Dental Anxiety New York City
What is Dental Anxiety?
Dental anxiety refers to the fear of dentistry and of receiving dental care. A pathological form of this fear (specific phobia) is variously called dental phobia, odontophobia, dentophobia, dentist phobia, or dental anxiety. However, it has been suggested that the term “dental phobia” is often a misnomer, as many people with this condition do not feel their fears to be excessive or unreasonable and resemble individuals with post-traumatic stress disorder, caused by previous traumatic dental experiences.
About Your Dental Anxiety
Many people with severe dental anxiety, also called dental phobia, have difficulty understanding why they have such a prolonged avoidance of the dentist. They don’t know why their heart pounds, their palms sweat, and they often lose sleep before dental appointments. Such a dental fear reaction is mostly a learned response to previous dental, medical or life traumas. The sense of panic and dread that people experience, called panic attacks or anxiety attacks, are an involuntary reflex that no one can completely control. The good news is that that we can virtually eliminate these fearful dental experiences through the use of various types of sedation and good communication.
Results of Dental Anxiety
Traumatic memories can sometimes be unlearned, primarily through a series of good experiences, sometimes aided by medication. Effects of traumas can reinforce each other. It can be said that new traumas actually reawaken old traumas. These traumatic memories are stored in a place in the brain that mediates the fight or flight response. The fight or flight response is a short circuit that is designed to allow us to respond instantly, without conscious thought, to something that the brain believes is life threatening. Our adrenaline pumps, and we feel the physiologic need to run away, bite, reach out, grab or kick, all in response to a perceived threat stored in a more primitive, less conscious part of the brain. It’s a terrible feeling; one that patients say they would do anything to avoid. That’s why a dental fear is such a deeply held, primal feeling.
Patients with a sensitive gag reflex at the dentist, or who have difficulty with novavcaine often struggle at the dentist from a very young age leading to a lifetime of dental fear. Children who have been held down for injections, throat cultures, or minor medical procedures often remember their experience, and point to it as the original source of their dental fear. Victims of abuse as children frequently suffer anxiety and depression as adults and may also manifest dental phobia as well. Over the years, I’ve found that using sedation provides the comfortable dental experience that enables people in need to get help. Often for the first time, people feel like it’s possible for them to have healthy teeth and smiles.
Chronic pain can lead to depression and avoidance of the dentist. Everyone has a limit to their suffering. Intravenous sedation allows us to use every pathway possible to make the dental experience a comfortable one.
Our professional and caring team is dedicated to helping you overcome your dental fear.
Bringing You The Softer Side Of Dentistry
Over 35 million Americans have some level of anxiety when it comes to going to the dentist. But for many, it is more than being afraid. Some of our patients have had a traumatic experience in a dental chair; others come from a painful past. But regardless of your personal history, we are here to help. We understand that your fears may have kept you from a dentist, but there is no need to feel embarrassed. We are not here to judge you; we are here to help you and encourage you so that you can have the confidence a beautiful smile can bring.
- A man struggling with the embarrassment of his teeth now has the confidence to succeed, go for job interviews, and form new personal relationships
- A woman who once couldn’t show her teeth when she spoke has now started her own business.
- A woman whose past experiences left her unable to trust anyone has since put her faith in our office.
For some people, having avoided dental care because of fear of pain or embarrassment, having bad teeth is a major problem. Many such people believe that comfortable dental care is not possible for them. Our team has been proud to have helped many such people remove the burden they bear, so that their teeth will no longer be a problem for them in their daily lives.
Why do people trust our softer side of dentistry? Because we give you a safe place to bring your smile.
Your Comfort is Our First Priority
Whether you feel it in the serenity of the paintings that hang on our walls, in the team’s warm greetings and attention to your needs, or while you listen to soothing sounds on stereo headphones, you’ll understand that we cater to your comfort. Our goal is to provide dental care without fear, anxiety, or pain. That is why we not only listen to your needs, we keep you informed of all your options. Dr. Siegelman as Diplomate of the prestigious American Dental Board of Anesthesiology and Director of Dental Anesthesiology at Lutheran Medical Center, and our team have the knowledge and expertise to help you through each phase of your treatment. Our team will discuss your options and decide on the type of anesthesia that is most appropriate for you.
The Possibility of a Beautiful Smile
Over the years, our team has helped thousands of people regain the confidence a beautiful smile can bring. With a caring approach, w give each patient a dental experience more comfortable then they ever thought possible.
Regardless of a patient’s personal history with dental care, our team can help. At our office, we are dedicated to providing comfortable dentistry, even to patients who have not seen a dentist for years or even decades. And for many patients, Our approach has changed their lives.
Dental Phobia And Childhood Abuse
Dental fear is frequently linked to a history of childhood or adult abuse. I have found that this is one of the most common reasons for a patient to seek care in my office, and to seek that care with some form of sedation. Abuse as a child can cause an individual to grow up with a myriad of different emotional issues, which may or may not include dental phobia. Patients may feel tremendously burdened and embarrassed by these past events, and that carries over into the dental environment. Often patients have not felt comfortable sharing these feelings and their true cause with strangers, and sometimes even their spouses. This causes patients to be particularly uncomfortable, because they know others may consider their behavior inexplicable, and yet the patient can’t stop the anxiety and fear behind it. As time passes, and patients haven’t been able to go to the dentist, their dental condition can worsen. This only increases patients’ embarrassment, and leads to further avoidance of the dentist. Often when patients finally do go to the dentist, they can face criticism for their dental absence, leading to further avoidance and loss of self esteem. Many patients don’t know how to escape this downward spiral and aren’t aware that real help is possible for them. The nice thing is that, over the years, I’ve found it surprisingly easy to relieve patients of this “dental” burden. Given the opportunity, and a secure feeling that they are understood, patients are often glad to open up and be frank about why it’s been so hard for them to have dental care in the past.
Victims of abuse store their traumatic memories in a place in their brains called the amygdala. This center mediates the “fight or flight reflex.” Because it’s a reflex, patients don’t have control over their desire to run from the office, put their hands up, hold the dentists hands, or even bite the dentist. These behaviors are literally “fight or flight” responses; and they are overpowering for patients. There is good news, however. That is that the proper use of medication can make the dental experience a “non-event.” Patients are able to have dental care without experiencing the fear or anxiety by using sedation. It has been gratifying, on occasion, to hear that the experience for these patients has been life changing. Patients will tell me about new relationships, and new self esteem. Patients can make their mouths clean and healthy, with appealing smiles. For many victims of abuse, this is something that they never thought was possible for them. Healing. It’s a step for many in turning their lives in a positive direction.
When a new patient comes to my office I want to listen to them. I am grateful for the trust they often have to tell me about themselves, what they’ve been through, and their needs. Together, we plan how we can comfortably restore, and care for them.
Gagging and Dental Visits
A sensitive gag reflex is a source great concern and embarrassment for many people. It’s often beyond an individual’s ability to control. Children are especially effected because adults may not fully understand how physically difficult it is for them. Kids may be easily embarrassed, particularly if they vomit. Children frequently need a long series of visits, often over a period of years if they require orthodontics (braces). A sensitive gag reflex can be a childhood battle when kids are sick and need to take medications or swallow pills. These events can add up to a series of traumatic episodes that leave the patient with dental phobia as an adult. Patients may also have a gag reflex or intolerance of foreign objects in their mouth relating to a traumatic, abusive past. Intolerance to foreign objects in the mouth, sensitivity to tastes, textures and even foods can also be caused by a condition termed, sensory integration dysfunction. Fortunately, there are many things we can do to make patients comfortable at the dentist and make dental care available without the fear or embarrassment. Dental visits most often begin with dental X-rays. We can use mouth rinses that dull sensation to help the X-ray process. Panoramic X-rays are also available, where no dental film is placed inside the mouth at all. If need be, all X-rays can be taken while the patient sleeps under sedation. There are techniques with local anesthesia (commonly called novacaine) that can numb the tongue and palate to reduce gagging. Various forms of sedation are available that generally can make patients entirely free from the gag reflex. The purpose of the initial consultation is to learn the needs of the patient and begin to develop a plan of care so that the patient can have their dental care in comfort, their way. I hope that my patients will always be able to tell me how they feel, and what I can do to make them the most comfortable.
Needle phobia is a severe fear of needles or injections of any kind. Some people are fearful about injections only in the dental environment. Others avoid injections for medical examinations, blood work, vaccinations or medical procedures. This fear can lead people to avoid needed medical care. While the cause is often a learned fear from a bad experience, some doctors believe that the cause may actually be genetic. The question is, “What kinds of help are available for patients so they can receive the care they need. Our office has many levels of techniques, depending on the needs of the patient. The following are just some of the services available, from the easiest to the most advanced. The first step is simple caring and understanding of the issue. We start with a frank discussion of the patients past experiences which may include a previous doctor who was perceived as rough or stern. For many patients, letting them know that we have a gentle touch, backed by good technique is all they need. However, other patients may have a history of panic attack, or fainting associated with injections. For these more advanced cases, some type of medication to relax the patient is usually recommended. Some patients just need “something to take the edge off,” others need a deeper level of sedation. Each patient is treated as an individual to give them what they need to be comfortable. We listen, and get the history of the patient’s experiences so that we know how we can best help. Premedication with medication for anxiety, is sufficient for most patients. It is often followed by deeper sedation if the dental procedures are prolonged or involved. Patients can have complete anesthesia just by breathing a gas, called an “inhalation induction,” if needed. Advanced formulations of topical gels are available. We also have a device that uses ionophoresis, a light electrical current to allow medication to pass through skin. “The Wand” is available. It’s a computer controlled device that controls the speed of injection, and therefore can create less pressure. “The Wand” looks a lot less like a syringe, which helps many people feel more secure. For some patients, just reading this article is very difficult. Just the thought of an injection may be too much for some people. Even so, there are ways we can help. Talk to us, and we’ll work out a plan that addresses your concerns.