Overcoming Obstacles to Dental Health
by Coleen Travers, LMSW, ACSW
Matt*, 42, has asked his wife Katie to schedule a dental appointment for him during her next visit. Katie confides in the dentist that her husband has a very strong fear of needles. Matt consistently waits until the week of his appointment, canceling the day before and blames it on his work schedule.
Carol*, 36, suffers from chronic tension in her jaw, has been diagnosed with bruxism, and mentions, "I'm so stressed out!" to her hygienist. Several members of her family have developed TMJ problems and she fears she'll be "the next one" if she doesn't do something different.
Harold*, 57, has just moved to Kalamazoo from another state. On his intake form, he writes he had a "disastrous" treatment experience with his previous dentist, who had inadvertently drilled into his tongue and jaw. Harold has suffered from pain, horrible nightmares, and intrusive images and sensations from that event for the past 3 years. He knows he can no longer postpone getting a new dentist.
Annie*, 20, is a college student majoring in theater and dance. She's been a patient of the practice since she was a child. The enamel on her teeth has eroded dramatically in the past few years, and she has scarring on the backs of her hands and fingers. Her dentist suspects Annie is bulimic, but hasn't said anything.
*In order to protect privacy, all of the "patients" are actually composites of many people who, over the years, have sought therapy to alleviate their distress.
What do these people have in common? Each of them thinks they are "the only one" experiencing their suffering, but many dentists and their staff members know otherwise. When mental health issues affect the well being of patients, their basic dental treatment needs may go unmet for years.
People may be consciously aware they are avoiding a dental visit, or they may keep it out of their awareness by denying it ("I'm fine"), minimizing discomfort and pain ("I don't need to see the dentist, they'll only find something wrong"), procrastinating (also known as "fear in five syllables"), and other strategies that, over time, has protected them from addressing the source of what may potentially overwhelm them.
Though an individual may not think of a therapist when preparing for a visit to the dentist or hygienist, counseling can assist individuals who have experienced dental trauma/injury, excessive fears of needles or feeling "trapped" in the dental chair, stress-related syndromes, eating disorders, when teeth have to be pulled for dentures, oral surgeries, domestic violence (one of the most frequent reasons women have one or more broken teeth), to name a few of the areas that affect people's decision to see a dental professional.
When an individual is able to address the source of the emotional pain associated with their mouth and/or dental work, they feel more in control of the process. Their feelings and their self-esteem improves as their fears diminish. Necessary dental, periodontal, endodontal, or orthodontal work can begin or continue. Contrary to public misconceptions about therapy, many times it is the "stronger" person who is able to admit when obstacles are getting in the way of their health and well-being, doing something about it.
With so many practitioners to choose from in our region, it may be helpful to delineate the six different disciplines trained to assist clients in skill-building, efficacy, and developing healthy coping patterns. These different disciplines are explained here.
The strategies utilized by providers may include, but are not limited to, the following:
- Traditional, insight-oriented talk therapy (developing a supportive relationship in which one can discussing one's fears, previous experience, associated losses, etc.,) in a safe and confidential setting
- Cognitive-Behavioral Therapy (examining, then changing, beliefs that support the problem behaviors)
- Guided Relaxation and Visualization (using one's imagination to enhance the body's natural relaxation responses)
- Biofeedback (technology that permits the patient to gain control over their somatic and emotional responses to fear, pain, etc., as well as relaxing specific muscle groups)
- Trauma protocols, such as desensitization or EMDR (Eye Movement Desensitization and Reprocessing), to allow the person to process traumatic events (often residing intact in the nonverbal, emotional side of the brain with all the associated thoughts, feelings, self-beliefs, images, body sensations, etc., that result in nightmares, flashbacks, being constantly "on guard", etc.) that, left untreated, can develop into Post-Traumatic Stress Disorder (PTSD)
If you, or someone you know, has been nervous about seeing a dental professional, many providers and their staff want to help you feel at ease. Here are some suggestions/strategies to help you have a successful appointment:
- Practice deep breathing before, during and after the appointment. When we slow our breathing, the body's natural defense system (adrenalin) that urges to "Fight, Flight, or Freeze" may not be engaged. The more tight the muscles, the more painful a procedure can be.
- Ask (ahead of time is best) if you can choose the chair in which you can sit.
- Plan with the provider when you can take a break during the appointment. Can the work be done in stages? What's the best time of day for you?
- Some providers may encourage you to bring a personal CD or tape player so you can listen to soothing music, or nature sounds, or a book on tape to distract you but not interfere with the procedure.
There are mental health professionals within Professional Consultants and Clinicians, Inc. (PCC) that can help you with your negative past experiences and the beliefs you may have about yourself as a result of those events. Visit our Specialty Areas page to learn which of our members specialize in working with anxiety, or medical stress, or post-traumatic stress if you're considering talking to someone about how you feel about your dental health. With all the news regarding plaque, and dental health contributing to cardiac health, visiting your dental professional is an example of prevention as well as true self-care.