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Something different to chronic pain: Dental fears and phobias

No-one likes going to the dentist, but some people are truly terrified. They may try to avoid the dentist, risking their dental health. When they are in the dental chair, they can be so distressed that it is difficult for the dentist to do their work. The process takes longer and the patient still dreads the dentist.

It is estimated that up to one in five people suffer from dental fear or dental phobia. No-one knows how many seek help as figures have never been collected. But my experience as a qualified hypnotherapist tells me it is a common issue. It certainly brings a lot of people to my clinic.

Many of these people are suffering badly. I see people who are so frightened of going to the dentist that they put it off at the risk of losing teeth, they may find it hard to sleep even several nights before the appointment. I have seen people who feel so nervous they want to run away when they are in the waiting room. This can even escalate to panic attacks or feeling physically sick. Once in the dentist’s chair people with dental fear or phobia may experience other very unpleasant feelings. This is often a fear of having objects placed into the mouth or worry that breathing will become difficult. 

I am going to take a look at these fears and how they can be overcome. I do believe that in most cases this fear can be conquered, making life better for both patients and dentists. I am going to describe some of the things I do with my clients, to show how this can be done.

Breaking down the fears

One of the characteristics of fear is that it presents as an uncontrollable, indefinable, incoherent cloud. It can often help clients if we break down the fear into distinct areas. 

Fear of pain

Of course, we all try to avoid pain, it is part of our primitive defence mechanisms. But for some people the fear is paralysing. 

Sometimes a good first step is to find out where this fear comes from. This can stem from a bad previous experience, especially from the client’s childhood. In childhood, we all lack power. And if we have a bad experience at the dentist, we can process this into several unhelpful beliefs. Powerful adults are hurting you and you cannot stop them. Your parent, who is supposed to protect you, is betraying you by doing nothing. 

One established hypnotherapeutic technique is to take a client back along their own memory timeline and let them look at their unfortunate experience from their wiser adult point of view. This can help take the emotional sting out of the memories and decouple these memories from fear of the pain. 

Fear of injections

This is a very common phobia, and of course many dental appointments involve an anaesthetic injection. I often use a technique from neuro linguistic programming called the fast phobia cure here. I ask the client to imagine a cinema and to take a seat in the front row. I encourage them to relax then to see themselves on the screen happy and relaxed. Then I ask them to see themselves having an injection then being happy and free afterwards. I then get them to run this film again and again, using sounds and colour in special ways until their fear lessens to a level where they can cope. The technique works by divorcing emotion from events and imaginings. We then hold the thing which was causing the fear differently in our thought patterns and can cope with it. 

Loss of personal space

Another emotion which can cause fear and even panic is the feeling of being overwhelmed by the close physical presence of someone you do not know or want near you (in this case the dentist).

This can sometimes be caused by unpleasant or traumatic previous experiences, such as sexual harassment or assault. In this case we can use hypnosis to disassociate these memories with the dentist experience. This can break the link and then the fear is lessened. 

Getting the dentist involved

I have described some of the techniques I use when a client comes to me for help for dental fear or phobia. I do favour something else as well, that is getting dentists involved. 

I prefer to use a two-stage approach. 

My approach works like this. I like to see a client in my own clinic several days or weeks before they have the appointment. 

I will work with the client to find the roots of their fears as I describe above and work to change how they hold the memories and emotions which are causing the fears. This is relatively simple to do. By considering memories and fears, especially those which developed in our younger lives, we can use techniques to remove unhelpful beliefs. 

With the client’s grown-up wisdom and in a safe and supported environment it is possible to detoxify those memories. And if we can do that the dental fear will be lessened. That is the core of my approach. I also offer some practical tips and techniques which the client can use on the day of the appointment. These include:

Positive visualisation

Under hypnosis, I show the client how they can explore what being at the dentist, pain-free and relaxed, can feel like. I then use a technique, called anchoring, which enables the client to recall their positive feelings in the real situation.

Deep-breathing for relaxation

I teach the client to breathe slowly and deeply, using all their abdominal muscles. This creates a physiological reaction which sends messages to the brain saying ‘relax, it’s all okay.’ With a little practice the client can do this even in difficult situations, such as the dentist.

That is my ‘Stage One’ plan for conquering dental fears and phobias. 

My ‘Stage Two’ involves the dentist and his or her staff, usually the dentist and the dental nurse. I can teach these professionals some simple hypnotic techniques, which they can use while the patient is in the chair. By inducing a light hypnotic trance, using positive reinforcing language, by using guided metaphor to distract the patient from the procedure, dental treatment can become easy for nearly everyone. 

Many dentists are onto this and have learned to use these techniques successfully. To those who have not yet tried I would say it is in your interests as well as your patients to spend a couple of days learning these techniques. You as a dentist will be better able to manage nervous and even phobic patients. This means they will have a better time and your work will be finished more quickly. I would advise anyone suffering from dental phobia to seek out a dentist who uses hypnosis.

It’s a win all round.

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