dental care

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Drilling Into Our Fear Of The Dentist — And What To Do About It

(AP Photo/Michael Probst)

For the estimated ten percent of Americans with dental phobia, research suggests therapy and other options may help. (Michael Probst/AP)

When I arrived at the dentist’s office for my implant procedure, I was already sweating and on the verge of tears.

After several shots of Novocaine, I felt no pain whatsoever. But that didn’t matter. I squirmed as I sensed incisions in my gums and heard drill collide with bone. I panicked about how intrinsically wrong it felt for someone to put titanium in my body. I worried: Would I be able to eat? To talk? Would I get an infection?

After an hour and a half, I returned to the receptionist swollen and tear-streaked. The periodontist joked, “She was shaking like a leaf, it was like a moving target!”

Not long afterward, I checked out my score on the Dental Anxiety Scale. My whole body tensed up when I read the first question: “If you went to your dentist for TREATMENT TOMORROW, how would you feel?” I scored a 21, which qualifies me as a “highly dentally anxious patient, possible dentally phobic.”

I have a lot of company. In fact, the Diagnostic and Statistical Manual of Mental Disorders estimates that almost 4 percent of people are “dental phobics.” According to the DSM, the prevalence rates for dental fears are similar to the rates of people who fear snakes or heights.

But we’re not quaking alone in the chair. Of late, researchers have been seeking to understand dental fear better, from its prevalence to the disparate elements that add up to phobia. For example, one recent brain scan study found that the buzz of the dental drill is a particular source of distress. And they’ve been exploring and testing potential remedies, from therapy to sedation.

Dr. Matthew Messina, a Cleveland dentist and consumer adviser for the American Dental Association, estimates that the rate of dental phobics is even higher than 4 percent. Around 10 percent of the adult population in the United States, Dr. Messina says, have a dental phobia so paralyzing it prevents regular dentist visits.

Dr. Lisa Heaton, a licensed clinical psychologist who treats patients at the University of Washington’s Dental Fears Research Clinic, says that up to 75 percent of adults have at least some anxiety about going to the dentist. Continue reading

Festering Cavities, Missing Teeth: Desperately Needed Dentistry For Disabled

(U.S. Department of Defense Current Photos/flickr)

(U.S. Department of Defense Current Photos/flickr)

Most people consider going to the dentist a minor inconvenience.

But for patients with an intellectual or physical disability, it can be a major ordeal.

Recently, there have been several reports on the significant obstacles people with all kinds of disabilities face in accessing the medical care they need.

People in wheelchairs, for instance, struggle with significant barriers trying to get appointments with medical specialists, according to a recent study by Dr. Tara Lagu, an internist at Baystate Medical Center in Springfield, Mass. And if you’re poor or mentally ill, dental care is even tougher to access, notes a 2011 report from the Institute of Medicine. Here, a dentist and Tufts University associate professor who treats people with disabilities offers his perspective on overcoming the towering barriers to oral health for the disabled.

By John Morgan, DDS
Guest Contributor

Dental care for people with disabilities can be particularly complex. It can also be life-changing.

Consider this:

An acquaintance of mine has a teenage daughter with a mild-to-moderate intellectual disability who attends a middle school in Boston. Because of badly aligned teeth and an open bite, she couldn’t close her mouth completely or use her tongue to speak effectively. On the recommendation of her daughter’s speech therapist and the encouragement of hygienists working with special needs children, the girl’s mother found a dental office that could manage her daughter’s dental care.

For three years, the daughter and her mom made three-hour trips by public transportation for monthly (sometimes more often) visits the dentist. But it was worth it. When the orthodontic treatment was completed, the girl’s speech was so improved that she was able to gain employment at a local fast food restaurant. She had gone from shy, awkward girl who hardly spoke to a girl who smiles and talks and enjoys being social.

On WBUR recently, Rachel Zimmerman’s piece, “Caring For Kevin: An Autistic Man, An Exceptional Doctor, A Life Renewed” – sheds needed light on the unique challenges of medical care for people with disabilities and their caregivers. Oral health is a fundamental part of overall health, and dental care for people with disabilities presents similar complexities. The challenges to providing dental care can be at least as complex, if not more so.

A recent study I conducted with my colleagues at Tufts University, published in The Journal of the American Dental Association documented the urgent need for dental care among people with intellectual and developmental disabilities. For instance, they are much more likely to have poor oral hygiene, periodontal disease, untreated tooth decay and missing teeth than the general population. Specifically, in our review of the electronic dental records of more than 4,700 people who received care, we found:

•10.9% of all patients did not have any teeth Continue reading