How to beat FEAR of the dentist

From humming a tune to putting salt on your tongue ...

ARE you afraid of going to the dentist? If so, you’re not alone — 40 per cent of us are, with 5 per cent of people suffering a severe phobia, according to research.

Nor is it a problem that we seem to grow out of. Indeed, women in their 40s are most likely to be affected.

As you would expect, a phobia of dentists can have a major impact on oral health. Even when those who dread the dentist are in severe pain, they will put off making an appointment for an average of 17 days, researchers at the University of Sydney’s faculty of dentistry found.

Here, Dr Mark Skimming, a Glasgowbased dentist, shares his tips on how to overcome it . . .

Magic wand that makes jabs painless

AROUND one in ten dental phobics suffer specifically with a fear of needles, which often stems from the worry that an injection will be painful.

The pain is not so much due to the needle piercing the skin, but the result of the anaesthetic going in too fast, which puts a lot of pressure on tissue.

While it’s rare that an injection can be administered without any discomfort, this can be minimised.

For example, the numbing gel — which is put on to the gum prior to injection, to lessen the initial sting of the needle — should be left on for two minutes to take effect. But some dentists may only leave it on for 30 seconds, so don’t be afraid to ask them to hang on for a minute.

If you are really scared of needles, you could ask your dentist if they use the Wand or the Quicksleeper (or call around to find one who does).

This is a device that looks like a pen, which houses the needle. The pen gives the dentist control over movement, and is connected to a computer, which ensures a slow and steady flow of anaesthesia.

This puts minimal pressure on the tissue so the injection is practically painless.

And if you’re very needle-phobic, another option is sedation in the form of laughing gas (or nitrous oxide, also known as relative analgesia).

Delivered via a nosepiece, this can kill the pain of the dental treatment and make you feel relaxed.

However, laughing gas can make patients feel nauseous — eating a few hours before may help reduce this.

Alternatively, oral sedation, in the form of anti-anxiety pills, can be prescribed just before a dental appointment to help you relax.

Redheads need more anaesthetic

SOME people find that local anaesthetic — which is given to make teeth and gums numb — may not work as well as it should.

If this is behind your fear of the dentist, it’s important to get to the bottom of the possible cause.

People with red hair often have this problem: the MC1R gene that leads to fair skin and red hair can also make local anaesthetic less effective. So, if you are a natural redhead, discuss this with your dentist as you may need more than the normal amount for it to take effect.

An infection or abscess under or in the tooth, sometimes known as ‘hot tooth’, can also reduce the impact of local anaesthesia. This is because the infection makes the tissue more acidic, and this acid can then reduce the dose of the workable anaesthetic that reaches the tissue.

Always mention pain that might be a sign of an infection, so the dentist can either increase the dose of anaesthetic or use the Quicksleeper to ensure a steady dose is delivered to exactly the right spot. And even feel ing anxious about the anaesthetic can mean that it works less well.

Stress hormones such as adrenaline, which your body pumps out when you feel under pressure, can prevent the anaesthesia from working, although it’s unclear why.

In my practice, we use scented candles and calming music to help to relax our patients.

Tricks that stop you gagging

THE gag reflex is a natural instinct to prevent you from choking. However, in some people, this reflex is over- sensitive and makes them gag when there is no threat.

This can be a problem if the mouth needs to be open for a long time during dental work, or if a patient needs to hold a mouthpiece in place during a dental X-ray.

But there are ways to overcome it. A simple but effective trick is to apply salt to your tongue just before treatment — this works because your mind concentrates on the taste on your tongue rather than the tools in your mouth.

And while you’re having the work done, hum a little tune — it might sound strange, but if you hum, you cannot gag, because you’ll be breathing out through your mouth (breathing in through the mouth can make you notice sensations in the mouth more).

If your nose is blocked, try using a nasal decongestant to open up the airways before treatment — a blocked nose can increase the gag reflex because if you are able to breathe through your nose it reduces sensation in the mouth.

Also, two or three squirts of an anaesthetic throat spray immediately before treatment or an X-ray may help desensitise the mouth before a gag reflex kicks in.

And if you have a tendency to gag while brushing your teeth, switch to an electric toothbrush with a small brush head and breathe through your nose very slowly.

Hand signals can help to tame terror

THE control-freaks among us do not make the best dental patients, because they dislike the idea of relinquishing power to their dentist. But a technique called Structured Time can help.

This involves agreeing that the treatment will be split into chunks of time (chosen beforehand), so you can have regular breaks.

And decide on a hand signal with your dentist, so you can indicate if something is uncomfortable or you are struggling with a certain procedure.

Test the sign before you need it to help establish trust with your dentist.

Another option is to leave the chair upright — some people feel more vulnerable lying down, which can increase feelings of tension and anxiety.

But if the whole idea of staying awake through dental treatment is too much, you could try intravenous sedation, which most private and some NHS dentists offer.

Also called conscious sedation or ‘twilight dentistry’, it’s now more commonly used than general anaesthesia for extremely nervous patients.

Typically, anti-anxiety drugs, such as benzodiazepines, are injected via a thin needle inserted in the back of your hand (the dentist may then give you local anaesthetic to numb any pain).

Although the drugs won’t send you to sleep, they will put you in a state of deep relaxation and make you unaware of the procedure.

However, the sensation — similar to feeling a little drunk or light-headed — can persist for up to 24 hours afterwards.

ADAPTED from Why I Now Love My Dentist More Than My Valentine’s Chocolates, by Dr Mark Skimming, available free from DentistryOnThe Square.co.uk