What are the causes of our patients’ fear of the dentist? Most persons harbor five universal fears:
1. Fear of pain
2. Fear of the unknown
3. Fear of helplessnes and dependency
4. Fear of bodily change and mutilation
5. Fear of death
Each of the above fears may easily be transferred into the dental situation.
The fear of pain is the most significant fear barbored by the typical dental patient. How often do I hear, “Is it going to hurt?” from a paient just before a procedure is to start? In fact, how do most patients select their dentist? Because of the superior quality of dental care or because the doctor has a repution for being “painless” and caring? I have heard “Its nother personal Doc, but I don’t like dentists” many times.
Fear of the unknown is present in varying degrees whenever a person is confronted with a new situation, be it attempting to cross a furnished room for the first time in the dark or facing anew and theatening dental procedure. Fortunately, this fear can be effectively diminished or or eliminated by the dentist by “preparatory communication.” Preparatory communication is when the dentist discusses the planned procedure with the patient, describing in nontechnical terms the nature of this planned procedure.
The fear of helpnessness and dependency is, unfortunately, more difficult to eliminate in dentistry. Because of the nature of dental care, the patient is both unable to observe the treatment and is usually placed in a very vulnerable position – the supine position. Most persons will experience a feeling of unease at this time, especially when they are receiving treatment from a stranger – a dentist or hygienist with whom they are not well aquainted. As the patient becomes more familiar with the dentist or hygienist, this feeling of helplessness should resolve.
The fear of bodily change or mutilation is common in all aspects of medicine but is especially evident in dentistry. The oral cavity is both a richly innervated and a psychologically improtant region of the body. All aspects of dental care have potentially great psychological overtones. Changes in the size and shape or configuration of the body may have a profound effect on the patient’s overall outlook and attitude. The loss of teeth, for example, in today’s society may represent the process of growing old, a situation that could prove to be extremely disturbing psychologically to the patient.
The fear of death is also ever present. Placed in a vulnerable position in the dental chair, patients next have a multitude of hands and instruments placed into their mouth. Drugs are injected that remove the patient’s ability to feel, and then a high-speed handpiece is placed in the mouth, with a bur rotating several hundred times per minute. Many sensations and feelings race through the patient’s mind at this time: Can I breathe with all this equipment and these hands in my mouth? Will I move my tongue too close to the drill and have it injured? Will the dentist slip and injure me?
Paul L. Caputo, DDS3490 E Lake Rd S Suite A