If you break into a cold sweat just thinking about a trip to the dentist, you’re not alone. There are many, many people who’ve had horrible experiences at a dentist, often as a child, and so, they can’t bring themselves to go back.
Dr. McHenry “Mac” Lee, a third-generation dentist in Edna, Texas, says he’s heard countless stories from patients whom have undergone traumatic dental work during when their jaws weren’t fully numb. Patients state they complain about the pain, but the dentist often does not believe them and keeps working. An experience like that stays with you, says Lee. He says it is not uncommon for these people to go another 20 years without stepping into a dentist’s office. If you are a dental phobic, the first step is to admit that it’s time to see a dentist; making sure that the professional is one who will listen and acknowledge the need for special care. After all, your teeth are crucial to your overall health.
Lee says half the battle of overcoming fear of the dentist is finding someone you feel comfortable with. “Because of their past, most (high anxiety) patients have an extreme fear of being out of control. Once they know they can be in control and they will be numb, that is all the assurance they need,” he says. “We let our patients first know we care and they will always be in control. All they have to do is raise their hand and we will stop whatever we are doing.”
Lee, who is the author of "Nothing Personal, Doc, But I Hate Dentists!" and a founder of the group "Dentists Who Care,” says it’s the lower jaw, or mandible that can be difficult to numb. This bone is very thick, and the numbing agent won’t penetrate to the tooth the way it does on the upper jaw. It must be injected at the back of the jaw, where the nerve enters. (This is why your lip lower gets numb, even thought the shot was nowhere near it.)
The theory is that some people have extra nerves in their lower jaw that come from the floor of the mouth. In these cases, dental patients need an additional injection, either down the side of the tooth or inside the jaw, according to Lee. He says neither of these two techniques is painful if the jaw itself is already numb.
If a patient needs extra help, the dentist can always use sedation. The most moderate form is laughing gas, which works by the patient placing a small mask over his or her nose and simply breathing in a combination of oxygen and nitrous oxide. If this isn’t enough to calm a patient’s fears, the dentist may offer a form of oral sedation. The most common oral sedative used is Trasilam. It is basically a short-acting sleeping pill that also produces an amnesiac state.
The final recourse would be general anesthesia. Administration of these drugs does require special training. However, none of them replaces local anesthesia, so it is still important the patient's mouth be numb when worked on.
Your fear of going to the dentist is very real as you know, but it doesn’t have to hold you back any longer. Avoidance of the thing that you fear is common to avoid uncomfortable situations such as panic attacks and other anxious responses, but deterring from your regular dentist visit will result in even bigger work that might have to be done. This avoidable consequence and the knowledge that there are very caring dentists out there should put you at ease. There’s no much information out there about different offices, individuals dentists, procedures and sedatives that you should be at ease with your choices.
