Dental Treatment and PTSD

[odette]

Salut everyone,

my name is Odette and I served as a peacekeeper for 10 years, where I was exposed to a lot of violence and evil while protecting innocent civillians. I have been diagnosed with severe PTSD (Post Traumatic Stress Disorder)

Having PTSD amplifies and complicates my dental phobia to the fact that I'm terrified to go to the dentist because, for example, I get confused with someone torturing and hurting you vs. a dentist performing treatment to help you.

If I ever got up the nerve to go, what is the likelyhood that an large urban practice dentist would know what PTSD is and maybe even a little tiny bit of training around such patients?

When would be the best time to disclose I have PTSD since it will so profoundly affect my treatment?

I know I'm screwed up, but I just want help.

Would any dentist here have any tips for me so I can finally get some help?

Thank you so much for listening to me.

Trying to be brave,
Odette

-- bravery is being scared out of your mind but rolling out with the convoy anyway.

 

[Stress Doc]

Hi Odette:

You are not "screwed up." You experienced real trauma that had an affect on you. This does not mean you are deficient of lacking in any way. You faced events, situations and challenges few of us can comprehend.

I cannot speak for dentists in Canada but PTSD training is not usually part of standard dental training in the USA. This does not mean many dentists have not dealt with this or read on it. PTSD comes from many sources and is not uncommon.

I would talk with the dentist at the very start about your concerns and experiences. Building trust and understanding is always helpful. You can also develop a plan that works for you.

fear is fear, regardless of the source. Understanding the nature and source is necessary to allow the both of you to work together.

This is not an insurmountable problem and can be dealt with. Good communication is one of the keys to success. I wish you the best.

If I can help you in any way, let me know.

Blessings

 

[odette]

Thank you so much for your response, Stress Doc, I`m just trying to trouble shoot so I don’t scare the shit out of the dentist because he is unprepared for the potential reaction I might have to him being in my personal space.

I am bringing my best military friend with me tomorrow so he can shout Stand Down`! if I start key`ing up while in the chair. I think having Chris there will help both me and the dentist. I mean, I know I have to check myself because it would be terribly unfair if I let my shit get to me so bad that it started to affect the dentist since the poor dentist is just trying to do this job and help me, and doesn`t need to hear me vocalize my fear through swear words, etc, directed at him.

I`m just trying to figure out how much I can assume will be intuitive between the dentist and I….see, I know people here have suggested that the dentist and patient work out a hand signal to let the dentist know if you need a pause in treatment, but if I get scared enough, I go into soldier mode and I will slip into a disassociative state where, sure, I`ll be able to tough it out and take it and I won`t flinch or move or breath, but that might not be the best or safest way to get through dental treatment. See, when I`m in that state, I won`t be in a position to raise my hand to ask for a break, so I`ll need the dentist to attempt to notice when I`m starting to lose my shit and stop for me, instead of relying on me to speak up.

The worst part about going to the dentist, well, one of the worst parts, is the having to lay flat on your back in the chair and let someone hurt you and you can`t do anything about it, act evasively to avoid being hurt, you just have to lay there and take it. I just hate feeling helpless and vulnerable like that. I hate it.

 

[brit]

Odette
Congrats on getting so far. Glad Chris is coming along I think this is a good idea so long as he doesn't put any pressure on you 'to tough it out' military style.
I strongly advise you to not even sit on the chair until you have chatted through your issues or at least what you need the dentist to do differently with you, so you can accept treatment.

It's best to give them some ideas of what you may think will work for you in case they are not experienced with phobics...'yes I have PTSD from military service and abusive military dental treatment (explain) BUT so long as you give me breaks/check on me every 3 minutes I should be able to cope.

You probably need to 'connect' with the dentist before you place yourself in what you consider to be a vulnerable position (It is potentially vulnerable for everyone but a civilian dentist is not a military dentist...military codes do not apply and most regular attenders lie down knowing if they say/signal stop..the dentist will stop immediately and top up their anaesthetic or whatever).....you basically need the dentist to look you in the eye and reassure you/give you his/her word that they would NEVER do to you what happened in the past....and trust me they wouldn't because you could sue them for assault etc etc ....since you are currently in a lot of pain, you may decide having had the chat that you want some treatment for immediate relief of pain..but if you don't like the dentist's attitude or they don't seem right for you....remember this is your call...you can elect to go elsewhere.

You might also benefit from sedation or this may be the absolute last thing you want as it involves giving up a greater degree of control....if this is the case, instead...you probably need someone willing to go at your pace and use lots of TLC....if not much gets done at the appointment but you feel you can work with the dentist at a subsequent appt that would be major progress.

In civilian life dentistry is an elective procedure something you opt to do; it can also be done painlessly using various techniques so your fear of having to accept someone inflicting pain on you is actually not likely to correspond to reality.

Do you know what facilities this particular practice offers and how have you chosen this dentist?...yes any dentist probably can deal with your immediate pain issue but with your history you owe it to yourself to find someone who is going to reduce/eliminate your fears by their behaviour not add to them.

 

[Stress Doc]

Hi Brit

Spot on , as usual. Are you sure you are not a psychologist? You know more and give better advice than many of my colleagues.

Odette:

I agree with you, discuss this in detail with the dentist. A good experience will help you reframe your past experiences. Working with your dentist will help in making sure your treatment is just what you need.

Blessings

 

[brit]

Stressdoc
Thanks for the compliment.
Odette - good luck and remember there are plenty more kind competent dentists out there if you don't strike gold today.

 

[Clem]

If you are in or near a university town, I'd check with the Dental college there for references to specially trained dentists (the college of dentistry is probably a subdivision of the medical college). Even if you can't find a person who is specifically trained or there's not one close, the dental community at the college will pretty much knows who is competent and who isn't, since that college is likely to have trained most of the dentists around. You might find someone at the college, in fact. It might streamline the process for you, and save you from having to explain your situation over and over while trying to identify someone a random.