One painful experience at the dentist can lead to a lifetime of dental anxiety

Oct 24 2013

One painful experience at the dentist in childhood can lead to a lifetime of dental anxiety and tooth decay. "Every week we see patients that are older, in their 30s, 40s and 50s who complain that at a much younger age such as in childhood, their previous dentist was rough, did not explain what was happening, carelessly drilled or poked and prodded and the memory is so fresh that they still feel anxiety as an adult," says Martin Hogan, DDS, Loyola University Health System. "Unfortunately, years of missing dental cleanings and routine visits means they often come in to see us as a last resort when they are suffering a really painful condition that could have been avoided."

Hogan takes actionable measures to prevent dental anxiety from happening. "We ask parents to bring their children in when they get their first tooth or at their first birthday more to establish a positive routine than to actually do anything clinical,"says the division director of dental medicine at Loyola Stritch School of Medicine where he is an assistant professor. "The dental staff introduces ourselves. We let them play with the chair and with certain equipment, and it is all done in a safe, nonthreatening environment without pain."

Hogan says the age of the patient does make a difference in their attitude. "Usually the younger children, under 10 and 12, have a harder time with the exams," he says. "Opening their mouth for a longer time, allowing the dentist to look at things in the mouth, holding still and not talking or moving can be tough for all kids," he says. Kids with attention deficit disorders especially.

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"For kids with ADHD, we deliberately schedule dental appointments earlier in the day; first thing in the morning is better than afternoons when kids are tired or stressed," he says. "Adults who have dental anxiety can also benefit from an early appointment to avoid escalation of fear."
Hogan also may suggest the use of a little nitrous gas. "Laughing gas takes away the edge and offers relaxation for many younger and also older patients who tend to get emotional," he says.

Explaining procedures and equipment thoroughly and involving the patient in the care, especially if they are older, can also be helpful. "I show them the equipment before I use the implement and I talk to them about what I am doing such as counting their teeth or polishing their tooth or removing plaque," Hogan says. "The patient has no negative surprises that way and is a more willing participant."

Hogan has some advice for parents of young children to help establish positive dental practices. "Do not tell the kids that they will get cavities or need a root canal if they do not brush their teeth," he says. "And do not share your own previous painful dental experience with your child." Tales of dated practices such as tying a string around the tooth and shutting the door or painful wisdom tooth extractions create unnecessary fear in children.

When Hogan experiences patients who are overcome with anxiety, he often gives them 5-minute breaks before moving forward. "Especially if they are younger, upset patients benefit from having time to release the stress through a cry or self talk and usually are able to proceed again with greater calm," he said."For kids, small rewards such as letting them choose a colorful sticker of a favorite character or giving them a coloring book, ends the visit on a happy note."

The Loyola Oral Health Center in Maywood is located on the first floor of the Maguire Center on the east side of the Medical Center campus. The Oral Health Center provides full dental services, including general dentistry and preventive care for adults and children, and oral and maxillofacial surgery.

The 19 patient care rooms include seven that are dedicated to general dental care, four to oral surgery, four to dental hygiene and two to recovery.

SOURCE Loyola University Health System