Anxious Patients in Liverpool

Dental phobia is the serious, often paralyzing fear of seeking dental care. It has been reliably reported that 50% of the UK population does not seek regular dental care. An estimated 9-15% of all Britishers  avoid much needed care due to anxiety and fear surrounding the dental experience. This translates to some 30 - 40 million people so afraid of dental treatment that they avoid it altogether.

In terms of your dental health and overall well-being, this can have serious ramifications. Besides chronically infected gums and teeth which can affect your medical status, your ability to chew and digest can be seriously compromised. Without healthy gums and teeth, your speech can be affected as well. Your self confidence can be compromised if you are insecure about your breath and smile. This can lead to serious limitations in both your social and business environments.


Dental phobias and anxiety stem from various sources. These can lead to a strongly conditioned fear response. The following are the most common origins of dental fear:

  • Previously painful or negative experiences during visits to a dentist's office. This can even include careless comments made by a dentist or hygienist during a past examination.
  • A severe discomfort with feeling helpless and/or out of control in the
    dental situation.
  • A sense of embarrassment of your dental neglect and fear of ridicule and/ or belittlement when you present to the dental office.
  • Scary anecdotes of negative dental experiences learned vicariously from family and friends.
  • Negative, menacing portrayals of dentists in movies, TV, newspapers and
  • A sense of depersonalization in the dental process, intensified by today's necessity for the use of barrier precautions, such as masks, latex gloves and shields.
  • A general fear of the unknown.


The first thing you can do is to realize that your dental fear can be overcome. Fear is a learned behavior which, therefore, can be unlearned. Patient-centered behavior modification that treats you as a whole person, not as a set of teeth can help you overcome your fears. This will obviously take a team approach between you and your dentist and his/her staff. Communication is the key. You must feel comfortable expressing your fears and concerns and have a sense that you are being listened to. If you feel that the Dr. and/or staff is not genuinely concerned and listening, then absolutely feel comfortable with seeking out referrals to other offices. 
You should never compromise the level of communication that you feel is necessary to give you a sense of control over your situation in the dental office. Modern dentistry with a compassionate dental team can be truly painless. You can desensitize yourself to your fears if you take the first step and allow the right team to help you overcome your fears. (Look for a future article on "How to Choose the Right Dentist")

  1. A Sense of Control in Liverpool
    • Explanation and clarification of any and all procedures proposed is your right as a patient. If you have a question about a particular procedure, ask it! 
    • Empower yourself with the knowledge to alleviate fear of the unknown. You should have input into treatment decisions and choices. You should be honest with your dentist regarding how much treatment you think you can tolerate at first. As you build confidence in yourself and trust in the team that is caring for you, the length of your appointment and the amount of work accomplished will increase.
    • A Signaling System should be established allowing you to stop for any reason, whether it be because you need more anesthesia, want to rinse out, or simply need a two second break. The most common signal is raising your hand.
  2. Never be Embarrassed in Liverpool
    • If you have been ridiculed in the past for your behavior or if you are embarrassed by your present dental condition caused by your neglect, please express yourself honestly and give your present dentist a chance to understand your concerns and show you that they care. You will be amazed at the wealth of treatment options that you might not have thought were possible. With modern dentistry, it's never too late to recreate a new smile!
  3. Relaxation Techniques in Liverpool
    • If you feel tense in the chair, the easiest way to relax is through forms of physical relaxation. A relaxed body promotes a clear and relaxed mind. The human body cannot be physically relaxed and mentally anxious at the same time! The brain won't process these feelings simultaneously. Physical relaxation methods are easier to accomplish at first as compared to cognitive ones, so practice forms of physical relaxation first.
    • Examples of physical relaxation are Diaphragmatic Breathing, Progressive Muscle Relaxation, and various methods taught in yoga . There are numerous books and sources for these methods. If you induce relaxation in the presence of the stimuli that normally induces your fears (the dental environment), the fear response will be greatly diminished over multiple exposures and you will gradually desensitize yourself to these fears as you build confidence. The memories of traumatic visits will be replaced with more innocuous ones and this less threatening environment coupled with your relaxation methods will help you eliminate your fears.
  4. Distraction in Liverpool
    • As you get more comfortable in the dental environment, you can engage in various distraction techniques that many offices have. The use of a Walkman or Discman is a common technique. Many offices now are equipped with Virtual Reality-like glasses that provide both visual and auditory distraction by allowing you to view videotapes through these glasses while having dental work done. We only suggest using distraction techniques once you have established some trust and confidence because your ability to communicate will be compromised, although it is easy to stop any of these devices if need be.
  5. Predictable Pain Control in Liverpool
    • Modern dentistry has many new techniques with regards to the administration of local anesthetics to block any possibility of pain. There are many people who have anatomical or biologic variations that do require more individualized techniques in order to predictably achieve proper local anesthesia. This variation must be respected and communicated to your dentist. All injections should be given slowly. The needle itself is not the major cause of discomfort, but in fact, it is the pressure and volume of the fluids being injected that causes the discomfort. There are also great differences in the types of tissue in various locations, anatomically and from person to person, that must be considered when administering injections. There are even computer-controlled machines that are now available to standardize the injection process and make it more predictable than the conventional hand-held syringe.


Dental Anxiety Self-Test in Liverpool

Many people have a high level of anxiety and avoid visiting the dentist. This can cause future dental problems. Below are some questions that, if answered yes, may signify that you have some form of dental anxiety. It is important to note, however, that many new, wonderful products and procedures are available that can make the dental visit a pleasant experience.

  • Do you feel slight uneasiness and tension the evening prior to your dental visit, which makes you cancel your dental appointment?
  • While waiting in the reception area of the dental office, do you feel nervous about the visit?
  • Have you had a prior dental experience that was unpleasant?
  • While in the dental chair, do you feel uneasy and anxious?
  • Does the thought of having a dental injection make you feel physically ill and tense?
  • Does seeing the dentist or dental hygienist's instruments make you anxious?
  • Do you feel embarrassed that the dentist will say you have the worst mouth they have ever seen?
  • Do objects placed in your mouth during the dental visit make you panic and feel like you cannot breath correctly?
  • Do you feel that your dentist is unsympathetic only with you?

Fear In The Dentist's Chair in Liverpool

What is the cause of dental phobia? According to a recent study in the British Dental Journal, dental phobia is initiated by a bad experience that unknowingly has become associated with dentistry. 
The study has found that despite the advancement of modern techniques and the use of very effective anesthetics, patients still seem to maintain the same level of anxiety as they did years ago. The proportion was shown to be the same today as it was in the 1930's, 
Dr. Ruth Freeman of Queens University Dental School in Belfast, wrote the article and explains that if all dental phobia were related to painful experiences from a patient's life, the condition should have gotten better over the years because of all the advanced techniques available today. This however is not the case and it suggests that dental phobia is brought on by outside experiences which are then related to dental experiences.
There are some techniques for relaxation that a dentist can put into practice for people with such trauma. Patients may be given sedation and be informed about pain control and they may be given the advantage of being able to control their own pain by stopping and starting treatment using hand signals.
Dental Phobia and Childhood Abuse

Dental fear is frequently linked to a history of childhood or adult abuse. I have found that this is one of the most common reasons for a patient to seek care in my office, and to seek that care with some form of sedation. Abuse as a child can cause an individual to grow up with a myriad of different emotional issues, which may or may not include dental phobia. Patients may feel tremendously burdened and embarrassed by these past events, and that carries over into the dental environment. Often patients have not felt comfortable sharing these feelings and their true cause with strangers, and sometimes even their spouses. This causes patients to be particularly uncomfortable, because they know others may consider their behavior inexplicable, and yet the patient can't stop the anxiety and fear behind it. As time passes, and patients haven't been able to go to the dentist, their dental condition can worsen. This only increases patients' embarrassment, and leads to further avoidance of the dentist. Often when patients finally do go to the dentist, they can face criticism for their dental absence, leading to further avoidance and loss of self esteem. Many patients don't know how to escape this downward spiral and aren't aware that real help is possible for them. The nice thing is that, over the years, I've found it surprisingly easy to relieve patients of this "dental" burden. Given the opportunity, and a secure feeling that they are understood, patients are often glad to open up and be frank about why it's been so hard for them to have dental care in the past.

Victims of abuse store their traumatic memories in a place in their brains called the amygdala. This center mediates the "fight or flight reflex." Because it's a reflex, patients don't have control over their desire to run from the office, put their hands up, hold the dentists hands, or even bite the dentist. These behaviors are literally "fight or flight" responses; and they are overpowering for patients. There is good news, however. That is that the proper use of medication can make the dental experience a "non-event." Patients are able to have dental care without experiencing the fear or anxiety by using sedation. It has been gratifying, on occasion, to hear that the experience for these patients has been life changing. Patients will tell me about new relationships, and new self esteem. Patients can make their mouths clean and healthy, with appealing smiles. For many victims of abuse, this is something that they never thought was possible for them. Healing. It's a step for many in turning their lives in a positive direction.
When a new patient comes to my office I want to listen to them. I am grateful for the trust they often have to tell me about themselves, what they've been through, and their needs. Together, we plan how we can comfortably restore, and care for them.

Gagging and Dental Visits in Liverpool

A sensitive gag reflex is a source great concern and embarrassment for many people. It's often beyond an individual's ability to control. Children are especially effected because adults may not fully understand how physically difficult it is for them. Kids may be easily embarrassed, particularly if they vomit. Children frequently need a long series of visits, often over a period of years if they require orthodontics (braces). A sensitive gag reflex can be a childhood battle when kids are sick and need to take medications or swallow pills. These events can add up to a series of traumatic episodes that leave the patient with dental phobia as an adult. Patients may also have a gag reflex or intolerance of foreign objects in their mouth relating to a traumatic, abusive past. Intolerance to foreign objects in the mouth, sensitivity to tastes, textures and even foods can also be caused by a condition termed, sensory integration dysfunction. Fortunately, there are many things we can do to make patients comfortable at the dentist and make dental care available without the fear or embarrassment. Dental visits most often begin with dental x-rays. We can use mouth rinses that dull sensation to help the x-ray process. Panoramic x-rays are also available, where no dental film is placed inside the mouth at all. If need be, all x-rays can be taken while the patient sleeps under sedation. There are techniques with local anesthesia (commonly called novacaine) that can numb the tongue and palate to reduce gagging. Various forms of sedation are available that generally can make patients entirely free from the gag reflex. The purpose of the initial consultation is to learn the needs of the patient and begin to develop a plan of care so that the patient can have their dental care in comfort, their way. I hope that my patients will always be able to tell me how they feel, and what I can do to make them the most comfortable.

Needle Phobia in Liverpool

Needle phobia is a severe fear of needles or injections of any kind. Some people are fearful about injections only in the dental environment. Others avoid injections for medical examinations, blood work, vaccinations or medical procedures. This fear can lead people to avoid needed medical care. While the cause is often a learned fear from a bad experience, some doctors believe that the cause may actually be genetic. The question is, "What kinds of help are available for patients so they can receive the care they need. Our office has many levels of techniques, depending on the needs of the patient. The following are just some of the services available, from the easiest to the most advanced. The first step is simple caring and understanding of the issue. We start with a frank discussion of the patients past experiences which may include a previous doctor who was perceived as rough or stern. For many patients, letting them know that we have a gentle touch, backed by good technique is all they need. However, other patients may have a history of panic attack, or fainting associated with injections. For these more advanced cases, some type of medication to relax the patient is usually recommended. Some patients just need "something to take the edge off," others need a deeper level of sedation. Each patient is treated as an individual to give them what they need to be comfortable. We listen, and get the history of the patient's experiences so that we know how we can best help. Premedication with medication for anxiety, is sufficient for most patients. It is often followed by deeper sedation if the dental procedures are prolonged or involved. Patients can have complete anesthesia just by breathing a gas, called an "inhalation induction," if needed. Advanced formulations of topical gels are available. We also have a device that uses ionophoresis, a light electrical current to allow medication to pass through skin. "The Wand" is available. It's a computer controlled device that controls the speed of injection, and therefore can create less pressure. "The Wand" looks a lot less like a syringe, which helps many people feel more secure. For some patients, just reading this article is very difficult. Just the thought of an injection may be too much for some people. Even so, there are ways we can help. Talk to us, and we'll work out a plan that addresses your concerns.





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