Information sheet: Stress at the Dentist
Stress at the Dentist
Very few of us will claim to enjoy a visit to the dentist
Yet a logical view doesn't reveal any great threat. The dental surgery may be comfortable, the reception and nursing staff cheerful, the dentist friendly and competent, and after some mercifully anaesthetised treatment we leave minus the problem we came in with, or at least with a solution in sight. Yet for many the prospect is tinged with foreboding, and for some it is shot through with catastrophic terror.
And of course, if those ideal conditions don't apply – if the premises are indeed unwelcoming, the staff indifferent and the dental surgeon negligent or callous – then fears will be compounded.
Getting there is the first hurdle
Basically, we are going somewhere we do not want to go. The trip to the surgery may resonate with previous unwilling journeys in our early years, when we were not allowed to make our own decisions nor voice a protest against decisions made for us. Perhaps we were forced to venture out of the security of home to fend for ourselves in the scary world of nursery or school; lured into painful and humiliating episodes with bullies; summoned to interviews with head teachers that ended in punishment, to job interviews that ended in rejection or the drudgery of unwanted employment; commanded to be present with various "authorities" in family and society who passed judgement upon us, constricted us and obligated us to walk along paths not of our choosing. The emotional charge from such ordeals may unconsciously reinforce our anxiety as we are summoned to yet another appointment with fear.
"Where's my toothache gone?"
During that dreaded journey there often occurs a mysterious cessa-tion of pain. Is this journey really necessary? The puzzle of disappearing pain is less enigmatic when we understand how the endorphins – natural biochemical painkillers that are automatically released by the brain – kick in when prolonged pain is not resolved. In addition to dental nerve pain, emotional pain may also be present due to the abovementioned associations with fearful appointments in the past. A whole complex of emotion-induced physical pains may therefore be anaesthetised by the natural morphias, and as a by-product of this – hey presto! – the toothache has vanished.
It follows that if we don't keep the appointment we feel relieved and relaxed. Then the body lets go of the painful tension of bad expectations and the endorphins are no longer called upon to deaden it. They stop circulating … and the toothache returns.
Entering the surgery marks the point of no return
It is still possible to say "No!" and leg it – but not if our upbringings have made us afraid to protest, make a fuss, draw attention to our-selves or reveal our "weaknesses" (natural reactions). It is also with-in the realm of possibility to express our fears and ask the nurse or dentist for reassurance; but for those same reasons we tend to hold back.
We may feel ashamed of our teeth: perhaps a long-term addiction to sweets and sugary foods, consumed in an attempt to swallow down and dissolve emotional stress, has brought us here.
But we "must" be brave. At this crucial moment some of us achieve a zombie-like state of dissociation. In our vulnerable early years, trance may have been the only escape from painful situations: we held our breath and split off from our bodies, taking refuge in some out-of-body safety zone.
Now, almost supine, we are asked to "Open wide" as we feel probing gloved fingers and explorative scrapings. The dreaded needle is presented: there is a sharp jab, an interminable-seeming infusion of anaesthetic, then the needle is ever-so-slowly withdrawn and we wait as the deadly numbness spreads, paralysing lips, tongue, cheeks and jaw. This may give rise to anxiety. How far will the numbness spread? Will it reach my brain? Could I have been given an overdose? An emotional charge from old experiences of being constricted and becoming dissociated may come to the surface.
Now the work begins in earnest
Teeth are to be drilled-out in preparation for fillings, or they are to be extracted. We feel helpless and besieged. A suction tube is inser-ted as the dentist gets to work with a whizzing, whining drill, or pliers. The fact that there is no pain (apart from the ache of constant-ly forcing open the jaw) does not reduce the terror. We are invaded and violated by persons virtually unseen while our mouth is clutter-ed with instruments so that we are unable to protest. We can hardly swallow or breathe. We've been told to raise an arm if we feel pain but not what to do if we feel panic. We may feel submerged in an abyss of unutterable horror which, we believe, the dentist and nurse cannot possibly understand. We may be unconsciously plunged back into past emergencies when the big people we looked to for protection didn't recognise our predicament. We hold on, forgetting to breathe out.
Present fear connects us to past pain
During infancy, we may have often been examined and probed by doctors and specialists. In childhood we were obliged to respect the hallowed medical profession whose "authority" was not to be ques-tioned. We learned to shut up, stay put and put up. This outward compliance will have involved inhibition of breathing, especially of exhalation, tensing of muscles and locking of joints. From the beginning, a pattern of stressed response to medical procedures will have been established.
Counselling and therapy can help to release the stress of bad dental experiences
In counselling, a sensitive listener enables us to get off our chest those fears that the dentist did not address. We can be guided at our own pace to connect those fears to past experiences of helplessness. Therapy enables us to release patterns of stress from our systems and the resulting flow of energy can make us more equal to what are – unfortunately – sometimes necessary visits.