Dental Appointments

RA Survivors and Dentistry
 

By Jean
 
I have a miserable time at the dentist. It’s not that I’m a chicken; it’s because I was tortured as a child by a dentist or somebody pretending to be a dentist. Over the years, I have learned ways to make it a little less unbearable.
 
First, I tell all new dentists, in general terms, what my background is. I learned this the hard way twenty years ago when I had an emergency, and my regular dentist wasn’t available, so he sent me to the person covering for him. I figured, “I’m only going to see this guy once, so I won’t bother telling him.” 
 
I was so anxious that he tried everything he could think of to make me relax. Finally, he said, “Just think of me as a witch doctor who make everything all right by magic.” I shot right up in the chair and said, “Don’t talk to me like that! I was abused by a dentist in a Satanic cult.” Shall we say he was startled? We both were!
 
We both calmed down enough to get the procedure done, but my regular dentist said that he was so shaken up that he had to send him a nice bottle of wine to persuade him to continue being on call.
 
Second, I kept changing dentists until I found a gentle soul, a total gem. Unfortunately, he recently retired. He practiced dentistry half time, was a practicing MFT, and was writing a book on treating phobic patients. Luckily, I am in a better place after years with him. I have fewer flashbacks and more tools to handle them when they do occur.
 
Third, I have figured out some ways to keep myself in the present and out of flashbacks. I now have no compunctions about asking for what I need because I have learned that dentists and assistants dislike flashbacks almost as much as I do. Here’s what I’ve learned to do:
 
I ask them to keep talking about anything at all during the procedure. Hiking, dental school stories, their grandmothers, baseball, whatever. I just need their voices to hang on to and keep me in the present.
 
Talking is hard for them because they need to pay close attention to what they are doing. The assistant doesn’t need to focus as closely and usually manages to talk to me. If that isn’t an option, sometimes somebody in the front office can join us. In the days before COVID, I could bring a friend who understood trauma and flashbacks, and that worked very well. I have not asked for a recording of the dentist’s voice, but I think it is worth trying.  
 
I tell them to let me know ahead of time what they are going to do, how much noise it will make, and how long it will take. Surprises are not a good idea.
 
I ask for a lead apron because the weight is reassuring and goggles because they make me feel like my eyes are protected. Apparently, I am not a freak; others find the apron and goggles comforting.
 
Once, I was asked if I wanted nitrous oxide. I thought I could get through it without it. But why make life harder for myself if I didn’t have to? I gratefully accepted it.
 
Nitrous disinhibits, and I got relaxed enough to give him some feedback I had kept to myself until that point. (I had made life harder for myself by not speaking up sooner. I think this pattern needs looking at!)
 
 All dentists seem to minimize the amount of pain involved. They must teach them in dental school that the word “pain” frightens patients and it is better to use a euphemism. Well, it’s not. At best, it’s annoying, and at worst, it destroys trust. It’s not a “little pinch” or “you may feel some pressure.” Be honest and call it what it is. “This will hurt moderately for about one minute. Raise your hand if you need me to stop.” I may be dental phobic, but I am still an intelligent adult, and I don’t appreciate being lied to.
 
The other thing I figured out that day when under nitrous is that the torture I had experienced as a child had magnified the nerves’ response to pain. Repeated stimulation of the nerve-to-brain pain pathway had set me up to be overly sensitive to dental pain for the rest of my life. I checked this out and was told that I was right. Perhaps some people really do experience a Novocaine shot as “a little pinch.” Some lucky folks are even able to fall asleep while being given Novocaine!!!
 
So it’s not our fault. We aren’t being sissies. It’s totally sensible to take care of ourselves and soothe ourselves the best we can. We can’t lessen the pain or eliminate the fear; we are stuck with it for life. But we can handle pain and fear in a way that gives us some measure of control, which we never had as children. That in itself is assertive and empowering, well worth doing.