Share your thoughts about fear of complications

[Dr. Daniel]

Hi everyone,

I am writing a new text for my project treatyourdentalfear.com and I am looking for some feedback on a text I have recently wrote. This text is for a video made for people who are afraid of complications from a dental or any medical procedure.
My goal is to provide practical ways to lessen the chance for a complication. I am not addressing the question whether this fear is rational or realistic but just stay practical.

The text is too short and I would like to pour in any thoughts you might have.

Fear of complications:

There is always a certain chance to encounter complication from a dental procedure. How can you lower this risk for complications?

Firstly, by getting treated only by specialists. That would probably make the costs more expansive, at least on the short-term.

Secondly, by choosing a conservative dental treatment, in other words, doing the minimal needed and changing as less as possible the current situation. This should decrease your expanses, at least on the short-term.

Thirdly, ask your dentist to be available also on outside working hours. If an appointment should be needed, how much would that cost.

In the end, you have to accept the fact that there is always a chance for a complication, even if you did the utmost to prevent it.


Thanks,
Daniel

 

[Judythecat]

In terms of being afraid of complications, I want to be informed about the success rate the dentist thinks the treatment will have, and then what the “next step” would be if that happened. For example, I had a root canal and a retreatment done last year on two upper right molars. My own dentist was happy to do the RCT, but said a specialist would have a better success rate (he then discovered the next door tooth had a half-done treatment from 20 years ago with one missed canal!). He told me very clearly what his expectations were, and I asked what would happen if the treatments failed and the teeth had to be extracted. It cost me almost £2,000 for both teeth, but I am glad I went ahead.

My surgery has “pain appointments” every day, and shares an on-call service with two other surgeries. It is helpful to know that I could ring at 8.30 tomorrow morning and that someone would see me that day, even if it wasn’t my own dentist because she’s only in four days.

I was diagnosed with atypical facial pain last year after referral to maxillo-facial. The pain moves around my mouth, so I can worry it’s not just the neuralgia, but something wrong with a tooth. My dentist has a flag against my name which tells reception she will see me as a priority, even if it’s at the end of surgery hours. She’s also put me on three monthly checkups, even though there is nothing clinically wrong wth my teeth or gums. Both of these things are very reassuring.

 

[Judythecat]

(Sorry, That last point is not really relevant to your question at all, but I suppose it illustrates excellent patient care!)

 

[MountainMama]

Coming from someone who has had a lot of dental complications, I would love to see something about how to handle it if you do have a complication, and how it isn't as worrisome as your anxiety makes it feel in your head. I also appreciate straight forward talk. When I had my upper front apicoectomy, and the whole area was still numb a few weeks later, I went back to the endodontist and saw a different one, as mine was on vacation. He told me it was really rare and would most likely go away in a few weeks. When it didn't, I was panicking that it meant something was wrong. My endodontist later told me straight out that it was most likely permanent at this point, but that it wouldn't affect movement of my lip, and I wouldn't notice it after awhile. She was right. After I stopped worrying about it, I don't even notice it anymore.

I would also ask for an "after care" pamphlet. My oral surgeon provides a whole pamphlet listing normal symptoms after surgery and extractions. It is comprehensive and lists normal things not to worry about, like the pain increasing on day 4 or 5, or seeping blood for up to 48 hours, and lists symptoms that you should call in for. I referred to that pamphlet so many times to determine if my symptoms were normal. The endodontist does not do that, so I ask what I should expect.

 

[Dr. Daniel]

In terms of being afraid of complications, I want to be informed about the success rate the dentist thinks the treatment will have, and then what the “next step” would be if that happened. For example, I had a root canal and a retreatment done last year on two upper right molars. My own dentist was happy to do the RCT, but said a specialist would have a better success rate (he then discovered the next door tooth had a half-done treatment from 20 years ago with one missed canal!). He told me very clearly what his expectations were, and I asked what would happen if the treatments failed and the teeth had to be extracted. It cost me almost £2,000 for both teeth, but I am glad I went ahead.

My surgery has “pain appointments” every day, and shares an on-call service with two other surgeries. It is helpful to know that I could ring at 8.30 tomorrow morning and that someone would see me that day, even if it wasn’t my own dentist because she’s only in four days.

I was diagnosed with atypical facial pain last year after referral to maxillo-facial. The pain moves around my mouth, so I can worry it’s not just the neuralgia, but something wrong with a tooth. My dentist has a flag against my name which tells reception she will see me as a priority, even if it’s at the end of surgery hours. She’s also put me on three monthly checkups, even though there is nothing clinically wrong wth my teeth or gums. Both of these things are very reassuring.

It sounds you are getting excellent care. You mentioned wanting to have information, it goes without saying I agree. When I give pre-operative explanation or post-operative instructions I try to lessen the the uncertainty factor.

 

[Dr. Daniel]

Coming from someone who has had a lot of dental complications, I would love to see something about how to handle it if you do have a complication, and how it isn't as worrisome as your anxiety makes it feel in your head. I also appreciate straight forward talk. When I had my upper front apicoectomy, and the whole area was still numb a few weeks later, I went back to the endodontist and saw a different one, as mine was on vacation. He told me it was really rare and would most likely go away in a few weeks. When it didn't, I was panicking that it meant something was wrong. My endodontist later told me straight out that it was most likely permanent at this point, but that it wouldn't affect movement of my lip, and I wouldn't notice it after awhile. She was right. After I stopped worrying about it, I don't even notice it anymore.

I would also ask for an "after care" pamphlet. My oral surgeon provides a whole pamphlet listing normal symptoms after surgery and extractions. It is comprehensive and lists normal things not to worry about, like the pain increasing on day 4 or 5, or seeping blood for up to 48 hours, and lists symptoms that you should call in for. I referred to that pamphlet so many times to determine if my symptoms were normal. The endodontist does not do that, so I ask what I should expect.

Worrisome is indeed a tough one. I think it links to what I call the uncertainty factor. Worrisome and uncertainty are two distinguished phenomenas but they are tangled within each other, meaning if you lower the uncertainty, the worrisome is also lowered.
I also appreciate straight forward talk. I agree it is essential to inform the patient, in an written or spoken manner, better both.

 

[LittleLynnie]

Perhaps you could mention that the patient should concentrate on how rare a complication is, and that hundreds, and/or thousands, go through a given procedure every day, and come out fine at the end. This can't be expressed in a "pooh, pooh", kind of way though, but as an aid to lessening the fear.

 

[Dr. Daniel]

Perhaps you could mention that the patient should concentrate on how rare a complication is, and that hundreds, and/or thousands, go through a given procedure every day, and come out fine at the end. This can't be expressed in a "pooh, pooh", kind of way though, but as an aid to lessening the fear.

Your comment made we wonder: is fear of complication should be seen as an unrational kind of fear? Unrealistic?
I believe it can be unrealistic but in principle it is a realistic and legitimacy consideration. It can become a problem once it becomes the only consideration the only thing in the mind, not being able to see also other benefits and considerations.

 

[krlovesherkids777]

I think one of my big fears on the worry of complications is that "if I get complications I will have to bug the dentist again or the staff, I will need to call again and be a bother etc and then start ruminating on what it is or what to do".

Well. I'm getting better at this and have really found that having a warm , professional dentist that makes it easy to ask questions and approach them makes a whole lot of difference, My current dentist asks before we start and after I'm done before I go so I know questions are welcome and even if I fear complications , I can approach and ask about them so the fear doesn't have to ruminate as much,

However still I'm human and do fear if I go this tooth pulled ...is a.b.or c going to happen. I guess taking baby steps at a time and realizing that most the time I feared it didn't happen helps too. But I think its when they do happen, how are they going to treat me and am I in safe care?

 

[MountainMama]

Your comment made we wonder: is fear of complication should be seen as an unrational kind of fear? Unrealistic?
I believe it can be unrealistic but in principle it is a realistic and legitimacy consideration. It can become a problem once it becomes the only consideration the only thing in the mind, not being able to see also other benefits and considerations.

It isn't irrational or unrealistic to those that experience it. As I said in my other post, when I was told it wasn't likely and was brushed off, I felt as if they didn't believe me. When my endodontist was straight forward about "yes this can happen and here is what to expect from now going forward", that lessened anxiety. I agree with you on that.

 

[Dr. Daniel]

I think one of my big fears on the worry of complications is that "if I get complications I will have to bug the dentist again or the staff, I will need to call again and be a bother etc and then start ruminating on what it is or what to do".

Well. I'm getting better at this and have really found that having a warm , professional dentist that makes it easy to ask questions and approach them makes a whole lot of difference, My current dentist asks before we start and after I'm done before I go so I know questions are welcome and even if I fear complications , I can approach and ask about them so the fear doesn't have to ruminate as much,

However still I'm human and do fear if I go this tooth pulled ...is a.b.or c going to happen. I guess taking baby steps at a time and realizing that most the time I feared it didn't happen helps too. But I think its when they do happen, how are they going to treat me and am I in safe care?

You used the word ruiminate and I totally agree. Woridsom is amplified by rumination.
Aftet a treatment so many factors in addition to the quality of the dentist’s job, such as: general health, dental health, orL hygien, masticatory muscles, temperature differences, bacteria, immune system...
There are couple of possible scenarios because there are multiple factors that effect the end result. That's why we cannot predict the result.

 

[Dr. Daniel]

I think one of my big fears on the worry of complications is that "if I get complications I will have to bug the dentist again or the staff, I will need to call again and be a bother etc and then start ruminating on what it is or what to do".

Well. I'm getting better at this and have really found that having a warm , professional dentist that makes it easy to ask questions and approach them makes a whole lot of difference, My current dentist asks before we start and after I'm done before I go so I know questions are welcome and even if I fear complications , I can approach and ask about them so the fear doesn't have to ruminate as much,

However still I'm human and do fear if I go this tooth pulled ...is a.b.or c going to happen. I guess taking baby steps at a time and realizing that most the time I feared it didn't happen helps too. But I think its when they do happen, how are they going to treat me and am I in safe care?

There are couple of possible scenarios because there are multiple factors that effect the end result.
The trick is: to see on the individual level see which factors are more relevant to the patient and which are less.

 

[Dr. Daniel]

Hi,

Just wanted to share with you some thoughts.
Fear of complications can be very vague. It is tangled with other concerns (fear of pain, worryingness, losing control, the uncertainty factor) and sometimes difficult to define what this fear is really about.
I think it would help if a fearful person could articulate in words what this fear of complications is really about.
Let's divide the potential complications into three:
1- complications with financial consequences. For example, a filling ends up in a root canal treatment.
2- complications with dental and physical consequences. For example, intensive post-operative pain.
3- complications that require more time and visits to the dental practice.

Do you think this can be helpful for you?

 

[letsconnect]

Now that you mention it, the fear of developing dry socket seems to be HUGE thing on this forum. There have been hundreds of posts by people who were terrified of developing dry socket after an extraction (many, if not most of them, by people who don't experience dental phobia generally). I'm not sure how many hours I've spent deleting old "help, I'm worried I might develop dry socket" posts (they had to be deleted because Google was beginning to think that our site was all about dry socket . I don't even feel comfortable typing this lest I stir up a hornet's nest ).

It would be really great if you could address this fear in one of your videos, and explain what can be done in the unlikely event that a person does develop dry socket

 

[Dr. Daniel]

Now that you mention it, the fear of developing dry socket seems to be HUGE thing on this forum. There have been hundreds of posts by people who were terrified of developing dry socket after an extraction (many, if not most of them, by people who don't experience dental phobia generally). I'm not sure how many hours I've spent deleting old "help, I'm worried I might develop dry socket" posts (they had to be deleted because Google was beginning to think that our site was all about dry socket . I don't even feel comfortable typing this lest I stir up a hornet's nest ).

It would be really great if you could address this fear in one of your videos, and explain what can be done in the unlikely event that a person does develop dry socket

sounds like a plan

 

[Stupiddentalfear]

Hi Dr Daniel,
I think I'm in the minority group of people who actually fears tooth removal. It's not so much the physical removal but the fear of being short of a tooth - a part of my bod! So my fear of complication is that any work done on my teeth will result in them being removed. Hence, I left a tooth with a cavity that would have been a simple filling, for a while, turn into a tooth that was to most dentists unrestorable. For me, it's this extreme anxiety about the 'what-ifs' and a feeling of being out of control. The hard part is that with most other dental treatments there is another option/route to try but with extraction once it's gone it's gone!
Sorry, not sure if this is entirely relevant.

 

[Dr. Daniel]

Hi Dr Daniel,
I think I'm in the minority group of people who actually fears tooth removal. It's not so much the physical removal but the fear of being short of a tooth - a part of my bod! So my fear of complication is that any work done on my teeth will result in them being removed. Hence, I left a tooth with a cavity that would have been a simple filling, for a while, turn into a tooth that was to most dentists unrestorable. For me, it's this extreme anxiety about the 'what-ifs' and a feeling of being out of control. The hard part is that with most other dental treatments there is another option/route to try but with extraction once it's gone it's gone!
Sorry, not sure if this is entirely relevant.

Thank you for sharing your story.
Since the mouth is filled with sensitive sensoric nerves, every change in the mouth after a new filling or crown, is also new to the tongue, cheek and lips. It takes time to get used to changes in the mouth. Is it also your case? Do you find changes in your mouth are more difficult? Let’s presume that is the case.
I think that finding sources of motivation to perform a frightening procedure such as tooth extraction is something worth focusing on. I talk about finding motivation in the last part of my video The uncertainty factor.

 

[krlovesherkids777]

Hi Dr Daniel,
I think I'm in the minority group of people who actually fears tooth removal. It's not so much the physical removal but the fear of being short of a tooth - a part of my bod! So my fear of complication is that any work done on my teeth will result in them being removed. Hence, I left a tooth with a cavity that would have been a simple filling, for a while, turn into a tooth that was to most dentists unrestorable. For me, it's this extreme anxiety about the 'what-ifs' and a feeling of being out of control. The hard part is that with most other dental treatments there is another option/route to try but with extraction once it's gone it's gone!
Sorry, not sure if this is entirely relevant.

This is such a fear of mine too!! I fear that any work I do would lead to loss or given that bad news , and being out of control as well on this loss.. and its quite scary and really a grieving thing losing a part of you even one tooth .. what if's are so huge.. and anxiety producing .

 

[Stupiddentalfear]

I wish I had found the motivation to go when my cavity was small. My phobia left me with a repeated tug of war scenario in my head. I wanted to go if I could guarantee the outcome was a positive one but as I couldn't guarantee that something more than a filling was needed (at worst tooth removal) I continued to procrastinate. I have always had a deep seated fear of losing teeth. I still have my rotten tooth but it causes me great anxiety and depression. On one hand I don't completely like the look of it but on the other hand I can't bear to have it removed. It has had a deep impact on my self-esteem and still does. It was one tooth that went bad due to not visiting a dentist over 19 years. (Dentists have confirmed I otherwise have nice teeth and hygiene wise I shouldn't have even had a cavity form.) If I hadn't of feared dental complications/tooth extraction I wouldn't have the problem I have today.
I'm not sure mouth changes apply. I think it is more of a psychological issue with me in respect of not wanting to let go of a part of my body. I was just hoping to highlight how fear of the worst can actually make things a whole lot worse in delaying treatment.

 

[MountainMama]

I wish I had found the motivation to go when my cavity was small. My phobia left me with a repeated tug of war scenario in my head. I wanted to go if I could guarantee the outcome was a positive one but as I couldn't guarantee that something more than a filling was needed (at worst tooth removal) I continued to procrastinate. I have always had a deep seated fear of losing teeth. I still have my rotten tooth but it causes me great anxiety and depression. On one hand I don't completely like the look of it but on the other hand I can't bear to have it removed. It has had a deep impact on my self-esteem and still does. It was one tooth that went bad due to not visiting a dentist over 19 years. (Dentists have confirmed I otherwise have nice teeth and hygiene wise I shouldn't have even had a cavity form.) If I hadn't of feared dental complications/tooth extraction I wouldn't have the problem I have today.
I'm not sure mouth changes apply. I think it is more of a psychological issue with me in respect of not wanting to let go of a part of my body. I was just hoping to highlight how fear of the worst can actually make things a whole lot worse in delaying treatment.

Losing a tooth was one of my biggest fears. I actually had the worst happen, and a redone filling led to a root canal, which led to an apicoectomy, which failed also and I had to have the tooth extracted. After that experience, I no longer fear the extractions. I fear the complications, and the infection that won't go away. In the past 6 months, I have lost two molars, and am waiting to see if my front tooth is going to have to be extracted. I went from having teeth with no issues to losing two teeth, and an abscess in my front tooth. Now, looking back, I wish I had just had the tooth extracted from the start.