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Feeling safe at the dentist

O

odette

Member
Joined
Sep 10, 2009
Messages
89

Hello everyone,

I have PTSD -- post traumatic stress disorder -- from serving as apeacekeeper for almost 10 years.

I did manage through support from this forum to get to a dentist I thinkthree years ago (I know the fact that I'm not even sure is part of theproblem).

While I did manage to sit through x-rays, that was all I was able toaccomplish. I never went back. Partly from sheer fear and partly because I hadsuch a damn hard time just managing the x-rays alone, I felt humiliated by myover reaction when it's not like I even had any treatment or anything done.

I had two strong male friends accompany me, for support and also, to behonest, to keep me from accidentally losing my shit on the dentist if I wastriggered.

I know I need to go back. I know this because I actually risked self-surgerya few weeks ago rather than book an appointment and have it looked after safely.I know this must be a huge red flag for phobics when you feel so have to resortto such dangerous extremes just to feel safe.

And despite the numerous and dangerous reasons why self-surgery is not safe(dealing with an abscess) which I cannot claim I am ignorant to, I really feltlike that was the safer route than attending a dentist.

Because 1: I’m afraid of the dentist. 2: Even if I went in to get the abscesslooked at, draining it doesn’t actually remedy the problem and therefore, Iwould get the bad news from the dentist that the treatment wouldn’t be over andI would have to subject myself to more treatment. 3: From the x-rays, I’m sureI would have been informed to all the other treatment I would need.

And the onslaught of this news would have made me feel unsafe, and I wouldhave lost my shit.

This said, anyone with PTSD is hyper-vigilant about safety. That’s all Ineed. But I don’t even know how to bring this up to my dentist so they wouldactually understand what I mean (and not misunderstand me and see me as acoward, I mean, I know I am a coward, I just don’t want it told to my face)when I don’t even know what safety at the dentist means.
 
kitkat

kitkat

Super Moderator
Staff member
Joined
Mar 27, 2006
Messages
1,583
Location
United States
Hi Odette,

It's great that you were able to get though the xrays that first visit. It is also great progress that you have made the realization that you need to seek treatment from a professional rather than attempt to treat the problem yourself because as you said, this would probably result in more harm than good.

I don't have any experience with PTSD so I can't speak for that. But as a fellow dental-phobic, I think I understand what you're trying to say in regards to feeling "safe." I think that in a lot of ways, the role of the "dental patient" is a very vulnerable one. I once read somewhere (may have even been on this site somewhere) that the dentist is the one person who can cause harm but is also the person trusted to protect you from any such harm. Therefore, in order to feel "safe" you need to be able to trust that your dentist will "protect" you from any potential threat that comes with the territory. What I would suggest is to think about specific behaviors that are exhibited by the dental staff that would make you feel more safe or vulnerable to determine what triggers occur that make you feel unsafe so that they can be avoided. For example, I feel safer establishing a stop signal prior to a procedure and having the dentist positioned in front of me when working on my teeth rather than from behind. I also feel safer when they explain each step of a procedure to me and warn me about any sensations that I might experience so that I'm not startled. These things make me feel more in control of the situation and less vulnerable. As a result, I feel "safer." I trust that during a procedure my dentist will do all that they can to act in my best interest and maximize my comfort. Unfortunately trust is something that is built overtime, very slowly and gradually. But I find that some of these small gestures are very helpful in laying a foundation for building that trust on. In my opinion, it's more about open communication of your specific fears and your dentists willingness to address them. If you are able to communicate specifically what you fear and what makes you feel "unsafe" they may be able to better accommodate you at appointments by avoiding those triggers. I feel like I've rambled a bit but I hope this helps some. Hang in there! You are not alone in this struggle and we are all rooting for your success!

Kitkat
 
A

April

Well-known member
Joined
Jul 26, 2008
Messages
281
Hi odette

As kitkat said, well done for getting through the x-rays and now realising that you need further help ... it really is the first step.

If you have a problem talking to the dentist I fully believe in the power of the internet, can you start up an email dialogue with the dentist? That's how my dental journey started. It doesn't matter how long or in depth the email is just so long as you get it ALL said. Send links in the email re: your PTSD to emphasise your points .... communication is a wonderful thing and with the right understanding dentist you will get through it.

Could your friends go with you again? You obviously trust them so give them a copy too, this way they can speak for you if necessary.

Give the email a try ..... you have nothing to lose but everything to gain

:)
 
Dr. Daniel

Dr. Daniel

Well-known member
Verified dentist
Joined
Nov 2, 2010
Messages
1,938
Location
The Hague , Holland
Hey Odette

Trust is indeed the most needed thing when it comes to treating a patient with a PTSD as well as with dental anxiety in general. The trust can be gained at once. The dentist needs to earn it from you, there are no shortcuts.

I have some experience with PTSD (although I admit not so much), and I found that it is extremely important to work very slowly, almost slow motion, especially in the first few appointments. There are so many triggers that can start the stress and I tried to do everything slowly so that if the anxiety starts, we can go back a bit (stop the trigger/treatment) before the anxiety becomes stronger, identify what started the stress and then we (I and the patient) find a practical solution.
So the patient's role is to find out the specific triggers and difficulties, and guide the dentist what and how to avoid that trigger.
For example, you mentioned the X-ray, I had a patient who were attacked from the right side of his face, and taking an X-ray from that side was challenging but the left side was OK. So we had to find a solution for that problem, and what we did, we took the X-ray beam further away from him and this way we managed to do the X-ray. Actually, when he was lying on the chair and I needed to treat his teeth, I had to approach him from the left side, because coming from the right side was to intimidating.
I saw (though not treated) and PTSD with a problem smelling the smell of burn. So the dentist used to leave the room and use a flame somewhere else.


In short, the things that can help you:
* treat your PTSD as much as possible, regardless to the dental treatment
* find out a dentist who is obligated to find solutions and adjust your treatment according to your needs.
* You need to guide the dentist.

With time and patience, trust will come :)

All the best
 
Last edited:
vicki

vicki

Well-known member
Joined
Oct 24, 2005
Messages
1,005
Location
UK
Hi odette

The others have given some great advice and so I'll just add a bit about things that I have found to work, from my own experiences.

I also have PTSD which was actually caused by years of horrendous events and experiences at the dentist when I was younger. I knew that something wasn't right when, despite several 'good' experiences at the dentist (after quite a few years of dentist dodging!), nothing improved and the flashbacks and everything else continued. After several sessions with a psychologist (when I was told that had PTSD - I knew that something was wrong but I guess I didn't want to admit it), I decided that I had to try and somehow improve things so that I didn't have to live in constant fear. Bit by bit (it's taken years), I have gradually managed to reduce the symptoms and triggers (a bit like slowly packing something up into a box), so that now it only tends to affect me during appointments (and for a few days before and after). Before this, it was in my life all the time and there was no escape from it. I was in a constant state of anxiety and almost paralysis sometimes in case something happened that might start it off.

Anyway, for me it's about safety as well and the only way that I feel safe is if I'm in control, because a lot of the things that happened to me when I was younger were all about control being taken away and being forced into things. If I'm in control (of whatever or wherever I am), then I know that I'm not going to make things 'unsafe' for myself, so that's OK.

As kitkat said:

I once read somewhere (may have even been on this site somewhere) that the dentist is the one person who can cause harm but is also the person trusted to protect you from any such harm. Therefore, in order to feel "safe" you need to be able to trust that your dentist will "protect" you from any potential threat that comes with the territory.
In my case, the dentist when I was younger was both the 'protector' and the 'threat'. He spent most of the time being a threat and he always chose threat, so in reality there was no protector. What this means now, many years down the line, is that even if I'm in a treatment situation with a dentist who is nice and patient and won't do anything to harm me, I am constantly on the watchout for the very second when they become a threat (even when there's no evidence that this might happen).


I think most people with PTSD are looking for safety, but everyone's idea or concept of safety and what it is that will make them feel safe, will be different. My feeling of safety in the dental situation depends upon knowing:
  1. That the events that happened when I was younger will never happen again.
  2. That nothing similar along the same lines will ever happen again.
  3. That the dentist won't force me into anything and will always give me a choice.
  4. That the dentist will always stop if I ask them to, but that sometimes I have a problem with being able to ask them to stop, so they need to stop regularly just in case.
  5. That if something should trigger off a flashback and I become detached, panicked or anything else, that the dentist won't react badly and that nothing bad will happen to me.
The dentist I have now is aware of this and so takes things very slowly at a pace I can handle and always tells me what's coming next, so there are no surprises. He's also very observant and if I start to get anxious (even if I don't say anything), he stops whatever he's doing, at least until I'm calm again and if necessary, he finds a way around whatever it is that made me panic. He also stops regularly (even if it's only an examination), so I know that if I can't ask him to stop, he will within a few seconds or minutes anyway. It means that dental appointments are fairly predictable as I always know what's coming next and I know that it won't happen all at once.

The key to all of this is actually communication. Although my dentist is actually very nice (and I never thought I'd say that about a dentist! :D), he wouldn't have known what I needed if I hadn't been able to tell him and so would have only been able to guess. It took me a long time to be able to openly tell a dentist that I was terrified (because I was scared that they'd react badly and would repeat the experiences I had when I was younger), but it made a huge difference when I finally did.

So, maybe it might help to start thinking about the following:

  • What would make you feel safe at the dentists?
  • Is there anything you know that definitely makes things unsafe (i.e. things you know definitely will be triggers)?
 
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