High Anxiety: Dentists Strive To Put Patients at Ease - The Ottawa Citizen

MAY 31, 2012
Linda Rosenbaum, POSTMEDIA NEWS

Fear of the unknown and bad experiences play a role in keeping people from seeking dental treatment. New technologies and practices can help make the dentist's office more friendly.

They call themselves "dentist haters." They'd rather let their teeth rot and in some cases fall out before putting themselves in a dentist's chair.

For these people, it's fear that keeps them away. Fear of pain or anxiety about needles, doctors, confined spaces, loud noises, and the high cost of dental care - what Dr. Joe Bulger calls the "drilling, filling and billing."

"Who can blame them?" asks Bulger, owner of Royal York Dental in the Toronto area. He understands where they're coming from - so much so, he started the blog Hate Dentists (, in-viting readers to share their personal horror stories.

"A dental chair can combine the sum of all fears," he says.

Bulger has his own story. As a fiveyear old, he remembers going to a "hard-as-nails, ex-military dentist who drilled my teeth without local anaesthetic. My sister bit him, but I didn't have the nerve." By the time Bulger reached his early teens, he dreaded going to the dentist. "People with experiences like mine build up their fears over time to such a degree, they become paralyzed."

Fortunately, the practice of dentistry has changed. "Dentists now know they have to create personal relationships and connect," he says. "Making patients comfortable in a dentist's chair is more psychology than technology."

Montreal dentist Dr. Barry Dolman, president of the Ordre des dentists du Quebec agrees.

"Patients feel vulnerable," he says. "Compassion goes a long way." Dolman sees at least one patient a week who hasn't been to the dentist in 10 years. "It's not the cost that's keeping them from coming in. They're lawyers and doctors, people who have cottages and take family vacations. They're embarrassed to be so afraid, and worry we're going to lecture them."

While Dolman doesn't deny that cost keeps some people from seeking dental treatment, he believes fear of the unknown and previous bad experiences play a bigger role.

He points out that, in Quebec, dental services are free to children under 10 and people on financial assistance.

"Yet less than 50 per cent of people covered by this program actually go to the dentist," says Dolman. "There's no cost, yet we still can't drag them in."

Getting children to the dentist as early as age three may be the key to reducing fear later in life. "Dentists now have tools to make the experience pleasant for children," says Dr. Harry Hoediono, president of the Ontario Dental Association. "Distraction is key. We have DVDs of favourite television shows, music and headphones, stickers, and balloons. Some dentists even give rewards like free movie passes. It all works."

New technologies and practices also make the dentist's office more patient-friendly. "For people seriously afraid of needles," says Hoediono, "we can offer anaesthetic sprays to numb areas, conscious sedation with nitrous oxide to calm them, and oral meds to relieve anxiety."

While not all dentists have stateof-the art equipment, patients can expect to see more intra-oral cameras that allow patients to see what the dentist is doing; pain-reducing lasers to cut through tissue without freezing and, in some cases, replace drilling; digital X-rays that give an 85-per-cent-lower dose of radiation; and digital impressions used for crown and bridge work rather than the tray and putty method.

And for people who just can't bear walking into a dentist's office, no matter what, there is an alternative. Many of the 24,000 dental hygienists in Canada have gone into independent practice, attracting the dental phobic who can't stand the drills, smells and noises they might come across in a dentist's office.

Some independent practitioners work from home. Others work in holistic clinics, retirement homes and workplaces. Some with mobile practices even travel to a patient's home.

"We provide a comfortable, slow re-introduction to the dentist's office," says Vancouver's Arlynn Brodie, president of the Canadian Dental Hygienists Association. She says people can get screening and treatment onsite, including tissue analysis, teeth cleaning and whitening, oral cancer screening, nutrition counselling or even tobacco cessation coaching. "We see what further dental care may be required, and if necessary, make a referral. We can have someone back in the dentist's chair within six months.

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