Historically, I’ve been so terrified of the dentist I would have panic attacks at the thought of going — I mean that literally. I felt like I was going to pass out or throw up, or possibly die a horrible dental chair death to a symphony of drills. This complicated things when I finally got dental insurance and had an appointment where they told me I’d need about $30,000 of work beyond what was covered. That was when I was 22.
If you’re similarly terrified of the dentist, I found that being trapped in the elevator at my dentist office really helped put things in perspective, so try that. Otherwise, my tips for overcoming dental paralysis for major procedures are as follows:
1. Manage your own pain. Accept that there’s no need for you to feel anything beyond the novocaine shot. The minute you do, ask for more novocaine. Because of the panic, I metabolize that stuff like crazy, and have to ask for up to two reapplications per procedure. Raise a finger so they know to pause and tell them you have sensation. A good dentist is uncomfortable when you are, and they’ll take care of it or explain your options.
2. Close your eyes. You don’t need to see the implements. Especially not the needle. Breathe.
3. Pay attention to your body. Note how your entire body is clenched like a vise? Concentrate on relaxing your muscles one and at time, from the toes up. Unclench your jaw. Unfurrow your brow. If you feel yourself panicking, start again from the toes.
4. Wear headphones. Loud, soothing music you rarely listen to in real life. No need to sabotage your favorite tunes with dental recall. Ask your dentist to squeeze your hand if he or she needs something.
5. Find an escape. If your dentist doesn’t already have one, ask him or her to hang a poster of a soothing scene (the ocean or something) on the ceiling above the chair. That way, if you do open your eyes, there’s something non medical to look at.
6. Care for yourself. When you’re back at home, ice your jaw and rinse gently with warm saltwater whenever you’re in pain. This controls swelling and infection, both of which cause a lot of the post-procedural pain. If they gave you painkillers, take them the first day even if you don’t think you need them. If they gave you antibiotics, set an alarm on your phone to remind you to take every last one of them.
7. Take it easy. Trashy magazines, warm broth, ice cream.
Rinse. Repeat.
What did I forget? Tips for making your dentists appointment more bearable? Fill us in.
Mighty Girl 
Maggie, I want to tell you that this post (and all your health posts) have really affected me in a positive way. I’ve always felt really isolated with my fear because people tend to wave if off as “not a big deal.” To know that you and others suffer (and have overcome) something similar makes me feel less alone in the world. I know it took a lot of guts to write about your private journey on your public blog, but it made a difference in my life. Wow, that sounds corny, but it is true!
Anyway, hypnosis has done a lot to change how I feel about the dentist. Mainly, it has helped me to think about things in a different way, which gives me time to actually do the relaxation techniques. They are some unreputable practitioners, but I was referred to an excellent psycologist who does it as part of his practice. After about two sessions, I felt like a weight had been lifted. I’d recommend it to anyone for any issue that is deeply emotional.
(Also pre and post acupuncture and the BEST dentist ever help a lot.)
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I hate the dentist. I hate the dentist. I hate the dentist. I hate the dentist. I hate the dentist. I hate the dentist. I hate the dentist. I hate the dentist. I hate the dentist. I hate the dentist. I hate the dentist. I hate the dentist.
There’s no way that attitude helps, is there?
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A dental dam. No, really – http://en.wikipedia.org/wiki/Dental_dam. It totally segregates your tongue and saliva from the work they’re doing, so the having to concentrate to keep your tongue out of the way and incessant gagging of the vacuum to clear out the saliva is GONE!
Plus, you get to giggle when your friends look at you funny when you talk about how you were using a dental dam at your dentist’s office. 🙂
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It might not be your anxiety running through the pain shots. Redheads always need more pain meds (possibly not pills but def. during any procedure). My redheaded brother was told that as a teenager when he had an ingrown toenail removed. I had it happen on the freaking table. The doc and nurses so wanted to me just sleep and I babbled on asking if it was normal to “feel that”. They were flabberghasted I was awake and could tell EXACTLY what they were doing. I did not feel pain per se – but discomfort for sure.
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One of my friends had enough (with herself) of forgetting to take the antibiotics. So she would whole-heartedly agree with setting your alarm to take them–she did just that for every four hours. It was important, too, because she was sleeping all day and night long, for several days after having her wisdom teeth taken out, and just could not stay awake. She finally checked the label on the antibiotics…which were actually lortabs, as she had misread the label on the bottle.
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ditto (for the Nth time) on the ‘redheads need more analgesic’ fact. It’s true, honestly, so ask for it. (it’s also true for some brunettes with the gene, so if you can feel it, ask for more drugs).
I don’t have particular dental anxiety (I’ve had fillings and extractions done without analgesia) but what is really helpful is to know what they’re planning to do and how long each stage will take. Ask before they’ve injected and reclined you.
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Absolutely NO CAFFEINE before an appointment/procedure. I follow this same advice before flying, too. Why add fuel to your inner fires?
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I was terrified of the dentist after a bad experience as a little kid (bit the dentist, he told my parents not to bring me back). So, when I started my career and got good dental insurance I kept telling myself I would go get my (not so great) teeth sorted out.
That took 4 years. I paid for the insurance and didn’t use it because I was afraid.
Finally, I got a dentist recommedation from a coworker who loved her dentist. I made an appointment, explained my fears, and discovered I made an excellent choice- and not a moment too soon. I needed deep fillings in all of my molars and 2 crowns.
The dentist explained everything she was doing. Would ask me to touch the drill before she put it in my mouth so I would be familiar with the sensation, and never ever made me feel bad for neglecting care.
Since I got that taken care of, I’ve needed 2 root canals (I was warned that might be a possibility) and every time I’ve used the same visualization technique. After they numb me, I close my eyes and imagine I’m floating in the ocean. It really works!
I think the biggest help for me was deciding I wasn’t going to be scared anymore and then refusing to let anyone make me feel bad. And pretending to float in the ocean. That’s just great.
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Oh, Maggie!
I have such a severe dentist phobia that I cried when I saw the title of your post. But I soldiered on, and I’m glad I did.
I know people love nitrous, but I can’t use it. It gives me severe anxiety and nausea. I think it’s one reason I have such a fear of the dentist, actually: the guy we used when I was little *insisted* that I take it, and it always made me sick. I really better not examine these memories any further–I can’t afford the therapy bills.
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One thing that has helped me is to NOT let other people tell me their horror stories. My MIL has a big dentist phobia and I swear, I have begun to be afraid of the dentist since knowing her!
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For fillings & smaller procedures, ask for the anesthetic without epinephrine. It takes longer to work and doesn’t last as long, but it doesn’t trigger the adrenaline response that may feel like a panic attack.
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Ditto a million to having a good dentist who makes you comfortable, especially if, like me, you’re doing a prolonged run of work. I find that when I head to my next procedure, how I feel both before and during it is determined by what my experience was like the last time. I was having a super-good run with my current dentist, who’s really funny (and really skilled), and then I had one bad time when he was kind of in a hurry and I found that the next two trips were awful because I was starting to dread them again. Hopefully I’m breaking out of the spiral now since the last few have been OK, because building on that confidence that everything will be fine really makes all the difference.
Also, yes, treats afterward. I get my favorite mocha frappe at the grocery store next door every time.
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Ask people in your area what dentist they use, or if they like their dentist. My parents did that when they moved to the area, and I’ve been going to the same dentist since I was a baby. He is the nicest guy, gives you plenty of options (for instance, I needed a filling and he asked if I wanted white or silver, and told me while white was more attractive, silver held better so I wouldn’t have to come in in the future and get it re-filled).
The oddest thing about him is that he adds the word “happy” in front of everything, such as the “happy drill” and “happy numbing juice”. When giving a Novocain shot, he sings a song so you pay attention to him, not the needle.
Also, whenever I try to be brave if it hurts a little, he can tell, and will stop and ask me if I’m ok and if it’s hurting. That’s a good dentist.
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Oh, how well I know this! I would have full blown panic attacks even calling the dentist on the phone to make an appointment, just two years ago. Now I happily bounce in to see my dentist and get cleanings like a normal person. Here’s what worked for me:
1. Find a dentist that children love to go to.
2. Tell the dentist you are extremely anxious. If the dentist’s reaction is anything but supportive, walk out. Walk away from a dentist who lectures you for not having been there – that’s not someone who understands.
3. Use noise cancelling headphones and use the volume button like its for anxiety management (I would turn up the volume as I got more anxious)
4. Tell the dentist whether you want to talk about everything or if you just want to try to zone out. I don’t want to touch the drill or anything, just tell me when the hard part is over.
5. My dentist automatically asks me if I’m Ok every few minutes, but if he didn’t I would arrange a signal.
6. Use nitrous.
7. Give yourself a reward when its done. Its hard work, you shouldn’t be embarrassed and you should reward yourself for being so brave.
After getting myself through the fillings I needed and through my first cleaning afterward, I started to wean off the nitrous and the headphones. I’m so freaking proud of myself, and you should be too. Good for you, Maggie!
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Valium (if you don’t have to drive yourself home) – 1 the night before and 1 an hour before the procedure. If you have to drive, Xanax, but it doesn’t work as well.
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Make believe: I’m a big fish, hanging out in my coral reef. Those aren’t dental tools, they’re cleaner fishes!
http://en.wikipedia.org/wiki/Cleaner_fish
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True Story: I bit my dentist’s finger when I told him it hurt and still didn’t stop. I was 6. I still sometimes wish I could do that.
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I second that — as for more Novocaine if you need it. Let them know you are a nervous one — you don’t get a merit badge for suffering. I always give myself a prize for going – like a “no points counted” milkshake and a trip to the bookstore. Take painkillers before and ask for some if you are likely to be sore.
And, I speak from experience, don’t avoid it. A toothache is not likely going to fix itself. Instead, it will get infected, abscess and turn into a larger more complicated problem. If something hurts – get it checked.
And if they won’t work with you – call someone else. It’s a medical practice but there are options — you don’t have to suffer.
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Redheads require more anesthesia than the general population, novacaine in particular. Here’s a study that tackles the issue of redheads and dental work in particular: http://jada.ada.org/cgi/content/abstract/140/7/896
“Genetic Variations Associated With Red Hair Color and Fear of Dental Pain, Anxiety Regarding Dental Care and Avoidance of Dental Care”
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NITROUS.
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I’m totally on board with the nitrous as well. That is awesome stuff.
However, the last time I had a major procedure (2 wisdom teeth out) I couldn’t have the nitrous – for reasons I don’t quite recall – and I had to make do with freezing alone. I brought my iPod and had it ready on the one song I had decided to listen to. It was a loud, screamy song, and I CRANKED it every time they used a loud instrument and when they started wrenching on one of the teeth since it didn’t come out as easily as expected. Totally worked for me.
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I am absolutely terrified of dentists, which means that I have not seen one in almost seven years. If I knew how to get my body to a dentist’s office, there might be hope. I think they’re going to have to stage a kidnapping with general anaesthesia.
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My tip for surviving the dentist? Find one that does sedation!! Have heard of a new dentist in town that sedates you for the visit, get tons done in one go and remember NOTHING! Must book appt.
You know, if I didn’t hate going so much. But love their ads that say they specialize in scaredy cats 🙂
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Just reading your other comments and have to pipe in again.
Ariel I was one of those kids that was ‘tied down’ and after I bit the dentist had my mouth propped open with some sort of archaic device.
I have few memories from that age but the 4 year old in me just cannot shake that one loose..
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Nothing helps me overcome the pure terror I get just sitting in a dental chair. Music just seems overwhelming, and the terror is so physical there is nothing my brain can do to relax those muscles. Typically I would stew in it and dig my nails into my palms until they bled. My latest dentist noticed this and prescribed me lorazepam to take a couple hours before an appointment. And a whole new world opened up. Not only do I not care about anything when I’m in the chair, I typically fall asleep either during or after the procedure, and forget most of it after a few days. Brilliant. The con is that somebody has to drive me to and from the appointment. I have to go to the dentist unfortunately fairly frequently – I’ve always had problems – so knowing I get to be relaxed instead of thoroughly terrorized is very important.
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Hi,
I can’t read all these comments right now so I hope I”m not being redundant, but …
I have always needed way more novicaine than any dentist thought I should need. I recently read an article that said that redheads (yes, I am one) have some funky gene mutation that makes them … wait for it … have a reisistance to pain blockers like novicaine! It never occurred to me before, but it felt good to be validated.
Here’s a link:http://well.blogs.nytimes.com/2009/08/06/the-pain-of-being-a-redhead/
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I used to work at a dentist’s office, but unfortunately that doesn’t make me more happy about dental work. And I have no suggestions other than what have already been mentioned, other than “Whatever usually works to quell your everyday anxiety, bump it up by about 5x for dental anxiety.”
However, I do want to say three things about nitrous and the use of anti-anxiety medications.
#1, about nitrous, it clears your system really rapidly, more rapidly if you’re given a few minutes of plain oxygen once the nitrous is shut off.
#2, also about nitrous, it can interact in really weird ways with other drugs. We had a patient come in once who had been given anti-anxiety drugs, but was still nervous, so he smoked a few joints before coming in. The results were utterly hilarious – I had to put all the phones on permanent hold for about 15 minutes because we were all gasping for air from laughing at this guy, and it threw off the hygienist’s schedule for the rest of the day because she couldn’t work on her patient since they were both laughing too hard – but as hysterically funny as it was, the guy didn’t get his dental work done, so he had to go through all that anxiety AGAIN on another day. Only use what you really need, and tell the dentist everything else you’re taking (legal and illegal) before they put the nitrous on.
#3, my father had horrific dental anxiety. He was in the military, and his experiences with their boot-camp dental procedures made it a hundred times worse. He refused to go to the dentist unless and until it was required by his military commander (for troop preparedness). The anxiety would then trigger cluster migraines that would leave him bedridden for days and, one time, hospitalized for more than a week.
After he got out of the military, he didn’t go to the dentist for well over a decade. When he did go, of course, he needed a lot of work. So he found a dentist who would give him sedatives and anti-anxiety. My dad’s a big guy – 6’7″ and 350+ pounds – and his anxiety was profound, so they made sure to give him a high-dose and plenty of pills.
Unfortunately, the anti-anxiety drugs caused some short-term memory issues. After a dental appointment in the morning, he went to the bank that afternoon and withdrew more than a thousand dollars in cash that they needed to pay something. He came immediately home and went to do chores. When my mom asked where the money was, he #1 had no memory of going to the bank, and #2 had no idea where the money was. They finally found about $400 of it in the glovebox tucked into the car owner’s manual, and a friend mentioned that my dad had stopped by his house but “couldn’t remember why he was there,” but the rest of the money (and afternoon) is a complete blank. (And my dad’s so tight with money, there’s no chance he just pretended not to know what happened.)
That was enough of a wake-up call that he stopped using the anti-anxiety medications, and found that the nitrous worked fine by itself. That first appointment without anything to calm him down ahead of time was a bitch, but once he realized that the nitrous would be enough during the visit, it made his subsequent visits much easier. He now goes every six months for cleanings on his remaining teeth, and doesn’t even have anxiety headaches the day before.
SO, if you DO use sedatives or anti-anxiety drugs, be extra careful and maybe have a 24-hour companion (or as close to it as you can) for a day or two after.
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Sorry, should say “he remembers going to the bank and then coming immediately home.” When they pieced everything together later, there was about 45 minutes unaccounted for. If it’d been the man *I* was married to at that time, I’d be certain that he’d just been up to no good and was *claiming* amnesia, but for lots of reasons that would be too long and irrelevant to go into here, we’re sure that wasn’t the case with my dad. He also put the folded laundry into the freezer that afternoon, and emptied the silverware drawer into the sink. Bottom line: The cumulative effect of the medicine (he’d had three or four dental appointments within two weeks) really messed with his mind and memory. So be careful.
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I haven’t been to a dentist in… I don’t know, 13 years? I didn’t even know nitrous was an option. Your post and the comments are really inspiring.
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On second thought, maybe you shouldn’t watch Steve Martin’s movie, “Novocane.”
I do self-hypnosis/relaxation techniques while waiting in the chair. I get so relaxed that I’m ready to fall asleep. I’ll also repeat a mantra while the dentist is working on me to distract myself from what’s going on.
My dentist is really good at shots with little pain which helps the experience a lot. The shots used to be the worst part for me and I can’t believe I used to let the dentists drill without them when I was a kid.
The dentist used to offer video glasses to wear while he was working on you so you could be distracted by watching a DVD. Though I really liked that, I was always annoyed that I’d never finish a movie there and would then have to rent or buy it to see how it ended.
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Switching dentists. As soon as I was able, I switched from the one my parents always took us to, who I was panic-ridden, horrified of, to the one the kids I sat for saw. I had taken them to the dentist before, and couldn’t believe how nice he was, how relaxed the kids were. So I switched, and now every cleaning is a cakewalk.
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I’m one of the lucky ones, I don’t have issues with the dentist (FTR my Mom made sure we had an AWESOME dentist growing up).
But a dental dam really does make a difference.
Also, they have a block that they can put in your mouth to help you hold it open. I find it less tiring to be able to rest my jaw on this block, instead of forcing my mouth open.
One more thing, my Mom is allergic to the standard anesthetic Dentists use. She would have a panic attack in the chair, it would hardly numb her / take a huge amount to get her numb. A new (smarter / savvier) dentist spoke with her and they changed the anesthetic and it was a totally different experience for her. Please don’t wait until you’re in your fifties to figure this out!
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i always take the first available dental appointment of the day. the office is quiet and calm and on schedule, and i don’t have to spend the whole morning dreading the afternoon.
i also sometimes buy myself a reward after a dental cleaning, for being so brave.
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Nitrous Oxide all the way, baby!
I too was having panic attacks just thinking about the possibility of seeing a dentist. I knew I had work to be done and the idea of going made me think I would surely die.
I asked for Nitrous Oxide and found out it was only $30 out of pocket. WAY worth it. It didn’t knock me out (which would have been nice) but it relaxed me and made it bearable. Just remember to keep breathing through your nose so you get that wonderful gas.
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BANANAS!! no joke. i have always had to have novocaine administered repeatedly to get sufficiently numb. a dentist friend remarked that sometimes this is due to a person’s PH balance being acidic (i.e. more acidic, rather than alkaline, systems tend to be more resistant to the numbing agent). he said eat banana(s) the day before to shift my PH to be more alkaline. i figured nothing to lose, and ate one banana the day before my appt. the novocaine worked its magic with just one shot, and no need for multiples. may just be a coincidence, but you bet i’m eating bananas before every appt in the future!
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Ask for referrals from friends if you don’t like your dentists and SWITCH! As a child I had a horrible dentist who was rough and made every filling a nightmare. My parents thought I was being dramatic and of course,the dentist isn’t supposed to be pleasant. Flash forward – I didn’t see a dentist for close to 10 years as an adult! It took a few tries, but I got lucky and found 2 amazing, gentle, professional, really lovely dentists in my town and never hesitate to refer people to them. An abcessed tooth, 2 crowns and all my required cleanings later and I have NO anxiety about the dentist anymore.
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de-lurking to give you this link!
as a fellow redhead, I’ve had problems with Novocaine, as in, hell YES I can feel that! ow. Now my dentist knows to give me more than he would give other patients and, if it’s a long procedure, I may need a second shot halfway through.
http://well.blogs.nytimes.com/2009/08/06/the-pain-of-being-a-redhead/
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I can’t talk or hear talk about the dentist without bursting into tears. However, it’s not exactly the fears you address. I fear that (since I haven’t been to see anyone in many years) that A. It will cost me more money than I can ever afford; and B. They will tell me that the neglect is so bad that’s it’s not fixable — that they’ll have to pull teeth and shake their heads sadly, while telling me IF I HAD ONLY GONE to the dentist, I could have prevented it all. Just typing this makes me shake. So I DON’T GO.
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