Fear of the drill

Nobody likes going to the dentist. But for some people, the problems run deeper and form a phobia. The causes of dental phobia can be many and varied. This case study is of a patient whose dental phobia stemmed from fear of a specific (and essential) piece of dental equipment: the drill.

The Patient

Not all phobias related to complex dental work or difficult types of procedure. Caitlin developed a phobia of the dentist’s drill, most likely owing to having a toothache and a tooth repaired during childhood. It meant that she was terrified of having further drill work done, even to repair the slightest cavity.

Fear of the drill is one of the phobias that most dentists will recognise and are familiar with. So that is the first reason to feel reassured. If your dentist is more likely to understand what you are going through, they are more likely to know the best way to treat you and your phobia.

For dentists and patients, it is also important to remember that fear of the drill can mean a number of different things. For some patients, it can simply be the word ‘drill’ that causes the anxiety. After all, when you consider that drills are also used in DIY, it is a pity that they don’t have a more reassuring name for the dentist drill.

Other patients feel fear when they hear the high-pitched noise of the drill. This is especially common if their phobia is connected to a bad memory, in which case the noise acts as the trigger.

The Scenario

Caitlin had needed a cavity filling as a child and still had a memory of the pain suffered. She had looked after her teeth well ever since, hoping to avoid more drilling work, following dental instructions in terms of brushing twice daily, using a fluoride mouthwash and flossing .The result was that her teeth were in very good condition.

However, a standard check-up revealed a very small cavity, which the dentist offered to fill during the same appointment. Clearly, it was a very minor procedure. But Caitlin’s phobia of the drill and the fact that she was so unprepared meant that, as soon as she heard the high-pitched noise of the drill, she refused to undergo the procedure and did not make another appointment.

It was the shock of the need for dental work that Caitlin really found difficult to handle. She thought that by looking after her teeth so well, for so long, she would successfully avoid further painful dental work. Unfortunately life is not always that simple and, sometimes, we just have to be prepared for the occasional cavity.

The Symptoms

For Caitlin, the physical characteristics of her phobia were nervousness, anxiety and a complete denial that she needed the procedure. For so long, she had convinced herself that if she looked after her teeth that a trip to the dentist could be avoided. So when the bad news came, she found it very difficult to accept.

In many ways, Caitlin was lucky. Her phobia meant that she was also very conscientious about looking after her teeth. So even though she required some further treatment, it could have been much, much worse. She had been able to carry on with regular check-ups and visits to the dental hygienist, so her teeth were in good condition.

The problem now was finding a way to get back to the dentist and to finish her treatment. She was at a point now where her refusal to go back to the dentist meant that she would not only miss out on her filling. She would put at risk all her other teeth, which she had spent so long caring for.

The Solution

As with other forms of dental phobia, communication and preparation are just as important in relaxing a patient as anything that the dentist does during the treatment. What triggered Caitlin’s adverse reaction was the dentist offering the drill the tooth immediately. This meant that, psychologically, Caitlin had no time to digest the idea or come to terms with it. Her instinct was always going to be to say no.

Clearly, what Caitlin needed was to postpone the treatment and to spend more time with the dentist, talking through the procedure so that the dentist can understand what she is afraid of. Now, modern dentists are far better at discussing treatments in a friendly and accessible way.  After all, it is better for the dentist to spend more time with a patient and to get to know them – than to risk losing them as a customer altogether.

After consultation, comfort in the dental chair is the most important factor. Many patients use mp3 players or iPods to drown out the sound of the dental drill. Dentists themselves also deploy a range of simple distraction techniques, such as asking different questions at different times, to take the patient’s mind of the procedure. Every little helps. Nowadays, some dentists will even have a television or DVD playing!

All of this is all well and good, but when you are dealing with someone who has a deep phobia of the dental drill, it might not be enough. For someone like Caitlin, who hasn’t experienced the dental drill for several years, it can come as a surprise to see how much the technology has changed. During the consultation, it is often enough just to talk them through the new types of drills, explain how they are less painful and let the patient listen to see how much the noise has been reduced.

Finally, if all else fails, your dentist may recommend some other techniques, such as air abrasion or laser dentistry. However, a word of warning, while these may be applicable in some cases, they certainly will not replace the dental drill every time. So in the long term, tackling the phobia is by far the best option