This can be anything done to correct imperfections in the appearance of the mouth. Anyone who is unhappy with their smile can have it fixed. The upper teeth show, usually, only when smiling, while the lower teeth remain hidden. This is reversed when talking, with the upper teeth remaining hidden while the lower teeth show. The color, alignment, spacing as well as regularity of the teeth are the characteristics that give the overall appearance. Any of these can be repaired to give a stunning look to the mouth.
“I’m terrified of dental injections. They hurt like hell! The syringe looks like a medieval torture instrument, and the needle is about 10 inches long!” ”I’m completely terrified of all needles. It’s the thought of shots that I can’t tolerate, to the point where I avoid them even when they are absolutely necessary.”
The facts about needle phobia
If you’re very anxious about needles, you’re not alone! The Adult Dental Health Survey (UK) 1988 stated that 8% reported a fear of injections (Todd & Lader 1991). Some studies suggest that almost 5% of the population may be phobic of needles in general. The level of fear varies from person to person, and some people are afraid of dental injections in particular, while others are phobic about any sort of needle. Some people are phobic to the point of avoiding injections at all costs (including their life). Thankfully, there are various methods of help available. Local anaesthetic administration can be entirely painless. Most needle phobics have had a very bad experience with an injection. There are various reasons why a dental injection may be painful:
Lack of empathy:
Perhaps surprisingly, the very first injections dental students give to their classmates in dental school are painless, but oftentimes, their injections become increasingly uncomfortable as time goes on. Interestingly, dental students are surprised at how painless those first injections are, because some have experienced painful injections in the past when they were patients. The most likely explanation is that the students went out of their way to make the injection painless (knowing that they would be at the receiving end next, and having to face their classmates for the rest of their time at dental school!). “Taking turns” fosters empathy, but this empathy is sometimes lost as dentists move out of dental school.
Not using a topical anesthetic (numbing gel):
While it is possible to give painless injections without numbing gel in some areas of the mouth, numbing gel should always be used for injections which would otherwise be traumatic. It really works, if it is left on for long enough – the soft tissue will be so numb that you cannot feel the needle going in.
Using a dull needle
This has become very rare nowadays, because disposable needles are used, but it used to be a common cause of painful injections. The issue can still arise today with multiple injections – the needle should be changed after 3 or 4 penetrations.
Not making the tissue taught and injecting gently:
In some areas of the mouth, the tissue needs to be stretched to make the injection comfortable. Applying pressure (using a finger or a q-tip) can block out any feelings of pain (the nerves which transmit movement and pressure actually block some of the transmission of pain from the other nerves). The principle is the same as when you’re rubbing something better if it hurts, for example if you bump into something. This is also known as the “Gate Control Theory of Pain”. Applying pressure is particularly important in areas where painless injections are more difficult, especially the palate.
Administering the anaesthetic too quickly:
This is the most common cause of injection pain. Quite a few dentists administer local anesthetic too rapidly. Rapid injections can tear the tissue, which results in immedate pain followed by soreness. It’s difficult to say exactly how long a comfortable injection should take, because this varies a lot between different injections sites and techniques.
If you reckon that dentistry is simply too painful to bear, it is highly likely that you’ve had at least one very painful experience in the past. This could have been due to a number of reasons: the dentist starting the procedure too early, before you were properly numbed; a dentist having trouble getting you numb due to anatomical variation (that is, nerves being in a slightly different location from where they are in the majority of people); an infection (this can prevent the anaesthetic from working properly – but infections can be treated with antibiotics first); the dentist hitting a nerve; or you may have been refused anaesthetic in the past (in which case you’ll most likely fear the No Needle, rather than the needle aspect!). You may have had a dentist who wouldn’t stop even though you were obviously in a lot of pain. And, of course, some dentists are much more gentle than others – you do get the odd dentist who simply lacks the dexterity required for the job!
Dentistry, in general, is not painful if you’re properly anaethesized. Yes, it can be somewhat uncomfortable at times (if you’re severely phobic with regard to the pain factor, you might interpret “uncomfortable” to mean “unbearably painful” – but it’s not the same thing! Otherwise, the majority of people would never visit a dentist). But what if you fear “the jab”? There’s an ointment or gel which can be applied to your gums first in order to numb them, before you get the jab. If you don’t like the sight of needles (and who does?), closing your eyes might help. If you are a severe needle phobic, there are both behavioural and pharmacological methods available which can make it easier to receive treatment.
Recent research (Moore et al, 2004) has confirmed what most people who suffer from dental phobia have long known: that “intense embarrassment due to poor dental status or perceived neglect, often with fear of negative social evaluation as chief complaint”, is extremely common among people suffering from dental phobia. This is the vicious circle of dental phobia: whatever caused the phobia initially (be it painful or traumatic experiences, hurtful remarks, or something else) leads to avoidance, which in turn means no access to professional dental care, usually resulting in poorer oral health, and at some stage the results of this “neglect” are perceived to be so embarrassing that it’s totally impossible to see a dentist, even when in pain. If shame, embarrassment and guilt are keeping you away from seeing a dentist, you’ve got plenty of company!
First of all – it’s highly unlikely that any dentist hasn’t seen teeth which aren’t as bad as or worse than yours – if you don’t mind graphic photos, check out this page: ”My teeth are the worst the dentist has ever seen!”
Embarrassment is perhaps THE most common concern voiced by people who haven’t been to a dentist in a very long time. It may come as a surprise to some that the days when “the lecture” was part-and-parcel of a visit to the dentist are gone. Dentistry has evolved into an industry which supplies a service to the potential customer – you!
This development mirrors trends seen throughout society. The authoritarian parenting model which used to be so popular has fallen out of favour big-time, to be replaced by tender loving care and open communication. Similarly, dentists nowadays realize that admonishing people is a sure-fire way of keeping them away. Many dentists now endeavour to make dental appointments a positive experience, not only for those whose teeth are in great shape!
As always, beware – there may still be some old-school dentists around who see “lecturing” and negative remarks as a good way of frightening people into compliance. But this has become increasingly rare. Choosing the right dentist and communicating your fear of being lectured will ensure that you have nothing to worry about on the shame and embarrassment front. Don’t torture yourself – be upfront about your fears and ask your dentist not to make any comments that you might construe as negative! There’s absolutely nothing to be embarrassed about.
The psychology of embarrassment is pretty interesting. Studies, for example by sociologist Andre Modigliani, have shown that shy people with high levels of empathy – the ability to imagine how others may be feeling – can be more easily embarrassed. Easy-to-embarrass people also have a tendency to believe that others see him or her as somehow inadequate.
The good news is that the mortification is mostly in your own mind. Research has shown that most onlookers are actually very sympathetic when others embarrass themselves – and that people who are embarrassed and simply admit to it are tremendously well liked.
Other factors which make a sense of shame and embarrassment so common when it comes to dental fear and phobia may include an emphasis on beauty and perfection in modern Western society and – dare I mention it – the fact that the mouth is an erogenous zone.
It may help to know that from the operator’s (that is, the dentist’s) perspective, the situation looks very different. They’ve been trained to help people who are experiencing problems with their teeth and gums – it’s their job to fix these problems. And a lot of dentists view their job as a caring profession – which is what it should be.
You might find it more reassuring to hear this “from the horse’s mouth”, so to speak, that’s what Dr Silverfill (relax – it’s only a pen-name, he’s state-of-the-art, really) is here for!
Dental phobia can have wide-ranging consequences on a person’s life. Not only does their dental health suffer, but dental phobia may lead to anxiety and depression. Laughing out loud is out of the question – too hard to hide one’s teeth… Depending on how obvious the damage is, the individual may avoid meeting people, even close friends, due to embarrassment over their teeth, or not be able to take on jobs which involve extensive contact with the public. Loss of self-esteem over not being able to do something as “simple” as going to a dentist and intense feelings of guilt over not having looked after one’s teeth properly are also very common. Dental phobia sufferers may also avoid doctors for fear that they might want to have a look at their tongue or throat and suggest that a visit to a dentist might not go amiss.
If you suffer from dental phobia, you’ll be inclined to think that nobody else feels the way you do – after all, who else would rather be dead or have open-heart surgery than meet up with a dentist?
Actually, quite a lot of people! While there are no reliable statistics (after all, few dental phobics will freely admit to never visiting a dentist… that’s if they hang around to complete the questionnaire!), the most conservative estimates reckon that 5% of people in Western countries avoid dentists altogether due to fear. And many more are anxious or scared about dentistry.
However, most people actually don’t mind going to the dentist. There is a reason for this – nowadays, dentistry can be pain-free and there are many personable, kind and compassionate dental professionals around. Many if not most people who’ve suffered with dental fears and phobias reckon that having found the right dentist for them has made all the difference.
One problem with defining dental phobia is that “dental anxiety” (a reaction to an unknown danger) may feel just as frightening as a “phobia” to a person, and they may well be defined (or define themselves) as phobic. From what little research there is available, this may be more common in people who are generally anxious. Also, some people who’ve never had a bad experience with a dentist or a dental procedure can develop dental fear or phobia – this is usually the result of vicarious learning (that is, scare-stories or media portrayal).
I like to think that “dental phobia” is simply useful short-hand for “terror at the thought of dentists and/or dentistry and/or anything dental-related”. Some people feel that their fear is justified and rational, while others feel they’re being silly for getting so upset over something which “everyone else” seems to have no problem with. “Dental Phobia” is really an umbrella term which covers a wide range of different fears, as you’ll see on the “Common Fears” pages. It would also appear that there are some fairly distinct subtypes of dental phobia, such as needle phobia or terror at the thought of gagging and being sick.