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Fear of the Dentist

At six years old, I find the prospect of a visit to the dentist rather intriguing. There are the curious anti-septic smells associated with the practice, pretty nurses in smart, white uniforms who smile and make a fuss of me, the pleasing feel of the electric, reclining dental chair, and the cultured, articulate voice of the dentist herself.

The combination of these fascinating associations, peculiar to dental surgeries, together with what often amounts to, at the very least, an afternoon’s absence from school, conspires to elicit from me a healthy toothed smile at the news that a six-monthly check-up is imminent.

For my mother, that guardian of my sister’s and my dental health, a visit to the dentist is regarded with the sort of foreboding, one might expect to accompany an impending funeral, and it is with a determined domination of her own anxiety that my mother leads us in the direction of professional dental care. Not wishing her children to inherit her morbid fear of dentistry, my mother makes a concerted effort to hide her fears from us, but occasional subtle signals (the dentist is heard to say that she, herself, requires Valium before she can face treating my mother) betray her fear, and I am sorry to say that my sister and I will both acquire this phobia in our later lives.

At sixteen, and being very wise, I decide that there is no need to visit the dentist unless I am in pain. This reckless decision is based not so much upon fear, but laziness. I regard dental examinations as an awkward, often expensive, irritation. Like many young British men of the eighties, I neglect my dental hygiene to a point which I will, in later years, find shameful to look back on. I give my teeth a cursory brushing on the mornings when I remember to do so, and before a social evening I occasionally swill and gargle with mouthwash.

Time passes. Teeth decay. The point of a canine snaps off when I try to remove a beer bottle cap with said tooth. Later an upper molar crumbles as I crunch a peppermint sweet. A gradual layer of tartar builds up at the back of my teeth, forming a smooth wall, which I presume to be the norm. My mouth becomes a breeding ground for unpleasant microscopic things, yet I feel no pain. I am fastidious in all other areas of personal hygiene, yet blissfully unaware of my slow, dental decline.

One day, I sip a mouthful of coffee and feel a slight twitch in a back tooth. The pain appears and disappears intermittently over the next few days and I consider visiting the dentist, but I am no longer in the habit of going and the process is unfamiliar and alien to me. I shudder at the notion of reclining in the dentist’s chair. The toothache is preferable to treatment. Uncomfortable days give way to nights of excruciating agony.

I am afflicted by panic of the worst sort, which only exacerbates the pain. Over-the-counter painkillers, often at dangerous doses, do nothing to ease my torment. Mere toothache reduces me to an emotional wreck. Unable to tolerate further torture, I decide, or rather the pain decides for me, that it is time for professional intervention.

I dare not return to the dentist of my childhood. She may seek an explanation for my intervening absence, which I cannot give. I squirm in the discomfort of my own stupidity. Friends at work recommend a good dentist, a local one who provides I.V. sedation for anxious patients. This sounds perfect. I make an appointment for the following day and do not sleep a wink that night.

I must be quite a sight, trembling before the receptionist with dark circles round my eyes. I give my name and am handed a medical questionnaire to complete as I sit in the waiting area. I struggle to concentrate on questions such as Do you suffer from asthma?; I actually begin to wonder if I do! Monitoring the expressions of other waiting patients for signs of fear, I strive to discern whether I am alone in my mental turmoil. As my tooth and gum throb, I am distracted by the whirring of a dental drill. A smiling, brave looking lady exits the surgery and takes a seat beside me. I notice the stroke like symptoms of the local anaesthetic, her drooping mouth and slurred speech when she jokes with her companion. I wish I had brought a companion with me.

My name is called and my mouth goes dry. I swallow hard and follow the nurse towards the surgery. The dentist introduces himself and shakes my clammy hand. I explain I have elected for sedation and that the sooner I am sedated, the happier I will be. The dentist insists that I must first be examined in order to determine the treatment course. My world collapses. This is not the scenario I envisaged. I point out that it has been fifteen years since I have been in a dentist’s chair and that I am terrified. The dentist is encouraging. As we talk, I take in details. A bunsen burner stands puzzlingly on a workbench. Flasks, beakers, trays and packages line the shelves of the whitewashed walls. From the centre of the ceiling an examination light on a moveable steel arm illuminates the piece de resistance, the dental chair, formidable.

The dentist sports a face mask, which shrouds his moving lips and rises to meet thin spectacles above a hidden nose. A nurse motions toward the chair. I sit. A buzzing sound as the chair reclines and I check the urge to resist and sit up. I go with the chair, reluctantly. I ask if tools are necessary and am told that the mirror is essential. The mirror sounds safe enough. I secure a promise that only the mirror and hands will be used for the initial examination. The very act of negotiation taxes me. The dentist asks me to relax. The request is redundant. I force my mouth to open and receive the gloved fingers, wet and rubbery against my lips. The mirror is cold and metallic on the tongue. As the dentist spouts a torrent of incomprehensible code to an impassive assistant who takes notes, I stare fixedly at the manufacturer’s label in the centre of the examination light, desperately trying to relax the muscles of my face, jaw and neck.

Keeping the mirror firmly against my tongue with his left hand, the dentist produces a thin metal instrument in his right. He tells me he needs to use the probe but that he will be very gentle. The probe. Dear God, the very sound of it. The probe. Again I am told to relax. I am breathing like Darth Vader. The sensation of the probe probing is terrifying. I lay rigid, willing the examination to end. There is no pain, but the anticipation is utterly unbearable. The examination concludes and I rise with the chair, willingly.

When the mask comes down, a surprisingly friendly face gives me a damage report, and it’s worse than I expect. Three extractions and two fillings are required. Extraction is preferable to drilling, I decide. Because the problem teeth are distributed throughout my mouth, it will take four sessions to complete the work. Against the dentist’s advice, I request five extractions, ruling out the possibility of any drilling. The dentist agrees. Because I will be in a vulnerable state, arrangements are made for a relative to collect me post-treatment. The dentist takes my arm and prepares to inject the sedative. He tells me that I will be unaware of the impending procedure and I will probably not remember anything about it. I feel confident I will not be raped.

Later that evening, I wake up at home. I have no memory of the procedure at all. The throbbing toothache has gone and has been replaced by mild discomfort at the extraction site.

In the following months, I have three repeat performances of extraction with I.V. sedation. My fear of the dentist does not lessen and each visit proves to be an ordeal.I have had four teeth extracted. I have no back teeth on the lower right side of my mouth and only one on the upper right. Although I am still terribly afraid of the drill, I realise that to continue with my extraction-only policy, I shall quickly lose most of my teeth. I am also disturbed by the memory loss triggered by the sedative.

I desperately want to overcome my fear of the drill and I realise that I am not going to be able to do that via the sedation route. I select a new dentist from the telephone directory and make an appointment to see her. I consider the appointment a fresh start, an opportunity to confront my irrational fear. I tell myself that if I feel any pain, there is always the sedating dentist as a last resort.

The new dentist is a lady; a pretty one. I tell her about my phobia and she is very reassuring. She promises me that there will be no unexpected pain during treatment and that at the first signs of the mildest discomfort there are various options at her disposal to avoid any actual pain.

We discuss my anticipation of pain and how uneasy it makes me feel, and I am surprised that she indulges me with a lengthy explanation of what I can expect from the treatment. I feel comforted and reassured. It is almost as though I have removed a burden from my shoulders, simply by confessing my fear to her. I have told her my concerns and now I must trust her, which I do. She knows that I am frightened, but she promises there will be no pain. This really helps.

I am initially referred to a dental hygienist, who thoroughly cleans my teeth. There is no pain involved. I am beginning to realise that metal objects can be scraped against my teeth without causing me any pain. This is something of a revelation. I become much more aware of the structure of my teeth and I purchase an electric toothbrush which works by bombarding my teeth and gums with sound waves, dislodging anything that oughtn’t to be there. I buy those little plastic swords often seen in the supermarket, with a piece of dental floss attached to one end and use them as part of my oral maintenance regime.

I have been seeing my dentist for fifteen years now and have undergone a plethora of procedures, the mere thought of which at one time would have reduced me to a blubbing wreck. I have had numerous injections, drilled fillings, crowns, root treatments etc. and I can honestly say I have never felt any pain at all. I no longer fear the drill.

I have had gold implants and my jaws contain so much precious metal I live in permanent fear of developing a taste for rap. My teeth and gums are healthy and I have six monthly check-ups, which I don’t mind at all. I can now relax in the dental chair to such an extent that I can actually follow my dentist’s conversation, though I never reply with my mouth full.

My experience has taught me that fear of the dentist can be a horribly isolating, very real dilemma for many people, but it can be overcome.

My advice to anybody suffering from this phobia would be to ask yourself what exactly it is about dental treatment that scares you? What specifically? In my case it was the anticipation of pain. When you have identified just what it is you’re really afraid of, find a sympathetic dentist (many now list themselves as specialising in nervous patients), discuss your fears with them and seek an assurance from them that your fears will prove groundless, and I really think they will. May I wish you the very best of luck.