Written by Fraser Hendrie BDS
Difficult Conversations – How much should I tell my new dentist?
I guess the place to start with this topic is to realise that what may be a very difficult conversation for one person might actually be a more straightforward one for someone else. In truth, when you meet a new person, be it a dentist or anyone else for the first time, you never really know how they will react to anything that you say, be it good or bad. We have all met people that we simply hit it off with immediately, people that we warm to over time and also folks that we just don’t really get along with.
Add to this the conditioning that most of us have growing up about “doing your best not to cause needless offence” and “being polite” and it is no surprise that before a visit to a new dentist you may question yourself as to how much or how little you actually say about things that have happened in the past. How will the dentist feel if I say x or y and will they believe me, ignore me, be irritated etc. etc.
Meeting your dentist for the first time
When two people meet for the first time, it is really a bit of a test to see if they get along and if they “like” each other. In the dental setting where dental fear is involved this is a little different, because as someone with fear or anxiety there is a likelihood that you won’t feel or be your “usual self” in that early interaction.
Lost for words
Fear makes us behave differently, can steal our words, make our mouth dry or induce tears to name but a few things. I have on numerous occasions had my patients tell me that in day-to-day life they are confident and capable, and they neither understand nor enjoy feeling like an emotional wreck at the prospect of seeing a dentist. Fear and the “Fight Flight or Freeze” reaction are closely linked too, so fear can even make some people more argumentative than they usually are.
Dentists who enjoy working with patients suffering with dental fear understand this, and realise that particularly over the first few visits, you may struggle to find exactly the right words or even any words at all in relation to some aspects of your care. All the while though we are working hard to figure out what we can do to make things easier for you and what makes you more or less stressed. This ability to “read” a situation generally is learned over a period of years by dentists, but even so every person is different. So usually as you work with a new dentist, we should get to know more and become better at “reading how you are feeling.” But without doubt getting some of this information directly (either in advance of an appointment or over the first few visits) will help us hugely. Having given some thought to a list of things you fear can be a great starting point for an e-mail or indeed a chat one-to-one.
What should I tell my new dentist?
Every patient with dental fear is different and will have a different set of things that raise or lower their anxiety. Our job is to keep as much of your appointment in the “things that lower your anxiety” territory. So coming full circle to the original question of what should you tell us and will we be offended? let alone know how to deal with the information? The simple truth is that most dentists have a thick skin when it comes to patients telling us about past experiences or how dentistry makes you feel. Sure it’s not nice to hear patients say to you “it’s nothing personal, but I hate dentists” and rephrased as “I have hated my past dental experiences” might soften the blow for us, but as a group we don’t take offence easily or indeed rush to judgement based on just a few statements.
When anyone (even a dentist) is nervous, there are occasions where the words don’t quite make it out of their mouth as intended and what should be a smooth communication can be significantly less so. Many dental fears are based around experiences in the past and it does help us to know about these. For you, the experience no doubt will have a strong emotional element which understandably can lead you to use very emotive words to describe what happened and how it made you feel and it is important to share that.
Disclosing bad dental experiences
From a dentist’s point of view what we are listening for are the key things that happened that may now make up part of your fear. Usually bad dental experiences from a patient’s perspective are made up of a huge range of factors, many of which are unknown to us as your new dentist – particularly if some years after the original event have passed. So it is normal that we will want to know about it, but also very likely that we will not pass any instantaneous judgement on your past dental experiences when you tell us.
It is really important to understand that as dentists we do not judge anyone on the condition of their teeth, gums or anything else when they come to see us – we are simply there to help assess the situation and in partnership with you look at how we start to move forwards and improve things. Similarly we do want to know about the past, to help us formulate a plan that will help you move forwards but will not necessarily linger there.
Disclosing other traumatic experiences
Sadly, some patients suffer from dental fear as a result of awful events involving abuse of some form or another in their lives. For many, these past experiences are firmly locked away or at the very least are only disclosed in a very high trust environment. I could easily say that as professionals, everything that you disclose to us is confidential and simply leave it there, but it does not address the issue of how or when you might disclose this type of information (if indeed you want to).
I think the answer here lies in the word trust. Any trust you place in your dentist (as with all folks in your life) should be earned rather than expected. Trust usually takes time and multiple contacts to develop, some of this is time to see if you and your dentist are a good fit to work together, and some of this is just time to build rapport and understanding with each other. If you are in this situation and you are able to or become able to share with your dentist, then this will help them understand and support you better. You don’t need to share everything, but even knowing that you have had such an event in your life and that it plays a role in your dental fear is often enough. There is a really helpful page on Dental Fear Central with tips for survivors of abuse and their dentists. Even if you don’t want to share your experience, asking your dentist to read that page in advance of your visit would be enough to make a difference, and let them know that this element is part of your fear.
Planning ahead and building trust
No matter what the message, past experience or feeling that you want to share with your new dentist, if it is important to you, then it is important to us, too. There are things you can do to help build some trust before you visit a new dentist – exchanging a few e-mails in advance can be a great help allowing you to take time to think about what you want to say to the dentist before they meet you.
For some people, it can be a great help to call and have a chat with another member of the dental team before your visit. At Craigentinny, we have several of our nursing team who are happy to do this and it will mean that you already have some connection to the people you will be meeting before you arrive. Your dental nurse is essentially your advocate within our surgery and so it is nice to arrive having already spoken to someone that you will be meeting.
I am a genuine believer in making a plan before you do difficult things. I know this is not for everyone, but I do think it helps to get your thoughts in order before the situation that you think will be difficult. A few notes jotted down in advance too can help if your fear takes over and words are not coming as easily as they normally do.
So in conclusion, I would encourage you to say what is on your mind. Tell your new dentist as much as you are comfortable sharing, an unpleasant reaction is very unlikely in a dental practice that cares for nervous patients and, without doubt, hearing what you have to say will enable your dentist and nurse to provide the best possible experience for you.
© Fraser Hendrie, 2019
If you live near Edinburgh, you can have a chat with Fraser and his team at Craigentinny Dental Practice.
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