GringoPost | Cuenca, Ecuador: Have fear of dentists?

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Have fear of dentists?

Fortunately, nowadays most dentists are specially trained in handling fearful patients; a variety of methods and treatments are available to reduce pain and alleviate fear in the dentist's chair. But serious anxiety still prevents millions of Americans from seeking proper preventative care. Dental diseases are serious infections that can affect other parts of the body. Studies now link it to illnesses including heart disease, stroke, and diabetes.

Fear of dentists stems not so much from the experience of pain as from the lack of control that patients experience in the dentist's chair, that creates a lot of anxiety for some people because they don't feel in control.  Still, many dentists create unnecessary anxiety in patients because they assume that all patients have similar pain thresholds and will handle dental procedures in the same way. If all dentists were a lot more careful about pain control, took the time to be sure patients were comfortable, and didn't go ahead if they weren't comfortable, then we would create fewer phobics. Fearful patients need to be more assertive about their needs. About 8% of Americans avoid the dentist just out of phobia, another third have other issues for which fear of dentists can be an unpleasant side effect, such as various mood or anxiety disorders, substance abuse, or posttraumatic stress experienced by war veterans, victims of domestic violence, and victims of childhood sexual abuse.

Many "people have a fight-or-flight reaction" to the sights, sounds, and smells of a dental office, and taking away these cues has a calming effect. The place where Jack Bynes, DMD, a doctor working in Coventry, Conn., is barely recognizable as a dentist's office. He first talks with patients in his office, rather than in the dental chair. He specializes in fearful patients today because he himself had to overcome his own medical phobias as he trained to become a dentist. The waiting room contains a fireplace and soothing photography; it's free of posters depicting the horrors of gum disease. Some dentists who specialize in treating fearful patients go out of their way to create a non-threatening environment.

The best dentists use simple methods to enhance that feeling of control:

• They gently explain what the patient will soon feel, and for about how long.
• They frequently ask the patient for permission to continue.
• They give the patient the opportunity to stop the procedure at any time the patient feels uncomfortable. If for any reason they need to stop, raise your left hand and they make time for breaks as requested.

If you're looking for a new dentist, it is suggested being honest about your fears from the first call. Many dentists lack the patience to treat fearful patients with the care they deserve. Surveys of patients before and after the most dreaded procedures -- such as a root canal or wisdom tooth extraction -- have found that they anticipated much more discomfort than they actually experienced. Wisdom tooth extractions get a bad name because of occasional jaw pain experienced several days afterwards, which can be treated with pills. The root canal in particular gets a "bad rap" because it is typically preceded by painful toothaches.

The truest approach to treating dental phobia is a direct exposure. It involves introducing the patient to feared items -- say, a needle -- in a gradual and controlled manner. If you can't bring yourself to go to any dentist, you might want to try seeing a psychologist. While over sedation can be dangerous, too many dentists are uncomfortable using any oral sedation. Options include local anesthetic, nitrous oxide ("laughing gas"), oral sedatives, and intravenous sedation. It is suggested to practice controlled breathing -- taking a big breath, holding it, and letting it out very slowly, like you are a leaky tire.

Grace Ordonez: 07 409 1958. Call after: 8 AM.

City: Cuenca