Knowing the Drill

What is dental anxiety, and why should it be addressed?

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Now that life in New Orleans is pretty much back to normal (knock on wood), it seems as though there’s always something to look forward to – whether it be a festival, a summer vacation or simply the celebration of a friend’s birthday. A trip to the dentist, however, likely doesn’t make the cut. Some people actually dread the thought of addressing their oral health. 

According to the National Library of Medicine, dental anxiety affects nearly 36 percent of the country – and 12 percent of the population suffers from extreme dental fear.

Dr. Michael Tufton, who runs Tufton Family Dentistry with Dr. Peter Tufton, says dental anxiety stems from a few factors.

“They don’t want to be hurt. They are scared of the shots. They are scared of the tools, thinking that something is going to be very painful,” he said. “Most people don’t like the sound of the high-pitch drill; they associate that with pain. A lot of times their anxiety stems back to a very bad experience they had, possibly when they were a child.”

In addition to traumatic experiences, “fear of the unknown” is another major reason individuals cringe when faced with the prospect of dropping by the dentist, said Dr. Erin Luft Katz, the owner of Smile Uptown.

“Patients come in not knowing what type of treatment they need, if something’s going to hurt, how it’s going to feel, how long it’s going to take and those kinds of things,” she said. 

Explaining to those patients what type of dental work will be necessary and why – and detailing how it will be accomplished – provides a sense of comfort, she added.

Dentists can also give nervous individuals nitrous oxide. The temporary anesthetic – also known as laughing gas – sedates patients and relieves their anxiety, but it doesn’t prevent them from going about their day after their appointment, said Katz.

Her practice offers headphones, but Katz recommends patients bring their own if possible. Listening to a podcast, an audiobook or music may distract them from any external factors that increase anxiety. Even noise-cancellation headphones will do the trick, she said. 

To prevent pain caused by oral injections, Tufton uses a special tool called the DentalVibe, which sends a vibration to the patient’s cheek. The vibration dominates the nerve that sends pain signals to the brain, so the patient doesn’t register the discomfort of the injection. The vibration also helps disperse anesthesia once it is injected, allowing the anesthesia to quickly get to work. 

“Dentistry has changed a lot and things have gotten better. There are different tools to help alleviate fears of pain,” he said, adding that all procedures should be pain-free anyway. “Once you’ve had the anesthetic to numb the tooth, there should be no pain associated with anything that we do.”

However, the best way for patients to avoid anxiety surrounding dental work is to find a dentist that puts them at ease, Tufton said.

“Dentists have different personalities and ways of doing things, so if the patient is comfortable with the person that’s doing the procedures, that is a big factor,” he said. “You can have all the tools to make things pain-free, but if they’re not comfortable with the person that’s providing the service, then it will be tough to get over those fears and anxiety.”

Katz also underscores the significance of the dentist-patient relationship, and the ability for both individuals to communicate with each other.

“I find that talking about the appointment beforehand and establishing that level of trust and communication helps a lot,” she said. “I’ve had patients say that they were absolutely terrified of going to the dentist before – which is the reason that they’re in the situation and they need to come visit me for several appointments – and realizing that they had kind of worked it up into something that it isn’t.”

Avoidance isn’t the answer

Not surprisingly, eschewing the dentist altogether will lead to bigger problems.

According to the Centers for Disease Control and Prevention (CDC), more than 40 percent of adults have felt pain in their mouth within the last year. 

Nearly 10 percent of children, ages two through five, suffer from untreated cavities. When it comes to adults, ages 20 through 64, the number jumps to 25-percent. Afterall, cavities are one of the most common chronic diseases people experience in life, even though they are highly preventable, the CDC notes.

Unfortunately, untreated tooth decay can cause a severe infection under the gums which then spreads to other parts of the body and creates serious health hazards, such as endocarditis, an infection of the inner lining of your heart chambers or valves; cardiovascular disease; pregnancy and birth complications; and pneumonia, since certain bacteria in your mouth can be pulled into your lungs. (The MayoClinic details these issues on its website.)

Regular visits to the dentist can also serve as cancer screenings. In 2016, there were nearly 45,000 new cases of cancer of the oral cavity and pharynx diagnosed in the United States, says the CDC. The 5-year survival rate for these cancers is about 61-percent. Early detection is the key to increasing the survival rate.

“I think the goal of most healthcare providers is preventive care,” Katz said. “Whether it’s a toothache or gum disease, or the loss of a tooth, it could have been prevented if you had acted sooner. If we can get to time-related things sooner, we can usually have a better outcome than if we wait until it’s a larger problem.”


More facts from the CDC:

More than 80% of people will experience at least one cavity by the age of 34.

The nation spends more than $124 billion on costs related to dental care each year. 

On average, over 34 million school hours and more than $45 billion in productivity are lost each year as a result of dental emergencies requiring unplanned care.