Fear of embarrassment: Case study Jayne Ann
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 who was so embarrassed about the state of her teeth that she couldn’t face visiting a dentist.
Often, poor dental hygiene is a result of people moving away from their local dentist and struggling to find a new dentist that suits them. If the patient also suffers from a dental phobia, this struggle to find a new dentist can be particularly difficult.
Jayne Ann, a woman in her late fifties, had only moved to the UK recently. As her career had involved working in a number of different countries, she had found it difficult to get consistently good dental work and she had also found it difficult to stick to an appropriate schedule for her dental visits.
The result was that Jayne Ann not only required a significant amount of dental work, but she was also suffering from acute embarrassment. She couldn’t bring herself to visit her dentist because her teeth and oral hygiene had degraded to such an extent that she felt nervous about what a new dentist might think.
The fact that she didn’t already have a dentist was a significant factor. She was worried about choosing a dentist who wasn’t sensitive to her condition and who would therefore exacerbat her phobia. She needed a dentist that she felt comfortable with and with whom she could have a long-term relationship – however, because of her lifestyle, she had never had the opportunity to use the same dentist time and time again.
This lack of an appropriate level of dental care meant that Jayne Ann’s teeth required substantial dental work. Neglect had led to some tooth decay, which in one tooth had created a cavity which bacteria had entered. Here, an abscess had begun to form which, left untreated, would eventually lead to severe toothache. In the near future, this would require root canal treatment to remove damaged pulp and to prevent further infection reaching the tooth.
The fact that Jayne Ann had not visited a dentist regularly also meant that she had poor dental hygiene. This added to her phobia about visiting the dentist, yet the longer she went without seeing an Oral Hygienist, the worse the problem became.
The urgent requirement for dental work meant that her dental phobia was becoming an increasing problem. Left any longer, and she may begin to suffer serious tooth pain. Yet the more urgent her requirement became, the more fear she felt about visiting the dentist.
Of course, it wasn’t simply the threat of toothache that was becoming more urgent. The longer she postponed visiting the dentist, the more visible her lack of oral care became. This made her more self-conscious and more aware of what her dentist might say. So as in many cases of dental phobia, it was not a condition that could simply be ignored. The more Jayne Ann avoided visiting a dentist, the more she needed to go.
Jayne Ann’s phobia manifested itself in chronic nausea, brought on by the thought of how she imagined her teeth had decayed. This phobia began early in the process so it was usually the case that she could not even register with or visit a dentist. Whereas some people experience their first sense of phobia actually in the practice, Jayne Ann was conscious of nausea every time she thought of having any dental work done.
As is often the case with phobias, the feeling of nausea only added to the sense that she could not approach a dentist. This nausea, allied to her awareness of and embarrassment about her poor oral hygiene, meant that she was now even more unlikely to make a dental appointment.
The final aspect to Jayne Ann’s phobia was that it involved more than simply tackling a fear. Her lifestyle and career choice meant that she regularly moved countries. This meant that she may never have an opportunity to build the kind of strong patient-practice relationship that is needed to reassure patients, overcome phobias and ensure effective treatment. Therefore, accompanying the nausea was often the sense that trying to overcome the phobia would not be worth it in the long run. She’d only have to go through the same process again, somewhere else in the future.
The barriers to Jayne Ann getting the treatment she needed were threefold. Firstly, she was not registered with a dentist she had visited in the past and was therefore uncomfortable starting treatment with a dentist she did not know.
Secondly, she felt that treatment could be cut short if she left the country. Therefore, there was the sense that beginning any treatment would be pointless.
Thirdly, there were the physical symptoms of the phobia to contend with. Prior to visiting her dentist, she was gripped by a sense of fear, nervousness and nausea as she did not know what to expect.
The solution was to find a multi-national dental brand that specialised in treating people who suffer from dental phobia. By finding a brand that operated in different countries, she could ensure that she would always enjoy a consistent approach and consistent quality of dental work, regardless of where she was based. In a sense, this consistency of approach also meant that she knew what to expect.
The dental brand that Jayne Ann chose had specifically tailored their approach to people who suffered from dental phobias. For example, the first step in any course of treatment was a preliminary visit to the dentist. On this visit, the patient is guaranteed not to be kept in a waiting room and not to undergo any treatment. It is purely consultative and very reassuring. This preliminary consultation helped Jayne Ann to feel comfortable with the dentist and also subdued her nausea – she knew in advance of this visit that no dental work would happen.
By choosing the right sort of dentist, this patient was able to manage her expectations more effectively and therefore manage her fear. By managing her fear and enabling treatment, she was able to improve the quality of her oral hygiene and increase her own confidence further.
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