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Dental phobia has returned

N

nkt

Junior member
Joined
Jun 2, 2020
Messages
3
Location
United Kingdom
Hi all,

I've never liked injections and had my first panic attack almost 20 years ago, while donating blood. As a result, I stopped visiting the dentist altogether. Five years ago, I cracked a tooth, and it was extremely painful. I went to the dental hospital and, to my amazement, I was easily able to tolerate the extraction, despite the trainee making a total hash of it, almost pulling my head clean off my shoulders and having to get someone else to take over. I then registered with a dentist and had several fillings and even a root canal on a molar with no problems at all.

Last year, the root canal failed and the tooth had to come out. This time, I was extremely anxious about it for weeks beforehand and had a massive panic attack during the procedure, which was fairly quick. The dentist was very understanding, but I felt utterly humiliated. Shortly afterwards, I needed a filling on a neighbouring tooth, but couldn't face the appointment and cancelled it. Now, some months later, I can feel an abscess forming under that tooth, my only remaining lower molar on one side. I am absolutely petrified about going back. I'm consumed with thoughts about the injection, being unable to 'escape', making a fool of myself again and losing yet another tooth. My GP has given me two 2mg diazepam pills but I doubt that will help much. Any other form of sedation is not an option as I have no one to accompany me to appointments. Does anyone have any advice? Apologies for the wall of text.
 
Enarete

Enarete

Super Moderator
Staff member
Joined
Sep 18, 2017
Messages
2,738
Hi nkt:welcome:,

your post doesn't look like a wall of text to me but even if you needed four pages of text to share how you feel, it would be ok and what we are here for :)

Fears can behave weirdly and there are many reasons why anxiety can return. I was wondering whether you had a suspicion about what caused you to have such an extreme anxiety before the last procedure or what caused the panic attack? It's not surprising that you couldn't bring yourself to getting that filling if that was your last experience.

Generally speaking - and you will find a lot about this in the articles here on this website - there are two ways of coping with treatment - the first one are drugs, the second one is a dentist who takes the time to put you in control and makes efforts to figure out how to prevent you from having a panic attack. If you know what triggered you and are able to watch yourself as your approintment goes on, you can let the dentist know that your anxiety is getting worse and ask for a break. Getting up for a while, getting a sip of water, having a non-tooth related chat or a chat about how you feel, those are all things that help you to calm down and make you able to go on with the procedure. If your mind sees that you are in control and can stop at any time, your anxiety will lessen. You can use a stop signal also during the injection and your dentist should be happy to stop.

Would it be an idea to first only schedule to have the tooth looked at and find out what treatment options you have? Such an appointment would be a good opportunity to talk about how to tackle the treatment in the most comfortable way. After that you can still decide whether to schedule and go for the treatment or not...

All the best wishes
 
N

nkt

Junior member
Joined
Jun 2, 2020
Messages
3
Location
United Kingdom
Hi, thanks for your reply. I think the problem was that I had well over a month to dwell on it, and the constant discomfort and pain made it impossible to forget. The panic attack started as soon as the cracking noises started; unfortunately, I've never been able to stop a major panic attack once it starts.
 
krlovesherkids777

krlovesherkids777

Super Moderator
Staff member
Joined
Jul 26, 2017
Messages
2,903
Location
Minneapolis, MN
Nkt,


I 100% agree with @Enarete , just love everything she mentioned about going and having a talk about your fears. what would help, and anything you want to chat about before feeling like you need to just get it done. I agree with being in control and how that is very calming to know they would respect your stop sign and how they would respond if you did panic or have anxiety.

I know for me I walk into my dentist feeling better that even though I'm anxious and I know I will be pretty much everytime. I also know he listens and takes my pain and questions and experiences very seriously and that I am in control.

You mentioned about cracking noises is that in the treatment? if so, could you maybe take headset to listen to calming music and not hear the dental noises? and diazepam. have you taken it before? I know for me it helps me be a little more chill and relaxed during treatment but still allows me to be fully alert and feeling in control.

Glad you are here! :grouphug:
 
N

nkt

Junior member
Joined
Jun 2, 2020
Messages
3
Location
United Kingdom
Hi,

I know that, ostensibly, I should feel as if I'm in control. However, I worry that if I get to the stage where I have to put my hand up, it's already way too late. I can't go home with my tooth halfway out, and if we wait for my panic attack to subside, we'll be there all day.

The cracking was just the tooth breaking apart as it was extracted. I've ony taken diazepam a couple of times before, during panic attacks years ago, and it didn't make any difference. Presumably it was a very low dose.
 
Enarete

Enarete

Super Moderator
Staff member
Joined
Sep 18, 2017
Messages
2,738
There is no point in waiting for a panic attack to subside, that's when it's too late; the only way to handle that is not to allow it to come in the first place. For this reason it's important not to interrupt the procedure just once you feel you're losing it but once you see the anxiety is getting higher, no matter how slightly, instead of staying constant or getting lower.

I ususally have to stand out of the chair several times during even a single check-up. Sometimes I even run out of the surgery for a moment (my dentist is cool with that and sits there until I come back, the receptionist usually looks a bit shocked while I am running to the door). It took a lot of visits to make me able to even give the stop sign and to learn that I have to use it whenever I feel something is building up. So it would be me jumping out and in the chair, three, four, five times during a visit, simply whenever I feel I am getting worse and I wouldn't go back until I feel calmer again. Also before even going into the chair there is a chat and I let my dentist know once I feel calm enough to start. With the time my tolerance got better and better and maybe in few years I will be able not to interrupt at all. What I want to say with this story is, that there are possibilities to deal with this and it is about watching yourself closely, having a good supportive dentist, communicating with them and a bit of trial and error.

There is also a technique called structured time which is about your dentist and you agreeing on a certain time the treatment would be going on before you get a break. By certain time I mean seconds. If you, for example have difficulties coping with an exam, you would set a limit of lets say five seconds, your dentist would start and end exactly after five seconds and you take a break to calm down. This would take the burden of giving the stop signal away of you. Not really applicable to extractions, but for many other things. For now, the first thing you need is an assessment anyway.

You will find a bit of what I mentioned and much more in the article about panic attacks and structured time here on the page.
 
letsconnect

letsconnect

Administrator
Staff member
Joined
Jan 1, 2005
Messages
5,170
My GP has given me two 2mg diazepam pills but I doubt that will help much. Any other form of sedation is not an option as I have no one to accompany me to appointments. Does anyone have any advice?
Hi, would nitrous oxide be an option? There's no need for an escort with nitrous oxide. We've got a page with more details here:

 
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