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Conquer Dental Phobia Forever Nobody likes going to the dentist, but for those who suffer dental phobias, a trip to the dentist's office is more than unpleasant: It's a descent into hell. "Some patients are so terrified that they can't even come into the building," says Louis Siegelman, DDS, director of dental anesthesiology at Lutheran Medical Center in Brooklyn, and a specialist in the treatment of phobic patients. "They'll try to practice dentistry on themselves-filling their own cavities, pulling their own teeth-anything to avoid the experience of going to the dentist," he says. Although some patients' phobias are rooted in deeper traumas, such as physical or sexual abuse, most dental phobics can trace their fears to bad experiences in the dentist's chair, usually during childhood. For people who were held into a dentist's chair as children, or ignored when they were experiencing pain, every visit to the dentist is a return to that sense of helplessness and terror. "Today there's a much greater focus on treating the whole patient, not just her teeth," says Kim Harms, DDS, president-elect of the Minnesota Dental Association. "Dentists today are being taught the importance of communicating with their patients," she says. "Trust is critical," says Dr. Siegelman. "The patient has to know that she is in control-that the dentist will listen when she says she's in pain." An anxious patient should discuss her fears with her dentist well before sitting down in the chair. If the dentist downplays your concerns, find another one. If your primary concern is pain, find out what forms of anesthesia the dentist can offer. "Local anesthesia isn't 100 percent effective in all patients," says Siegelman. "It's important to see someone who can provide options. " For example, one relatively simple technique for reducing anxiety is to use a local anesthetic that does not contain epinephrine, which can make the heart race and escalate a patient's sense of panic. Other options include nitrous oxide (laughing gas) or pre-medication with anxiety-reducing drugs. "Be forthright about your previous experiences and fears," says Siegelman, "and don't settle for anything less than a comprehensive, caring response."
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