RA Survivors and Dentistry

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 and so sent me to the person who was 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 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. He’s a total gem. He practices dentistry half time, is an MFT and sees clients half time, and is writing a book on treating phobic patients. (Anybody who needs a dentist in San Francisco, just let me know. And you bet I will review his book when it comes out!)

Third, I have figured out some methods to keep myself in the present and out of flashbacks. I have no compunctions about asking for what I need because my dentist and his 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.

I tell them to let me know ahead of time what they are going to do, how much noise it will make, 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.

Last time, 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. (Again, 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, at worst it destroys trust in the dentist. It’s not a “little tinge” or a “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 like being lied to.

The other thing I figured out 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.” Apparently there are lucky folk who are even able to fall asleep while being given novocaine!!!

So it’s not our fault. We aren’t being sissies. It’s completely 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.