John Gamba was 9 years old when a dentist failed to anesthetize a back molar properly and hit a nerve dead-on. The result was a lifelong fear of dentists that reached a peak in his 20s, when he stopped going to the dentist entirely. “I couldn’t even drive by a dentist’s office without getting stressed out,” he tells WebMD.
Gamba was 38 when a chipped back molar began to decay, eventually causing him constant pain. “I was paralyzed. I couldn’t even consider going [to the dentist’s office],” says Gamba, an Internet entrepreneur from Naples, Fla. “It was much easier to accept the pain, sick as that sounds.”
Few people look forward to a spell in the dentist’s chair. But serious anxiety prevents millions of Americans from seeking proper preventative care. The consequences of this problem may go far beyond dental pain or lost teeth. Gum disease is a serious infection that can affect other parts of the body. Studies now link it to illnesses including heart disease, stroke, and diabetes.
Fortunately, many dentists are specially trained in handling fearful patients; a variety of methods and treatments are available to reduce pain and alleviate fear in the dentist’s chair.
Milgrom’s dental practice specializes in fearful patients. About two-thirds of them relate their fear to a bad experience in the dentist’s office, Milgrom says. Another third have other issues for which fear of dentists can be an unpleasant side effect, such as various mood or anxiety disorders, substance abuse, or posttraumatic stressexperienced by war veterans, victims of domestic violence, and victims of childhood sexual abuse.
Fear of dentists stems not so much from the experience of pain as from the lack of control that patients experience in the dentist’s chair, says Ellen Rodino, PhD, a psychologist in Santa Monica, Calif., who has studied dental fear. “You’re lying prone, a dentist is hovering above you, and he’s putting you in a situation where you can hardly talk or respond. That creates a lot of anxiety for some people because they don’t feel in control.”
Still, many dentists create unnecessary anxiety in patients because they assume that all patients have similar pain thresholds and will handle dental procedures in the same way, Milgrom says. “If all dentists were a lot more careful about pain control, took the time to be sure patients were comfortable, and didn’t go ahead if they weren’t [comfortable], then we would create fewer phobics.”
Fearful patients need to be more assertive about their needs, Milgrom says. Patients should say to their dentists, “I want to talk about what can be done to make me more comfortable. I don’t want someone to tell me something doesn’t hurt me.”