Nervous Patient Program

Numbing Gel

Not all dental phobics are able to cure their phobia. Therefore, it is often necessary to find a dentist who advertises themselves as a specialist in treating dental phobic patients. These sorts of dentists will offer lots of different solutions, products and treatments to ensure that phobic patients are able to enjoy the same level of treatment as other patients. For many patients, their dental phobia revolves around a fear of pain, injections and anesthetic. Often, if the patient cannot overcome their phobia themselves, dentists will recommend using a numbing gel to reduce the pain and to give the patient enhanced peace of mind as they mentally prepare themselves for treatment.

What is Numbing Gel?
‘Numbing Gel’ is the patient-friendly name for Topical Anaesthesia. If you are phobic about dental pain, about needles or about injection, you dentist can apply numbing gel to your gums before the injection. This helps to reduce the pain of the needle as it enters the tissue.

Is it effective?
A topical anaesthetic is a type of anaesthetic that is specially designed for external application, rather than working internally and therefore needing to be injected via a syringe. For complex dental work, you may still need a local anaesthetic via an injection. However, the numbing gel should help you to relax and feel more comfortable about facing a needle – as well as removing any pain.

Do most dentists use Numbing Gel?
Some do and some don’t. What most patients don’t always realise is that injecting local anaesthetic into a gum is a tricky skill – especially if the injection needs to go into an awkward spot. It is especially tricky if the patient is anxious, nervous or tense because they are suffering from dental phobia. If you are uptight, it is much harder for the dentist to relax too. Therefore, you will experience more pain depending on the skill of your dentist. For some patients, especially patients who suffer from a phobia and struggle to relax in the dental practice, the solution could be to try a different dentist. There are lots of dentists who do not use numbing gel because they can deliver virtually pain-free injections anyway. Regardless of the skills of their dentist, the fact is that some patients simply feel more confident if numbing gel is applied first. You can ask your dentist about this. Alternatively, you can try visiting a dentist that specialises in pain-free procedures which will include the use of products like numbing gels.

Can you be allergic to numbing gels?
The anesthetic agent in numbing gel is usually benzocaine, which is actually found in a wide range of products such as throat lozenges, sunburn remedies, burn remedies and creams for treatment of skin irritations, such as caused by poison ivy for example. Some people are allergic to benzocaine but it is rare that it results in a serious allergic reaction. Most reactions include inflammation, rashes or dermatitis. If you are concerned about being allergic to numbing gel, it is important to make sure that your dentist tests you prior to applying it properly. Normally, dentists will test for an allergic reaction by applying a small amount of petrolatum to the skin which contains 5% benzocaine. Numbing gel used for dental procedures contains 20% benzocaine.

Are some people immune to numbing gel?
Sometimes, people claim to be immune to numbing gel and even to anaesthetic. There are a number of reasons for this. But the fact is that very, very few people are actually ‘immune’. Firstly, and most importantly, numbing agents take a period of time to work effectively. So rather than being immune to its analgesic power, you most likely just need to be more patient and give it the time work its magic. If you are in a busy practice where there is a lot of pressure to see patients, it could be that your dentist does not allow enough time for the gel to work. This is why it is so important for dental phobic patients to talk to their dentist and explain their condition – after all, while you suffer in silence, your dentist may see you as an ordinary patient happy to undergo a relatively simple procedure. One of the other reasons for people believing that numbing gel does not work is because their phobia makes them imagine the worst case scenario. With a phobia, your fears are exaggerated and irrational. There is no reason why the numbing gel should not work. But in your mind, you are already convincing yourself that it hasn’t. The more you think about it, the less numb you feel. As you become more anxious, more stressed and more worried, your awareness of your vulnerability heightens. The numbing gel may have worked fine. But your phobia has stopped you from believing in it.

Can numbing gel be used for children?
Many children develop dentophobia because they find the dentist intimidating, the environment unfriendly and the treatment painful. Numbing gel is safe to use in pediatric dentistry and can be an effective way of allowing the dentist to complete the appropriate procedure. Because the gel needs time to work, it can also help to slow down treatment, giving the patient time to relax and the dentist time to apply broader behavioural management techniques. Numbing gel is also good to use on younger patients because it comes into a variety of types and flavours. For example, as well as a gel it can be applied as a spray. And if a child doesn’t like the taste of the anaesthetic, flavours like cherry and banana make it a lot more palatable. A choice of flavours can also help to distract a younger patient from thinking about the actual treatment.

The Wand

For many people, suffering from ‘dentophobia’ really means suffering from a fear of something more specific. It could be fear of pain, fear of the drill or fear of choking, for example. They all usually have similar sorts of symptoms and they all usually result in people not visiting their dentist. But when it comes to treating them, it is helpful to know exactly what the root cause of your fear is. There are many treatment options for people who suffer from dentophobia. However, not everyone wants to confront their fear. For a lot of phobia sufferers, the best form of treatment for their phobia is to find a dentist that understands how they feel and tailors their practice accordingly.To help these kinds of phobia sufferers, many dentists are embracing new types of products that are specially designed to make visiting the dentist a less painful, less stressful and less terrifying experience.

Terrified of injections?
One of the most common forms of dental phobia is a fear of needles or injections. This type of phobia can make dental treatment very difficult for obvious reasons. Many types of treatment rely on anaesthetic injections to numb the patient. If the patient is not comfortable receiving injections, it means that the required treatment can often not be completed. Alternatively, even if the patient is able to confront their fear, their anxiety and stress levels can also mean that the anaesthetic is not effective.To help treat these kinds of patients, there are now a number of products that dentists can use which remove the fear and pain from injections, or which remove the need for an injection altogether. One of these products is The Wand.

What is The Wand?
The traditional dental syringe has never changed much in its design – and dentists have been using syringes since 1853! So you could say it is about time something new arrived on the scene. What many patients who suffer from a needle or injection phobia don’t realise is that the pain does not usually come from the needle. Certainly, a slightly blunt needle can cause discomfort, but it is rare to find a blunt needle in a modern surgery. Most syringes now are disposables that are used only once. In reality, the pain caused by injections is created by the anaesthetic being delivered too quickly or with too much force. Primarily, this is simply due to the dentist being a little clumsy or heavy-handed – it happens from time to time. But imagine if there was a system available that delivered the anaesthetic at the perfect speed, every time! Painful injections would be a thing of the past! This is exactly what The Wand does. The flow of anaesthetic is computer-controlled by the CompuDent hardware, while The Wand is the handpiece that holds the needle. Operating together, they remove the possibility of the injection being delivered accidentally fast.

So there is still a needle and injection?
Yes. Once again, the difficult issue with dentophobia is that there are so many variations and so many differences between sufferers. So a product that may be a revelation for one patient could still be terrifying for the next. The aim of The Wand is to remove the pain from injections. So it is primarily a product to help people who suffer from a phobia of dental pain. If you have a phobia of injections, it could be that your phobia is still pain-related and The Wand will still make a difference.

Many people have a specific phobia of needles. The Wand still incorporates a needle, so it is not necessarily the perfect solution for these sufferers. However, many people who suffer from a needle phobia do find The Wand helpful. The reason for this is its innovative, advanced, patient-friendly design. The Wand looks more like a pen than a syringe. Compared to conventional syringes, the needle at its tip is very small and discrete. For patients who experience anxiety simply at the sight of the needle and the thought of what is about to happen, The Wand can help to ease their fears and help them to relax.

Does it work as well as conventional syringes?
With the aid of cutting-edge technology, The Wand delivers exactly the anaesthetic you need, at exactly the right rate- so you’ve nothing to fear about how well it works. In addition, the ergonomic design means that it is a pleasure for dentists to work with. Regardless of what type of injection is required and in which area of the patient’s mouth, the dentist is able to reach comfortably and apply the anaesthetic accurately. This ease of use is another factor in ensuring that dentists offer the optimum patient experience. After all, if a phobic patient sees a dentist struggling to perform a procedure, their stress and anxiety levels will naturally rise. Using The Wand can help to prevent this.

Why don’t all dentists use it?
Like most exciting new pieces of technology, The Wand can take time and training until your can use it properly. Many dentists simply don’t have this time or, if they have been performing treatments using conventional syringes for a long time, they may not want to learn a new technique. Another factor that stops dentist converting to The Wand is cost. Firstly, there is an upfront cost for the CompuDent hardware and The Wand hand piece. Secondly, the disposable elements of the process are more expensive and more numerous than if you are using traditional syringes.

For these reasons, many dentists prefer to continue using conventional syringes and for the majority of their patients, this poses no problem. For dental phobic patients, however, finding a dentist that uses The Wand can help them to manage their phobia and continue with their dental treatment. Often, you will find that dentists who have adopted The Wand as their preferred injection technique will usually be dentists who specialise in treating anxious, nervous or phobic patients. The point about these practices is that The Wand will only be part of their solution; they may be able to offer other ideas, products and treatment methods that can further help you manage your phobia.

Sedation Dentistry

What is Sedation dentistry?
Sedation dentistry is a simple procedure that dentists as well as other medical professionals can use on their patients during any surgery which is potentially painful or lengthy. It uses medication to put the patient in a very relaxed, dreamlike state whilst having surgery carried out. Therefore, sedation dentistry means that the patient does not feel the stress and anxiety that they may usually feel prior to visiting the dentist and the dental procedure taking place.

For the dentist, sedation means that surgery is easier to perform, and that more surgery can be performed in one session, reducing the number of sessions needed to carry out a course of treatment. Sedation Dentistry is an ideal solution for those of us who suffer from dental phobia. It is used by dentists to perform dental surgery on patients in a stress and worry free way, and helps many patients overcome their fear of visiting the dentist.

It really is important to be aware of sedation dentistry if you suffer from dental phobia, because neglecting your teeth and not visiting the dentist can have harmful lasting effects to your oral health, and can often result in severe last minute surgery which can be expensive and not to mention painful.

Sedation dentistry has many great benefits for sufferers of dental phobia:
It allows the patient to visit their dentist without any pre-visit nerves and allows the dentist to complete the course of treatment in fewer visits than they would normally be able to do so. Many kinds of dental treatments can use sedation dentistry, allowing patients with different types of dental phobia to relax and not have to suffer the usual apprehension which they experience when visiting the dentist. There are many different types of sedative medications that are used to affect the patient’s central nervous system and relax the patient and put them at ease.

It is particularly useful for those who suffer from dental phobia and who are undergoing dental surgery for whatever purpose, however, many more people can make great benefit from sedation dentistry too. Those who have extremely sensitive teeth and find co-operating with the dentist and receiving dental treatment very painful can make full use of sedation dentistry, as it will take the pain away from their treatment allowing them to receive the health care they deserve without the stress and anxiety that may usually accompany it.

Patients that have conditions which make controlling their body movements difficult such as Parkinson’s disease and who have gag reflexes that make controlling their mouth stressful will also benefit from sedation dentistry and the physical and mental relaxation that it gives to the patient.

One of the best things about sedation dentistry is that it has numerous benefits, not just for the patient, but for the dentist too. The patient can experience a freedom from their past fear and apprehension of the dentist, allowing them to receive treatment with peace of mind, as well as receiving treatment that they have not been able to have for many years because of their dental phobia. Patients that do not normally suffer from dental phobia can still take benefit from sedation during some treatments, particularly treatments that are very painful such as surgery on the gums.

For the dentist sedation dentistry gives them complete control during treatment as patients are more likely to co-operate fully with their dentist, and it also reduces the amount of time and number of sessions that dentists require to carry out their treatments on patients, because more treatment can be administered in a single session.

Sedation dentistry comes in many forms, including oral sedation, inhalation sedation, and intravenous sedation. It is important for you to remember that sedation does not simply mean put to sleep, this is only part of it. Sedation techniques will make you feel drowsy, but are different from general anaesthesia, which puts you into a deep state of sleep, and has side effects which may last for hours after the surgery. Sedation dentistry allows dentists to complete a course of treatment much more quickly than they normally would be able to. Therefore patients who have conditions that require many trips to the dentist receive great benefit from sedation dentistry as it cuts the amount of time and effort they spend in receiving their treatment.

Whilst sedation dentistry is a fantastic solution for many sufferers, not everybody is suited to it. Those who are already taking some sort of medication must alert their dentist before accepting oral sedatives, as well as those who have a history of allergic reactions to medication. Some patients may find that it is not the actual dental treatment that they are scared of, but the dentist themselves, and using sedation is unlikely to help alleviate this fear.

Choosing the right sedation dentist for you is a very important task, especially as dentist training does not cover sedation dentistry in great detail. Ask your dentist about his experience in sedation dentistry, and how many times they have performed the procedure that you require. Do not be afraid to ask hard, detailed questions to your dentist, ask exactly how you will be sedated and how you will be monitored whilst you are sedated. Also, remember to ask your dentist how you should prepare for your treatment, and instructions on what to do after your treatment.

Distraction techniques

Dental phobia comes in many variations. Some are very extreme responses to specific aspects of dentistry. Others involve a more non-specific, harder-to-define fear that revolves around the entire dental experience. These sorts of sufferers often cannot associate their fear to a particular stimulus. In some ways, therefore, even though the symptoms may seem less extreme and easier to live with, these phobias become very debilitating over time. These are exactly the sorts of sufferers who, unable to identify their fear and find a solution, choose simply to try and avoid the dentist altogether.

Avoiding dental treatment can obviously lead to more serious dental complications in the future. So how can dentists help these patients? While someone with a phobia of dentists may pluck up the courage to make an appointment or even get into the dentist chair, anything in the dental environment can trigger their phobia. Their anxiety is often induced and heightened because they don’t know what is going to happen next, rather than because they do.

How do you tackle a fear of the unknown?
Many phobia sufferers manage their condition by avoiding the stimuli that trigger it. If you are afraid of needles, therefore, you may be able to avoid them. If you are afraid of the unknown, it is much more difficult to manage your condition so that it does not impinge on your everyday quality of life. Difficult, yes, but impossible? No. Let’s say you have a non-specific fear of the dentist. It is not a phobia about anything you can put your finger on, but it is stopping you from getting the treatment you need. How do you go about overcoming it? How do you face a fear when you don’t know what it looks like?

Nowadays, many dentists are trained to offer help, support and advice to patients who suffer from dentophobia. One of the key techniques that dental professionals have become more skilled in over recent years are distraction techniques. These techniques are designed to help dentists find ways to relax patients, to keep their mind off their phobia and to help manage their anxiety.

What are distraction techniques?
The term ‘distraction techniques’ often makes people distrust the idea from the outset. For some patients, it gives them the impression that their dentist will somehow fool them into accepting treatment. Obviously, if you are phobic, suffering from anxiety, paranoia and panic attacks, the idea that you dentist is trying to distract you will not be welcome.

But ignoring the poor terminology for a moment, distraction techniques are actually a proven and helpful tool for dentists. Many dentists use them successfully to make treatment easier for nervous patients – not just those with phobias, but also patients such as children who are visiting the dentist for the first time.

Distraction techniques range from the obvious to the more subtle. But in each case, it is your dentists way of trying to make you feel more relaxed and more at ease in their company. Maybe they will offer you the opportunity to listen to music through headphones – that can shut out the sounds that some phobics dread hearing. Alternatively, if your dentist spots you are nervous, they may simply choose to stop for conversation or offer you a cup of tea before the treatment begins. Some dentists who treat children have even been known to engage in an impromptu sing-along when their young patients start to feel the tension.

Really, distraction techniques don’t have to ‘distract’ you at all. That’s where the phrase is misleading. They are used to relax patients instead. To some degree, all dentists employ them – although you may find that some practices go to greater lengths than others by offering massages or other relaxation techniques.

Is that all there is to it?
On one level, yes, that’s all that distraction techniques involves. On another level, however, there is a separate point to be made to phobic patients in particular. What is most important is that all this talk of ‘distraction techniques’ doesn’t distract you from the key issue: if you have a fear of the unknown, the best thing you can do is get to know it better. Distraction techniques are your dentist’s way of helping you relax in the practice. At the same time, they are also your dentist’s way of getting to know you as a patient. The better a dentist knows you, the more effectively they are able to treat you. This is true for most people, but even more so for phobic patients. If your dentist understands how frightened you are, they will be more understanding and responsive to your requirements.

How should phobic patients approach their dentist?
One of the biggest problems for patients who suffer from dental phobia is that treatment can happen abruptly and unexpectedly. You rarely get time to prepare yourself mentally and if you do take time to think about it before an appointment, it can spark your fears and create extra anxiety.

One way around this problem is to approach your dentist when treatment is not a priority. See if they will agree to see you for a consultation. You can discuss your phobia, explain how you feel and ask your dentist what their approach is to treating nervous patients. As we mentioned, the majority of dentists are now able to adapt their treatment and will happily discuss a solution with you.

This takes away much of the fear you may have of visiting your dentist while treatment is imminent. It also gives you a chance to get to know your dentist better – to see them without the bright light shining in your face. Trust us, it makes a big difference.

You can also think about whether you can apply relaxation techniques to yourself. After all, why wait until you are in the dental chair before you start trying to combat your fears. You could try learning breathing exercises or relaxation techniques such as yoga or Pilates – they can be ideal preparation for a visit to the dentist.

What most patients forget when they visit their dentist is that the dental experience can be shaped to suit them. Most patients are happy to be treated in the same way. But if you suffer from a phobia, your best step forward is to consult with your dentist to discover how you can create a dental environment, experience and approach that you feel in control of. This way, the unknown may just become something you feel much more comfortable with.