Spotting the phobic patients – and caring for them at our Glasgow dental clinic.

Caring for phobic patients is something that we take seriously here at our Glasgow dental clinic.

Our dental hygiene team of Jen and Viv recently penned an article about the signs to spot in a phobic patient and how that patient is cared for from our team’s perspective.

It will give you an insight into the whole topic of dental phobia – and more importantly the things that can be done to help someone who is afraid of coming to the clinic.

Here are their words…

Now we’re all used to hearing the words “I hate coming to see the dentist”, ” I hate this, my last hygienist was worse than the dentist” or even ” I’d rather have a baby”!

While the latter may be a little extreme it does, at least, give a small indication that this particular patient is not overjoyed at the prospect of time in the dental surgery.

Our hygienist team - Jen and Viv

Our hygienist team – Jen and Viv

So what about this one – “I’ve got phobia of the dentist”.

Paramedics are taught that in emergency situations it will usually be the quiet ones who need most help and attention – different situation but same theory should be applied.

While more vocal patients give us the chance to quickly tailor our approach so that during their time with us we can accommodate for and hopefully allay their fears, it is the silent type that can be far more difficult to spot and it is often these patients who are truly phobic.

So how do we know if the patient doesn’t say? We’re not mind readers after all. Well, give yourself some credit here – you’re probably far better at reading a person in a short space of time than even you realise.

From the first call of their name in the waiting room when they look at you like a deer caught in headlights – but only for a split second – before regaining their composure, through to all the little things when actually in the chair such as pallor, sweating, tightly clasped hands, finger wringing, skin pulling (usually of the hands) and breath holding.

I once saw a patient who held her breath for as long as she possibly could during treatment and continued to do so even after a long, gentle discussion on how this was not the most sensible course of action as breathing really is quite important! The event that changed her behaviour was when she almost fainted through lack of O2. She now carries on – and breathes – normally!

As these are only a small example of some of the many, many signs that all is not quite right with someone we all must remember to pay a huge amount of attention to all aspects of our patients behaviour, then something out of the ordinary will be easy to spot.

So, how do we treat these patients effectively?

Well, if they fall into the first camp then they can be relatively easy to treat; the most important thing can be to calm them down and make them feel at ease, so a good conversation about something other than dentistry is a good distraction. We try to keep our own voice steady, calm and even and patients will subconsciously follow suit.

We empathise and try to find out what it is exactly that they really don’t like and cater for this…

Is it the ultrasonic scaler? Hand scale. Drilling noises? We provide headphones or suggest to the patient to bring in their own music. It may take a little more effort and imagination sometimes but is it not worth it for happy, relaxed patients who want to tell the world what an amazing dental practice they go to?

One of the things consistently mentioned as a dreaded part of any trip to the dentist is ‘THE NEEDLE!’ even people with tattoos complain about it! We must explain to the patient that although they have the impression that this nasty, sharp needle is the sore bit, this really isn’t the case – the worst part is more likely to be pain felt when the anaestheitc liquid is inserted into the soft tissues.

One piece of equipment trying to combat this is the wonderfully named The Wand from DPS (Dental Practice Systems). This is a pen-like syringe, synced to a specific computer programme, which automatically delivers the anaesthetic at a slow, constant rate therefore reducing any pain felt.

Admittedly this sounds like a pretty cool gadget to impress your patients with (and we all know that we love our gadgets…) and it probably works very well, but is it neccesary?

SEDATION

How about just using lots of topical gel and actually leaving it on long enough to be effective (10-30 seconds) gently heating the anaesthetic cartridges, which has been shown to reduce the patients awareness of delivery and most importantly…..OUR DENTISTS WILL TAKE THEIR TIME!

So how about the genuinely phobic patients? In our view and experience most can be treated successfully using many of the same techniques used with nervous patients but may require more time spent at each visit or spreading out appointments, whatever is going to work better for the patient. We believe it is important to know your limitations though. Certain patients may only manage to get through treatment with the help of sedation, whether oral or I.V no matter what you try first, whereas some may even have to call on outside help such as hypnosis or acupuncture.

So we don’t rule out anything that may help our patients and we certainly don’t underestimate the power of fear!

If you have any questions arising from this post then please contact our team on 0141 339 7579.