Fear, not cost, keeps many from seeking dental care

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Fear, not cost, keeps many from seeking dental care
By: Jeff Elder
Star-Telegram.com
October 24, 2007

How long has it been since you've been to the dentist?

For 30 years, Gene Lazar didn't go to the dentist. He was the CFO of a successful company and had health insurance. But money was not the problem.

"When it comes to dental work," says the North Carolina retiree, "I just freeze."

A traumatic experience -- cited by many who have anxiety about the dentist -- scared Lazar off. Thirty years ago, his employer pushed him to go; he hadn't been for years before that.

Lazar's two-hour visit was so terrifying to him that he stayed away for decades. His gums became so bad that his teeth were loose. Family and friends nagged him to go.

"I always talked with my hand in front of my mouth," he says.

Then, one day in April, Lazar went back. It wasn't easy.

"I couldn't sleep the entire night before," he says.

The American Dental Association estimates that 30 percent of Americans do not regularly go to the dentist. While many of them cite cost as the reason, one-third of Americans who have dental insurance still don't go -- sometimes for years.

"They just don't want to hear the diagnosis," says Dr. Kimberly Harms, a dentist in Farmington, Minn., and an ADA consumer adviser.

Two-thirds of people who believe they are in bad oral health -- the people who need to go to the dentist most -- do not go, according to a study cited by the ADA.

Until they have an unbearable toothache.

"And then, they hurt you even more," says Philip Weinstein, a clinical psychologist and the co-founder of the Dental Fears Research Clinic at the University of Washington in Seattle.

For 30 years, Weinstein has studied why people don't go to the dentist.

If you only go in an emergency, there is already something very wrong with your teeth. Addressing that advanced problem is painful and expensive.

"It reinforces the fear and adds to the problem of dental avoidance," Weinstein says.

In other words, the more you don't go to the dentist, the more you won't go to the dentist.

Dentists are trying to address their longtime stereotype as inflictors of pain and discomfort. Since the mid-1980s, many dentists have made patient comfort a top priority, investing in new equipment and learning techniques such as sedation dentistry.

"We are becoming more patient-focused," says Harms. "We're looking at the person, and not just the teeth."

Not enough, counters Weinstein.

"Most dentists are guilty of over-treatment," he says. "They confront the patient with a laundry list of everything that's wrong. They should ease into it more, build some trust, give the patient some control."

How to go back to the dentist

Talk to friends and get a recommendation on a dentist.

Call the dentist's office and tell the staff you are nervous.

Visit the office and interview the dentist.

Ask what choices you have in dealing with pain and discomfort.

Tell the dentist and the staff what makes you most anxious.

Go at a time that's good for you.

Tell the dentist and hygienist before you begin that you might need a time-out, and agree on a hand signal that will stop any work.

Copyright 2007 Star-Telegram Operating, Ltd.