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Dental phobia, and dental anxiety come in many forms. Anxiety may cause you to be slightly apprehensive to extremely frightened at the thought of visiting the dentist. A

Dental Phobia Marielaina Perrone DDS

Dental Phobia Can Be Overcome!

phobia, may cause a paralyzing fear that overtakes your entire body. Whichever form, dental phobia or dental anxiety, can be very difficult to overcome. Inability to have regular dental and health care can lead to health issues. Numerous studies have linked diabetes, alzheimer’s disease, heart disease, and even cancer to poor oral health. It is imperative to maintain a healthy mouth to keep our bodies happy and healthy. So, the question becomes, can dental phobia be overcome?

Dental Phobia Is A Learned Fear

There has been significant research to show that dental phobia and dental anxiety are linked to life experiences. These experiences can be direct or indirect.

-Direct experiences - are the most common way for people to develop a dental phobia or dental anxiety. Many people report fearing the dentist due to a prior traumatic or painful dental experience. However, it is often the dentist themselves who induce the dental phobia. During the many studies, patients report it was not the dental procedure that ultimately causes their fear. Instead it was the dentist’s attitude towards them. Dentists who were perceived as impersonal, uncaring, or even cold were found to be the root cause of the direct experience dental phobia. An interesting note from these dental phobia studies was, that patients who experienced a painful or traumatic treatment but had a caring dentist, failed to develop a dental phobia. This leads us to believe that dental phobia is a learned trait and can be overcome.

-Indirect Experiences - These can include:

Parental/Peer Influence – Dental phobia can develop from hearing about your parents, siblings, friends, bad experiences or their negative views on going to the dentist.

Media Influence – Many movies like to poke fun at the dentist in good and bad ways. A good example is the dentist in little shop of horrors whereby dentistry is portrayed in  a sadistic way. This extreme visual can be quite unsettling, and emotional. The fear can readily be instilled, and dental phobia can develop.

Dental Phobia Diagnosis

Dental phobia can often times be very easy to diagnose. All you have to do is ask a patient and they can tell you how they feel about the dentist. It usually produces a very profound reaction if they truly have a dental phobia. The usual method for diagnosing dental phobia is the use of a scale to assess the level of dental phobia or dental anxiety. The scale consists of a series of questions and based on the answers the dentist can assess the level of your dental phobia. Common questions on the scale include:

Dental Phobia Marielaina Perrone DDS

Unlearn Your Dental Phobia!!

-While waiting in the reception area of the dental office, do you feel nervous about the visit?

-Have you had a prior dental experience that was unpleasant?

-While in the dental chair, do you feel uneasy and anxious?

-Do you feel embarrassed that the dentist will say you have the worst mouth they have ever seen?

These questions will give your dentist an assessment of what you are afraid of. Further questioning will help narrow down the fears and their triggers, enabling the dentist to work with you to help slowly overcome those fears.

Breaking The Dental Phobia Hold On You

Overcoming dental phobia can be a very difficult proposition, there is work and time involved for both you and your dentist. The first step is believing in yourself, and your dentist.The second is, feeling that it is possible, and truly wanting to try and overcome it. Dental phobia is a learned behavior and can be overcome with hard work and the desire to do so. The biggest key to overcoming dental phobia is to find the right dentist for you. One who will always keep an open line of communication, is extremely important. This will allow you to express yourself and your emotions before, during, and after treatment.

-Feeling of Control -  A sense of control is your right as a dental patient. Understanding this, is key to confidence. Knowing that you can stop treatment as often , and whenever you want can be very freeing.The most common signal is simply raising your left hand to alert the dentist and staff of your need to communicate. A system should be established allowing you to stop for any reason, whether it be because you need more anesthesia, want to rinse out, or simply need a break.You should be part of the process of developing a treatment plan as well as have the ability to fully understand the treatment being offered and why it is needed. You need to be honest with your dentist and yourself regarding how much treatment you can tolerate initially. As time moves on, you will build confidence in yourself as well as increased trust in the dentist and staff treating you. Over time, the type and length of the appointments can be increased. You will be amazed how long you will be able to sit in the chair when it is your choice!

-Feeling Embarrassed or Self Conscious - If you have been ridiculed in the past for your behavior or if you are embarrassed by your present dental condition caused by your neglect, please express yourself honestly and give your dentist a chance to understand your concerns and show you that they care. Please know, that most dentists

Dental Phobia Marielaina Perrone DDS

Free Yourself Of Your Dental Phobia

do care, and want to treat you with the respect that you deserve. These feelings do need to be addressed, and talked through, so that you can begin to leave them behind.

-Use Of Relaxation Techniques - If you feel tense in the chair, the easiest way to relax is through forms of physical relaxation. A relaxed body promotes a clear and relaxed mind. The human body cannot be physically relaxed and mentally anxious at the same time! The brain won’t process these feelings simultaneously. Physical relaxation methods are easier to accomplish at first as compared to cognitive ones, so practice forms of physical relaxation first. Light meditation methods and music work very well. Light conscious sedation, such as valium, is a great way to start.

Examples of physical relaxation are Diaphragmatic Breathing, Progressive Muscle Relaxation, and various methods taught in yoga . If you induce relaxation in the presence of the stimuli that normally induces your fears (the dental environment), the fear response will be greatly diminished over multiple exposures and you will gradually desensitize yourself to these fears as you build confidence. The memories of traumatic visits will be replaced with more innocuous ones and this less threatening environment coupled with your relaxation methods will help you eliminate your dental phobia.

Repetition. The simple process of repeat appointments, will make you feel more comfortable. As you learn what to expect, and realize that you are in control of the appointment, you will be able to manage more time in the chair. Remember not to wait too long between appointments or to reschedule unless an emergency arises. Merely coming to the office and not having treatment that day is better than canceling.

-Distraction - As you get more comfortable in the dental environment, you can use distraction. The use of an ipod with your favorite music is a common technique. It is only suggested to utilize distraction techniques once you have established some trust and confidence, because your ability to communicate will be decreased, although it is easy to communicate by using your pre-established hand signals.

-Predictable Pain Control - Modern dentistry has many new techniques with regards to the administration of local anesthetics to help block pain. There are many people who have differences in their anatomy that do require more individualized techniques in order to predictably achieve proper local anesthesia. This variation must be respected and communicated to your dentist. The needle itself is generally the minor cause of discomfort, in fact, it is the pressure and volume of the fluids being injected that causes the major discomfort. Therefore, all injections should be given slowly. There are also great differences in the types of tissue in various locations, anatomically and from person to person, that must be considered when administering injections. There are even computer-controlled machines that are now available to standardize the injection process and make it more predictable than the conventional hand-held syringe.

Conclusion

Dental phobia and dental anxiety can be overcome! With proper guidance, trust, patience, dedication, and communication, dental phobia can be beaten. Do not allow your health to be held hostage by your fears. You can live a longer, happier, and healthier life, free of dental fear. Take that first step and find a dentist that understands dental fear, and make an appointment for a consult. Dental phobia and dental anxiety can be overcome!

 

Breast cancer is the second leading cause of death among women in the United States.  About 1 in 8 U.S. women will develop breast cancer over the course of her lifetime. InBreast Cancer Marielaina Perrone DDS 2011, an estimated 230,480 new cases of invasive breast cancer were expected to be diagnosed in women in the U.S., along with 57,650 new cases of non-invasive breast cancer, with almost 40,000 deaths in 2011 alone.  Many women’s lives could be saved if this cancer was diagnosed earlier, and early diagnosis could be achieved if there were more and easier opportunities to do so

Risk Factors of Breast Cancer

These include smoking, alcohol use, genetics, and others. Studies have also shown a link between breast cancer and dental health. You may be 11 times more likely to develop breast cancer if you have poor oral health or periodontal disease. Journal of Breast Cancer Research and Treatment conducted a survey of over 3,000 people and found that individuals with chronic periodontal disease had a higher occurrence of breast cancer.

 The researchers found that the protein levels in saliva have shown potential to assist in the diagnosis, treatment, and follow-up care of breast cancer. Dentists would be the perfect choice to take periodic saliva samples during regularly scheduled visits. This would aid the patient and physician greatly before, during, and after diagnosis and treatment.

 Salivary testing has some real advantages over blood testing. The studies say that saliva collection is safe, non-invasive, and can be collected without causing a patient any pain or discomfort.

This method of early diagnosis is not yet approved by the Food and Drug Administration (FDA).  If it does receive approval, dentists and physicians could use it to diagnose breast cancer as a team. It is good to remember that salivary testing would not be a final diagnosis. Patients would still need to undergo routine breast cancer exams (including mammography and blood screening).

Dental Health Factors

More than one-third of people being treated for breast cancer can develop complications that affect the mouth. These complications can affect your quality of life. Preexisting or untreated oral disease can even complicate cancer treatment. This is one reason to make sure you visit your dentist at least one month before beginning Breast Cancer Marielaina Perrone DDScancer treatment. Most chemotherapy agents suppress white blood cells, which protect against infection. Chemotherapy can also effect saliva production, leading to dry mouth, and serious dental implications. The oral tissues can become very inflamed, cavities can become rampant, and gums may bleed easily. All dental work should be completed and the teeth should be cleaned prior to cancer therapy. Oral infection can be hazardous when your immune system is suppressed.

Most patients are treated with chemotherapy, radiation,or both. If you are also taking bisphosphonates, such as Fosamax, Boniva, etc., you may be putting yourself at further risk for bone problems. Recent studies suggest long-term use of such bisphosphonates may develop into destruction of the jaw bone. The risk significantly increases with chemotherapy.

How to Minimize Side Effects

More than 1/3 of people being treated for breast cancer can develop complications that affect their oral health. Chemotherapy agents can cause a person’s mouth to become inflamed (also referred to as mucositis). This can be very painful for the patient affecting swallowing, taste, appetite, speech, and even sleep.

To maintain good oral hygiene during treatments, a woman can do the following:

-Brush with a soft toothbrush or sponge brush to clean your teeth and gums.

-Floss gently and regularly.

-Only use alcohol-free mouthwash, preferably one free of saccharin, but one containing xylitol.

-When white blood cells counts are reported by your physician to be low, avoid dental treatment.

-Avoid dental treatment for about a week after chemotherapy.

-Inflammation starts with red gums that may bleed. Even slight bleeding should not be ignored.

-Use toothpaste and chewing gum with xylitol.

-Regular dental visits to identify problems before they develop.Breast Cancer Marielaina Perrone DDS

-If you wear dentures, make sure you keep them clean and that they fit well. Make sure to take them out at night.

-Research shows that rinsing with chlorhexidine gluconate twice per day for 2 weeks, then twice per week through the remainder of cancer therapy will keep oral bacteria levels down. A prescription strength neutral sodium fluoride toothpaste and rinse should be used daily. Fluoride trays should be fabricated for you by your dentist and worn for a few minutes each night throughout therapy to help prevent cavities.

-If you develop mucositis, your dentist can prescribe an oral rinse to calm and soothe the irritated tissue.

Most patients are treated with chemotherapy or radiation. However, some patients may be treated with bisphosphonates, such as Fosamax, Boniva, and others. Recent studies suggest long-term use of such bisphosphonates may develop into destruction of the jaw bone. The risk is low but increases with chemotherapy.

Breast Cancer Conclusion

Breast cancer treatment is a difficult time for all that must go through it. Being aware of the side effects, will help you to avoid many of the potential problems. By practicing good oral hygiene, you can decrease bacteria levels in the mouth and consequently, some of  the side effects of breast cancer treatment. Visiting your dentist at least one month before beginning cancer treatment can help you fight potential threats to your oral health ahead of time. Breast cancer treatment should be a coordinated team effort which should include your physician, oncologist, and your dentist.

New studies are showing that poor oral health, tooth decay,  and tooth pain are putting some children at risk for falling behind in school. It is widely believed that many children, regardless of socioeconomic conditions, are not receiving routine dental care on a regular basis from a dentist or hygienist. It seems like good dental care takes a back seat at times in many families lives for various reasons.

The study recently conducted and published in the American Journal of Public Health examined close to 1,500 socioeconomically disadvantaged elementary and high school students in the Los Angeles area. They then matched their oral health to their academic achievement and attendance records. In previous studies, researchers found that about 75% of disadvantaged children in Los Angeles county area had some level of tooth decay.

In this study, children who reported having tooth pain were 4x more likely to have a low grade point average when compared to children without oral pain. The results also found that the tooth pain also resulted in a higher amount of absences, as well as more missed work for parents. This leads to lost classroom time as well as lost pay for parents and the family.

What can Parents Do to Avoid this?

Good oral hygiene must begin as soon as the child’s first teeth erupt into the mouth. Many of these tips take just a little time and patience to facilitate good oral hygiene. The following are some tips for parents to maintain their children’s teeth:

-Proper brushing. Many parents leave the tooth brushing up to their kids when they are as little as 2 years old. Parents and caregivers need to brush their child’s teeth, and then monitor that their children are brushing properly using a fluoride (as soon as they are old enough to spit and not swallow) toothpaste. Toothbrushing  can remove  up to 60% of the plaque, bacteria, and food debris from mouth.

-Flossing. Yes, Flossing. Children can floss and in fact when they get in the habit as a child they have that habit for life. There are children’s flossers which make it easier for them to perform themselves but again parents need to instruct, demonstrate, and monitor the job they are doing.

-Use a disclosing solution. A disclosing solution is a great tool to show what areas a child might be missing. It is effective in adults as well. It simply is a dye that colors the plaque remaining in your mouth. After you brush, you rinse with the disclosing solution to see what you have missed, then remove the remaining plaque and the color from your teeth. You are able to visually inspect how effective your hygiene techniques. It is a great learning tool, and it is highly effective.

-Rinse with an anti-cavity rinse. Children need fluoride more so than adults due to the developing teeth. A good example of this is ACT fluoride rinse. It comes in many flavors and is easy to use. There are also prescription fluoride rinses that are swallowed after rinsing to strengthen developing teeth. These rinses are only available through your dentist or pediatrician. DO NOT swallow over the counter fluoride rinses or toothpaste, it is harmful to both adults and children in this improper concentration.

-Avoiding or moderating sugars. Let’s face it children love their sweets from fruit roll ups to gummy bears to fruit juice. To avoid tooth decay we must modify that behavior and if they are to have these items have them brush and rinse soon after so the sugars do not have time to linger in their mouths.

Conclusion

Tooth Decay and Tooth Pain can be avoided or at the very least limited with proper dental hygiene and regular visits to the dentist. Remember it is far cheaper to see your dentist regularly for routine dental examinations and professional cleanings than to show up in pain.

 

A phobia is generally defined as an irrational severe fear that leads to avoidance of the feared situation, object or activity. Most people can live with some level of anxiety about going to the dentist. However, for those with dental phobia, the thought of going to the dentist is terrifying. They may be so afraid that they will do anything to avoid a dental appointment. Exposure to the feared stimulus provokes an immediate anxiety response, which may or may not take the form of a panic attack. The dental phobia causes a lot of stress, and not only affects your oral health but other parts of your life as well. People with a dental phobia will spend a large amount of time fretting about their teeth, dentists or dental situations. Some do the exact opposite and spend a lot of their time trying not to think of teeth, dentists or dental situations. People with a true dental phobia often put off routine care for years or even decades. To avoid it, they will deal with periodontal disease, pain, infections, or even unsightly and broken teeth.

The dental phobia may take an emotional toll as well. Damaged or discolored teeth can make people self conscious and insecure. When speaking, they may smile less or keep their mouths partly closed. Some people can become so embarrassed about how their teeth look that their personal and professional lives begin to suffer. There is often a serious loss of self-esteem. People with dental phobia also may suffer from poor general health, and possibly lowered life expectancy.  This is because poor oral health has been found to be related to some life-threatening conditions, such as heart disease and lung infections.

Dental phobia and anxiety are extremely common. Estimates show that 50% of Americans do not visit the dentist regularly. Of those people, an estimated 9-15% are avoiding dental care due to their dental phobia, anxiety of the unknown and phobias that grow with time. This translates into 30-40 million people per year who do not see the dentist because of dental phobias or fear.

Anxiety and Phobia are often interchanged, but they are very different. Phobias are generally much more serious than fears or anxieties. They are deeply rooted within a person. Unlike fears that are learned and can possibly be unlearned, phobias are not as easily dismissed with confronting the situation. It takes time and attention by both patient and doctor to move forward.

Some of the known causes of dental phobia include, previous negative experiences, an uncaring dentist, humiliation, history of abuse, or even the phobia could be learned from a parent or relative when young.

Dental phobia and anxiety come in varying degrees. At the extreme end, a person with dental phobia may never see a dentist. Others may force themselves to go, but they may not sleep the night before. It’s not unusual for people to feel sick (or actually get sick) while they are waiting to be seen.

The dental phobia can be treated. Without treatment, the dental phobia is likely to get progressively worse. That is partly because emotional stress can make dental visits more uncomfortable than the situation warrants.

People who are unusually tense tend to have a lower threshold of pain. This means they may feel pain at lower levels than other people. They may need extra anesthetic. They may even develop stress related problems in other parts of the body. For example, muscle stiffness and headaches are not unusual.

There isn’t a clear boundary that separates “normal” anxiety from dental phobia. Everyone has concerns and fears and deals with them in different ways. However, the prospect of dental work does not need to fill you with terror. If it does, then you may need some help overcoming the fears.

Some of the signs of dental phobia include:

1) You feel tense or have trouble sleeping the night before a dental visit

2) Increased nervousness while you are in the waiting room.

3) Overcome by bouts of crying when you think of going to the dentist. The sight of dental instruments (or even the white lab coats) increases your anxiety.

4) Feeling physically ill with the thought of a dental visit.

5) When objects are placed in your mouth during a dental appointment you panic or have trouble breathing.

Phobias are not easily treated like fears are, however the same techniques can be helpful. Your dentist can prescribe muscle relaxers that help their patients relax before and during an appointment. If the dental phobia is extremely severe, talk with your dentist about the problem. If you can, seek help from a psychiatrist that too may benefit you, allowing you, your dentist and doctor to work together to find the best course of overcoming the dental phobia. Overcoming dental phobia is best done with a team approach. meaning you, your loved ones and the dentist and his/her staff must all work together to move past this. Thankfully it can be overcome. Some of my best patients were former dental phobics with severe anxiety. They are now comfortable having dental work done and actually look forward to coming to their dental visits.