Let down by dentists......

[SoSoScared]

I have posted elsewhere of my terror of dental work. I just wanted to share the problems which the dental profession itself has caused me.

After years of plucking up the courage to go to a dentist, about 2 years ago, I agreed to have a root canal to save a broken tooth. I was almost hysterical with fear as I had not had one before, and knew it was a lengthy procedure (one of my major fears is the time in the chair, being pinned down and hurt, etc.)

When I finally arrived at the surgery using all the courage in my body, they had closed early. No-one had bothered to ring and tell me. Do they have any idea what that feels like? I have never been back.

Next, about a year ago, I tried a man who advertises locally as being very good with nervous patients. He had fabulous premises and a nice manner.

I begged him to deal with the broken tooth before I lost my nerve but instead he started me on a course of teeth whitening (2 x £400) for top and bottom.

Needless to say after a couple of weeks the inevitable happened and the last bit of tooth broke off leaving me with a stump at gum level. Now I am terrified to go to any sort of dentist (and I certainly can't afford to go back to the second person who charges about £300 for an extraction.

The point I want to make is that the two dentists involved have made a bad situation so much worse. The tooth could have been fixed two years ago but by their negligence/desire to make money, they have left me with worse problems and more terrified than when I started (oh and about £900 worse off with no improvement to my teeth other than the shade of white).

I mentioned in my other post that I 'hate' the new dentist I have chosen before I meet him. That is probably unfair, but you will understand why I am sceptical.

Don't hurt me, don't make yourself rich on money I cannot afford..........please just help me........

[letsconnect]

Hi there ,

it's understandable that you would distrust dentists following your experiences. I take it the ones before that weren't much better, either. I can actually relate to what you were saying regarding trying to prevent people from taking their kids to see the dentist - I did exactly the same thing, LOL . I thought they were making a HUGE mistake which would traumatize their kids for life!! As in your own case, my distrust was due to being submitted to wrong (as well as extremely painful) treatment in the past.

Yes, it is certainly true that dentistry, like any profession, has its bad apples. One of the things which made me want to start this site is that some people with a dental phobia think "they're all the same", somehow or other manage to find the courage to pick up the phone and make an appointment - but their *choice* of dentist may be totally arbitrary (such as picking the nearest one, or someone in the Yellow Pages who advertises themselves as catering to nervous patients). So as a group, those with a dental phobia are far more susceptible to running into yet another cr*p dentist than other people - and this, of course, only serves to reinforce the fears.

What I'm saying is - your not alone in your feelings towards dentists, but there are a lot of genuinely caring and responsible dentists out there as well.

[SoSoScared]

LC - thank you for your thoughts. It is good to have somewhere to air all these thoughts and feelings.

It is obvious from this board that many people feel very isolated and alone in their dental fear and a place to express those fears without feeling foolish is very very important.

I guess I do feel very betrayed by the guy who claimed to be a dentist for nervous patients. He examined my broken tooth and tut-tutted a great deal saying that it would take all his skill to save the tooth. (Hardly the way to treat a nervous patient I would have thought!!). The cost would be at the very minimum £390 and might be more.

I realise now of course that he is just like a plumber who talks the job up so he can charge more. However what I find really objectionable is that these dentists play on fear. They know you are afraid and take advantage of that fact

The whole dentistry thing seems to me to need such a major overhaul. The terrible experiences related on here and the unbelievable costs that people are expected to pay. We have the NHS here in the UK but most dentists no longer offer it and even if you can find an NHS dentist you are faced with waiting rooms full of people and being pushed through like a box on a conveyor belt due to the sheer volume of people needing help.

I also agree that nervous patients make bad choices! The trouble is that in the UK the people who are happy with dental treatment are with NHS dentists because they were registered before so many pulled out of the system. Therefore any recommendations are invariably for dentists you have no hope of seeing.

You end up paying and as I have discovered, cost is no barometer of skill!!

The one I have chosen now is near my office. I can walk there in about 1 minute and I figure it saves the trauma of getting their on public transport, etc. I have made an appointment for when everyone else has gone home so that I can be terrified before/after without embarrassment and can bolt back to the office afterwards.

He may well be rubbish at his job - I have no idea, but at least I can get away easily!! And that is important to me!

Thanks for the board. I have a month to wait for my appointment and it will play on my mind every day. So I will be back. It is so tempting to just say 'sod it' I will let my teeth go, nothing is worth this fear, but on other days I can be more positive.

[letsconnect]

Yes, it's true that the NHS is in trouble. I would advise anyone with a dental phobia who can at all afford it to seek private treatment. Dentists working under the NHS fee schedule are under an awful lot of pressure time-wise, because the reimbursement they get for providing treatment is very poor. Dental practices are expensive businesses to run (premises, equipment, materials, staff, etc. etc.). So if you're working as an NHS dentist, you usually have no choice but to rush things. You can get lucky and find that NHS dentist who both takes on new patients and is good with those who are anxious, but it makes the job of finding a dentist who's right for you more difficult. Some areas seem to be better in that regard than others, so it's not really possible to provide hard-and-fast answers.

I wouldn't necessarily assume that the dentist who quoted you 390 tried to rip you off - a lot of it the final price depends on lab costs (and these can be high). Things like crowns are not usually produced in the dental practice itself.

Have you heard any good reports about the dentist you've chosen, or did you select him purely based on location?

[SoSoScared]

Hi again LC,

No I picked the dentist purely on location as it is close to a 'bolt-hole!!'.

All recommendations I have received are for NHS dentists and are from people who have no fears. I don't know any 'nervous' people - everyone except me seems to be fine! Hence my delight at finding this board to share experiences.

I have a very close male friend who is totally unconcerned about dental treatment and who does not have injections for fillings/crowns, etc. because he says it genuinely does not hurt him.

He has had injections for extractions only because the dentist absolutely insisted!

The interesting thing is he has had a dental check-up every six months for as long as he can remember. Yet since I have known him he has had broken fillings, abcesses, broken crowns, endless trips to the dentist. He attends for treatment the minute anything goes wrong and never delays.

I on the other hand have not been to the dentist for treatment for at least, let me think, 10 years, and apart from a broken filling and the crumbled tooth which could have been fixed if that damned dentist had not gone home early, I have had no trouble.

I have never had toothache nor an abcess. In fact sometimes I wish I would have toothache so I would be forced to go!!

It is interesting however that ongoing dental treatment clearly does not prevent decay and infection, etc. since my friend has had so many problems and I have had none.

If I had my time again I think I would avoid any dental treatment. I think the minute you let a dentist near your teeth you are starting a chain reaction which just goes on forever (okay, that may not be scientific but it is how I feel!!).

BTW when I had a filling about 15 years ago the dentist wanted to crown it because a filling would not last. I said I preferred a filling as I hate impressions being taken - and that filling is still there and perfectly intact!!

The expensive/good with nervous patients dentist claimed all my fillings needed to be replaced with white ones - but I rather take that with a pinch of salt!!

Thanks again - it is good to talk!!

[letsconnect]

No I picked the dentist purely on location as it is close to a 'bolt-hole!!'.

I wasn't trying to imply that NHS dentists are generally 'bad' or anything, just that usually, they wouldn't have that bit of extra time it might take to treat someone who is anxious. And of course you have less of a choice of materials, and there are some procedures for which you'd have to pay privately. I think it's pretty common these days to have NHS/private mixed practices, where you can "upgrade" to private treatments for some things.

The reason why I reckon it's not a great idea to choose someone blindly: you're basically relying on luck alone. When I was first thinking about maybe seeing a dentist (after reading a story in a Sunday newspaper by someone who had coped with their fear), I sort of started considering making an appointment with a dentist just down the road. But of course, I never took any action. 5 years later, after I had been to a fantastic dentist (not the one down the road) who helped me over my phobia, I went past that practice down the road with some friends, who commented "that guy is a butcher!". You can imagine how relieved I was that I hadn't worked up the nerve to go five years previously!! Of course, you can get lucky, and also, most dentists are fine, but I would advise to check them out first and not to agree to any treatment unless you feel perfectly happy with them. I take it you talked to their receptionist when you made the appointment. Did you mention you're very nervous, and if so, what did they say?

It is interesting however that ongoing dental treatment clearly does not prevent decay and infection, etc. since my friend has had so many problems and I have had none.

No, treatment does not prevent things like decay or infection, it only treats the symptoms. It is becoming more common nowadays for dentists to provide tips on how to prevent problems, but (a) it can be difficult to do this if there's not much time available, and (b) it requires the person to implement changes. Dentists can only make helpful suggestions, but it is up to the individual to implement those changes. For example, if your friend has a lot of decay, their dentist may have suggested not to consume sugary things quite as frequently and to use a fluoride mouthwash, but if your friend doesn't act on that advice, there's nothing the dentist can do but to repair damage as it arises.

Unfortunately, not all dentists give tips for preventing problems, so it can be up to the consumer to figure out how to best care for their mouths. I'm planning to have a dedicated page on this topic once I get cracking on the new, improved Dental Fear Central website - in the meantime, I can recommend this book: "Something to Chew On" by Philip Christie (can be ordered from www.peopleaspartnersinmedicine.com ). It's very phobic-friendly (no scare tactics or dire warnings whatsoever). It doesn't cover some topics that I feel should have been included (such as fluoride or use of floss), but covers the basics fantastically well and also takes into account psychological issues.

The expensive/good with nervous patients dentist claimed all my fillings needed to be replaced with white ones - but I rather take that with a pinch of salt!!

Good decision (see my post about the "replacing amalgams scam" in the discussion section). While possible, it is rare that all your fillings would fail at once.

[SoSoScared]

Dear LC

Thanks again for your thoughts. Talking this all through is helping me enormously!

Re the replacing all the fillings with white ones issue - I have, in the short time I have been reading this board - started to feel more 'powerful' in the dentist/patient scenario.

Actually, although it is horrendously expensive I actually feel more comfortable paying privately here in the UK than using the NHS. I feel this puts me very much in the role of the 'customer'.

The more I think about it, if I was spending that sort of money on goods or services I would expect the person supplying them to show me some respect. Why therefore should I not expect that from a dentist?

As I have mentioned previously, I do feel very vulnerable at the dentist - almost violated - since I feel I am powerless to protest, or in any way participate in what is going on.

I am sure that if I can look at it in terms of 'I am paying you a lot of money and you answer to me' I can start to take back some of that power.

I think that the position of having items in your mouth and therefore being unable to communicate effectively is a major problem. If you could hold a normal conversation while all of that was going on you could participate far more fully.

I am going to try very hard to ensure that the dentist tells me exactly what he is going to do and that I have approved of it in advance. That won't stop me being terrified but will, I hope, help me to take back a little of the power that I feel I loose completely in the dentist's chair.

I also plan to challenge treatement which I do not think is required. I know dentists all have their various views and I have heard it said that any dentist wants to see all his own work in your mouth! In other words gradually replace every filling!! I intend to challenge that when I can!!

[letsconnect]

Looking at things in terms of being "the customer" helped me as well . There's one flip-side to this, which I only discovered later, and that is that the concept of "customer" and "service provider" does not imply the same level of care and genuine concern for a person's best interests as the concept of the doctor-patient relationship. But I don't like the word "patient" either, because it implies a relationship where one person (the "doctor") is in a position of power or authority and the other person (the "patient") is pretty much at their mercy. I prefer to look at the relationship as viewing them as partners in care, where the dentist takes the role of helper. I still haven't come up with a good word to replace "patient" yet . Maybe we'll have to invent a new word? It's neither here nor there, really - just nit-picking here .

As I have mentioned previously, I do feel very vulnerable at the dentist - almost violated - since I feel I am powerless to protest, or in any way participate in what is going on.

I think that the position of having items in your mouth and therefore being unable to communicate effectively is a major problem. If you could hold a normal conversation while all of that was going on you could participate far more fully.

One thing I've seen suggested is that, in addition to having a "stop signal" you can use whenever you want to take a break, to bring a notepad and a pen along. It can be difficult to speak properly when you're numb, so if you need to communicate something, you can write it down.

I am going to try very hard to ensure that the dentist tells me exactly what he is going to do and that I have approved of it in advance. That won't stop me being terrified but will, I hope, help me to take back a little of the power that I feel I loose completely in the dentist's chair.

Many people find that having a procedure explained to them beforehand, as well as during the procedure itself (so that you know what's going on and what you can expect to feel next) greatly reduces their anxiety.

also plan to challenge treatement which I do not think is required.

Usually, your dentist will be able to show you why something should be done, with the help of x-rays and mirrors (or an intraoral camera, if s/he has one). If you're not happy with the explanation, or you have grave doubts, you probably won't want to consent to treatment. Having said that, most dentists don't overtreat - it's just something to be aware of.