. It was painless but I just lost it. I calmed down during the filling itself, but I wasn't happy about having a bracket thing put around a tooth or having a file used between them. That was abit ppainful for my gums.
I am not going back until the 4th now so I can have a break.

You made it! Good for you!!! Sounds like you probably could have used a tad more anesthetic as you should only feel pressure with the bracket. The bracket is called a matrix band and holds the shape of the tooth when there is decay on the surface inbetween the teeth. I am not a fan of it either!

Enjoy your break! You deserve it!

 

[Cactus]

Well it's all over. I have been cleared - final two fillings done yesterday.
I had a bit of a hard time. I think taking a few weeks off actually made me a bit worse. I also had to deal with a much deeper injection than normal - it was not painful, but I found it hard to deal with anyway. I expressed my feelings by literally whimpering and whining like a dog... totally normal, right? And then the thing I was afraid of happened - I was not totally numb when the drilling started. Just so everyone knows, it wasn't that bad at all! It was very mildly painful - more uncomfortable than painful, actually. I raised my hand and had him stop until I was more numb. Easy. It did increase my anxiety, though. In the end, I needed a second (smaller) injection as I was feeling more pain - it turned out that my jaw muscles were just aching because I had been in the chair for a while.
One back tooth may or may not be ok. It may need a root canal down the line. Other than that, I am fine. I made my six month appointment for a checkup because I was worried that if I didn't set it up, I might not come back. The receptionist noted that I seemed much less anxious lately - and I burst into tears. I was just really, really emotional.