Fear of “the drill”

[sushantpatel_doc]

The Problem:

“I’m absolutely terrified of the the drill – even just thinking about that sound sends shivers down my spine! “

Some people have had painful experiences with the dental “drill” because they weren’t properly numbed (or perhaps not numbed at all). Not surprisingly, if this has happened you are likely to feel terrified of the “drill” (or “handpiece” in layman’s speak). Thinking of the sound alone is likely to produce intense anxiety.

There should be no pain once the tooth is properly numb – only vibration and light pressure.

Other people just don’t like the sound of the handpiece, or the very idea of it.

There are many ways of dealing with this fear, and you should choose the tip(s) which you feel will work best for you. Some are based on distraction, others are based on exposure (of course, you can use a mixture of both).

Distraction
Blending out the sounds:

•Bringing an mp3 or CD player and playing your favourite music is a tip frequently mentioned on our forum. Some people recommend turning up the volume really high and choosing fast tunes without lengthy gaps in between the tracks, to blend out any sounds.
•Others prefer more soothing music, relaxation tracks, or tracks with nature sounds such as waves or tropical thunderstorms.
•It is helpful to have the “Pause” button handy in case you want to communicate with your dentist.
•Choose earphones that don’t pop out easily.
•Some dentists provide CD or mp3 players, but most don’t. The reason is hygiene regulations (they would have to be cleaned in between patients). But all dentists will let you bring your own mp3 or CD player.

Getting comfortable:

•Some people much prefer to keep their eyes closed during treatment.
•You can bring a blanket to make you feel more comfortable and secure. Some people also like holding their favourite soft toy.
•Make a conscious effort to relax – it is impossible to be anxious and relaxed at the same time. Have a stop signal agreed with your dentist in case you need to take a break, or in case you need more numbing. There are various relaxation techniques, such as concentrating on your breathing, deliberately relaxing the muscles which you find tense up when you’re anxious (for example, your shoulder muscles), and self-hypnosis.
•Do not hesitate to ask for anaesthetic top-up if you don’t feel completely numb! Many people think that they can only have what they are originally given, but it’s easy to give a top-up.
•If you are worried about not being numb, ask your dentist to check that you are numb (for example, with the explorer) before using the handpiece.
•Stress balls are malleable balls which can be squeezed with one or both hands to reduce stress and tension. They are available from places like toy shops, drug stores, and sports shops.

Watching TV or DVDs:
A few dentists provide entertainment systems such as TV screens (sometimes with a selection of DVDs – you can also bring your own) or even virtual-reality goggles.

Exposure
Getting familiar with the equipment:
It can be helpful to be able to look at, touch and hear the handpiece before it is used. Our expectations about the size and noise of the handpiece are often exaggerated, and getting familiar with the handpiece can help put things into perspective.

Ask your dentist if they can show you the handpiece and ask if you can touch it. If this sounds too scary, you can ask for a prophy handpiece (used for cleanings) with a rubber prophy cup (see photo) first. Ask your dentist to show you the instrument like they would show it to a child patient. A lot of dentists are familiar with techniques to make children feel more confident and comfortable about treatment.

Seeing what is happening:
Sometimes it helps to see what is happening. Our imagination can often run wild. Actually seeing what is happening, with the help of a mirror, can put things into perspective.

Preparing for the sounds and sights:

•Some people find it useful to desensitize themselves to the sounds they may encounter. For example, using an electric toothbrush can help. You can play around with the way sound is amplified by brushing your teeth while having a shower, and letting the water run over your ears. This may be very anxiety-provoking at first, so only try it if you think you can handle it.
•Depending on the nature and extent of your phobia, you may find it helpful to watch a video where someone is having a filling. You can watch this repeatedly and observe if your anxiety levels drop over time. Please do not watch this if you feel it might increase your fears. Although the following video might not be the best (I’ve been told that the handpiece sounds louder than it does in reality), it is quite sensitively done. Click here for the video which shows a young woman with learning difficulties going to the dentist. Remember, there is a stop button if you decide you don’t feel up to it!

Other Factors
Dental Equipment:
•Although handpieces have generally become a lot quieter (you may be pleasantly surprised if you haven’t been to a dentist for a long time), some handpieces are even more quiet than others. If the sound level is a major concern to you, some dentists use electric handpieces rather than air-driven ones. Electric handpieces are the quietest type.
•While some dentists advertise air abrasion (a sort of mini-sandblaster) as an alternative to the handpiece, the reality is that air abrasion cannot be used in all situations. For example, it isn’t good when larger fillings are needed.
•Laser dentistry is still very rare due to the very high cost of the equipment. Again, lasers are not suitable for all situations.