Fighting dental fears

/Home/Dental Phobia/Dental Phobia Articles

Fighting dental fears
Oct 18, 2007
By Jeff Elder, The charlotte observer
The News & Observer Publishing Company
newsobserver.com

This is a story about people who climbed into the seat of their fears, and opened wide.
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 Mint Hill 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. And that two-hour visit was so terrifying 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.

"We have patients who cry the whole way here," says Christian Yaste, co-founder of Ballantyne Center for Dentistry, which specializes in patients with dental phobia. "Some have to ride the elevator up and down three or four times before they'll come in."

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. 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 inflicters of pain and discomfort. Since the mid-1980s, many dentists have made patient comfort a top priority, investing in new equipment and learning techniques like 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 overtreatment. 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."

For admitted control freak Mark Barrett of Monroe, having input was the key to getting back in the chair. "I've always felt so helpless at the dentist," he says. Allowed to choose a program of sedation dentistry, Barrett returned to the dentist after 20 years. He's now a regular patient at Ballantyne Center for Dentistry. Barrett went to a chiropractor nearby, and over and over he looked at their sign. Then, one day: "I just decided it was time to make a change."

Weinstein says that people go back -- and keep coming back -- if they believe they can improve their lives. Lazar changed his diet and lost 35 pounds. "I'm going to lose 50," he says confidently. Barrett got a new job and Lasik surgery on his eyes.

"This can have a profound impact on someone's life," Weinstein says.

Peggy Edmunds of Charlotte beat breast cancer, but lost one breast. After that, she said, "I'm going to live. I'm going to survive. Let's fix me up."

Edmunds went back to Dr. Lori Pappert, the same dentist who treated Lazar. Pappert uses approaches like sedation dentistry and "she just kept encouraging me," Edmunds says.

That encouragement -- rather than any kind of chiding -- is the best approach for the dentist, experts agree.

"It's not our job to be judgmental," says the ADA's Harms.

"They don't need a big reprimand," says Pappert. "Someone who's coming back after years often already feels embarrassed."

So how bad was it when these people went back to the dentist?

Peggy Edmunds needed two partial plates, which work well. "I can attack an apple now," she says.

Gene Lazar walked into Pappert's office and saw a sign that read, "We cater to cowards." He'd found a home. In a sedated session, he had four teeth pulled but felt "no discomfort." Now he's set for a deep cleaning of plaque and tartar below the gums. "I don't have any fear, but I do think this part might hurt the most," he says.

He's going to face it.

All rights reserved. This copyrighted material may not be published, broadcast or redistributed in any manner.

© Copyright 2007, The News & Observer Publishing Company