Suffering from Anxiety during your Dental Treatments?

The Dental Hospital in soi 49 (close but not part of Samitivej hospital) provides up-to-date dental treatment.

Suffering from anxiety when visiting your dentist?
We think anxiety when visiting a dentist is very common, and in many cases it can lead to postponements or cancellations of dental check-ups and dental cleaning procedures. If you are having tooth aches, loose a filling or break a tooth however, there is no escape from a dental visit..

Dentists must be well aware of this problem, not clear how they are taught to deal with it. In our opinion, they use the proceed as 'a matter of fact' approach. They just assume anxiety is there, and the best way to deal with it is pretending it does not exist. This works well probably 99% of the time, and that is why this approach is used. As for the patient, he/she does not want to appear to be a wimp, and suffers in silence.

Sometimes, anxiety can be just a bit more worrisome. Some people in the dental chair sense a significantly increased heart rate (tachycardia). For those with high blood pressure (and from what we read between 25 and 50 % of middle aged persons seem to suffer this condition), you can be almost sure that your blood pressure is going through the roof (if you suffer from dental anxiety) when you are lying there and getting your teeth cleaned or your root canal done.

It is important to notify your dentist about any medical condition. Often, you may not remember so, you are asked to fill a form regarding your health prior to a first visit. But this may be years back and not updated. So if you suffer from any cardiac condition, high blood pressure, bleeding disorders, diabetes or any significant medical condition, you need to inform your health service provider. He or she may change the approach in treating you.

If you suffer from a fast heart beat, and we think this is something that can happen according to your personal sensitivity, there is another issue to consider. Anesthetics injections, used to control pain during treatment, often include epinephrine. Epinephrine has the beneficial effect of prolonging the duration of the pain-killing effect of the other drugs injected, and reduces bleeding. However, some of the epinephrine is absorbed and you can get a feeling similar to the experience of an anxiety attack. Surely, if you already suffer from anxiety, this will intensify the feelings. Also, absorbed epinephrine may increase blood pressure, an unwarranted effect if you suffer from high blood pressure. So, you may want to discuss this issue with your dentist. Maybe he can proceed without or with a lower dose of epinephrine.
As I mentioned before, dentists tend to act in a 'matter of fact' way. During my many visits to the dental clinics in Bangkok, I was never advised about any of the drugs used during treatment. I just recently became aware of this issue.

In the case of anxiety attacks, we think they can be very disturbing, but tend to be transitory. It would certainly be helpful if dentists were less in a hurry while treating you. Giving the occasional time to take a deep breath, putting some soothing music on, and offering limited small talk, would go a long way in making the experience less dreadful.

You can help yourself by being aware of anything that initiates of exaberates anxiety. Do not drink caffeinated drinks such as coffee or tea in the hours before your visit to the dentist. If you smoke, try to avoid it in the hours preceeding treatment. Be well hydrated. Also discuss with your physician if anti-anxiety medication could be helpful.

You find a list of drugs that interact adversily with epinephrine, and conditions that make its use dangerous here.

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