Fearless Dentistry

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woman at dentist

Fear and dentistry go together like peanut butter and jelly. But unlike peanut butter and jelly, fear and dentistry aren’t good things and our lives would be a lot nicer if fear was replaced with fearless dentistry. Just because fear and dentistry seems to be rampant and very common (family, friends, the media…) doesn’t mean it is a good thing. In fact it is quite the opposite. It is time to stop the fear!

Just to name a few areas where there is fear in dentistry:

People worry about getting a cavity.
If there is a cavity that requires treatment, people are scared of the process and worry that it will hurt, cost a lot, they fear the needle, the sound of the drill, and so on.
Once the treatment is complete, people stress about whether the restorative materials are going to harm their overall health.
If someone has a cavity that their dentist has said is remineralized and does not require treatment, people worry that the cavity will start actively progressing again.
People worry that they are being harmed by their dentist or taken advantage of. They fear they are being over-charged, over-treated, under-treated, misdiagnosed or lied to. Clearly there is a lot of fear involved with dentistry on many levels, and it is time for this fear to stop. A common belief is that fear will keep people safe, but this is definitely not the case when it comes to dentistry. Fear will do much more harm than good.

 

Fear Increases Susceptibility to Cavities
For example, stressing about getting a cavity could actually increase one’s susceptibility to getting a cavity. Doesn’t that sound ironic? But the reality is that increased levels of cortisol (which are elevated during times of stress) constrict blood flow to the salivary glands and the pulp within teeth. Constricted blood flow to salivary glands decreases saliva and can also make the saliva more acidic, a combination that puts the tooth at higher risk of getting cavities. Constricted blood flow to the pulp within teeth hinders the ability of the teeth to respond to injury or insult (such as cavity-causing bacterial acids). Having an adequate supply of blood to the tooth pulp is a major determining factor in whether a tooth and cavity can remineralize or not. Give yourself and your teeth a break by dropping the worry about getting a cavity.

 

Fear Causes More Harm Than Materials
I have lost count of the number of times people have discussed with me their fears about different types of materials and dental work that is in their mouth. Some people have broken down into tears in front of me, sobbing to me about how they don’t want to get cancer, or some other illness. The ironic and unfortunate reality is that the fear people experience is much more damaging than anything a dentist could ever do to someone. Deciding what materials and dental treatments are best for you is a personal choice that you must come to on your own. It is not my intent to direct you in any particular way, only to encourage you to move away from fear-based thinking and towards more loving and compassionate thoughts. For example, people often fear the current state of their mouth, blaming their past dentists, their parents or themselves. However increased levels of cortisol (which occurs during times of stress) lowers immune system function, as one of the important function of cortisol. For example, you wouldn’t want your body to be focusing on fighting off an infection when you are supposed to be fighting off the proverbial sabre-toothed tiger. The immune system is suppressed during times of stress so the body can put more energy into the emergency situation. However when chronic stress occurs, from say, stressing out about the condition of your mouth and teeth, the immune system is chronically hindered from functioning at peak performance. Making decisions that are best for yourself will be far more powerful when made calmly, as opposed to fearfully.

 

Unnecessary Worry About Remineralized Cavities
Another area of dentistry where there is much unnecessary fear is remineralized cavities. Many people have remineralized cavities, also called arrested decay. Dental professionals see people every day with remineralized cavities. In fact, you as the reader of this article, are likely to have one or many areas of arrested decay in your mouth. I always tell people to open up and look in their mouth at their teeth. Do you see any little brown or dark spots on your teeth, perhaps on the grooves of the biting surface or sides of your molars? If you are being seen regularly by a dentist and the dentist has not said anything to you about these are areas, then don’t worry about them. They are most likely cavities that were once active cavities, but then remineralized and are now called arrested decay. The brown/dark colour occurred because some staining (like from coffee, red wine…) was locked into the cavity during the process and it cannot be removed. These spots are also called brown spot lesions. Many people worry about their remineralized cavities, thinking that the cavities are more likely to become actively progressing cavities again. But people should definitely not worry about arrested/remineralized cavities, in fact they ought to be celebrating. Remineralized cavities are not more likely to become an actively progressing cavity again. They are either at the same likeliness as the rest of the teeth or they are even less likely than the rest of the teeth. Studies have shown that remineralized cavities can actually be stronger and more resistant to problems than the rest of the teeth. See, all that worrying for nothing.

 

Negative Beliefs About Dentists Does Yourself a Disservice
I know that it may seem like a good idea to believe that dentists are out there to get you, either through pain inducement, over-charging for treatments, over-treating, or all of the above. It may seem as though fear-based thoughts will keep you safe and from harm. However that is the opposite of what really happens. Dentists are there to help you have the mouth you desire. Having a fearless-based relationship between dentist and patient/client promotes the achievement of that healthy mouth most people desire. For example, with the increased interest from the general public to remineralize teeth and cavities, some people are attracted to learning about all the reasons why dentists are bad and ‘out there to get people,’ from the media, online groups and organizations. The reality is however, that dentists are not out there to harm people in any way. In fact dentists are out there to help people. Dentists are highly educated, trained and experienced and are the only people who can diagnose remineralized cavities verses demineralized cavities. Dentists are the only people who can tell someone if their remineralization efforts are working and they can celebrate or if their remineralization efforts are not working and dental problems are on the horizon if changes are not made. So, while it may get a lot of (negative) attention, fear-based thinking about dentists only ends up harming people by creating a poor dentist-patient/client relationship. The most powerful and most beneficial relationship is one of mutual respect.

Fear, fear, fear… so much fear in dentistry. People fear getting a cavity, then they are scared in the dental chair having the treatment. After the treatment they fear the treatment will harm their overall health. If they don’t end up getting a cavity, they fear their remineralized tooth will suddenly turn into an aggressive cavity. They fear dentists are out there to ‘get them’ financially and/or through bad treatments. It is time to end all this fear.
People want a healthy mouth. Dentists want to help people achieve a healthy mouth. Drop the fear and these two wonderful desires will become a reality. Now that’s something to smile about!

 

1 Roberson TM, Heymann HO, Swift EJ. Sturdevant’s Art & Science of Operative Dentistry, 4th ed. (Chapel Hill, North Carolina: Mosby, Inc, 2002), 99

2 Roberson TM, Heymann HO, Swift EJ. Sturdevant’s Art & Science of Operative Dentistry, 4th ed. (Chapel Hill, North Carolina: Mosby, Inc, 2002), 90, 98, 424.