Dental Anxiety

OverlyAnxious

Hi,

I wasn't sure which sub forum to put this in so feel free to move it if it's in the wrong place!

I could really do with a dental check-up (and potentially descale & treatment at worst case scenario) as it's been several years since I last had one due to severe anxiety amongst other things.  A dentist visit is one of my worst nightmares though and I was wondering if anyone else is/was in the same situation and can offer any advice?

I suffer from severe contamination OCD and phobias around illness and injury which mean I struggle to get anything in my mouth, food is a daily hell, and a toothbrush even more so!  I can't cope with any liquid in my mouth (including water & saliva) without gagging and I struggle to spit anything out including the toothpaste.  Needless to say I am not able to keep my teeth properly clean despite trying hard every day, but am also absolutely terrified of the consequences of this!  I'm constantly 'checking' my teeth with my tongue and always feel something not right somewhere, I know that is most likely the OCD rather than anything actually wrong but of course I have no way to prove that without a check up.

On top of that, I struggle to leave the house and deal with people due to agoraphobia, social anxiety, IBS and again the OCD contamination fears around sitting in a waiting room etc.  I can't sit still, I'm constantly fidgety and suffer with acid reflux so have to keep swallowing which is not going to be easy in the chair.  I also suffer with an over sensitivity to lights, noises, smells, temperature, pain and touch - I can't stand being touched by anyone at all, let alone in my mouth.

I realise this is pretty much an impossible task but I am hoping to try and get at least a check up done by the end of this year...so if anyone does have any advice it would be much appreciated!

Thanks,
OA

EmmaB

Hi @OverlyAnxious

Have you ever had any CBT - Cognitive Behavioural Therapy? 

It can be a really helpful way of tackling OCD and anxiety.  If you've not had it before [or even if you have!] you could talk to you GP as they can refer you for some free sessions.  Depending on how many sessions they can offer this may or may not be enough but you could then find a local therapist who can continue to work with you. 

The only way to get through this is 'feel the fear and do it anyway' which is what you have been trying to do but you may find it helpful to have some support.

But I'm also thinking that if your OCD/agoraphobia stems from specific events in your past you might also need a more specialised approach [as well as the CBT] eg EMDR, trauma therapy - you can also talk to your GP about that too, if they are any good they will be able to refer you to the right service/s.

Either way I'd go sooner rather than later to discuss this with your GP [or talk to them on the phone if they'll do a telephone appointment] as the waiting lists for these services tend to be long...

In the meanwhile if you haven't come across them there are some good books on OCD eg Overcoming OCD and Break Free from OCD both on amazon.

I hope you get to achieve your goal of getting to the dentist, that would be a great achievement - I think when you come to actually have your appointment it would be worth asking for a dentist who maybe has experience of the sort of issues you have as they should be much more aware nowadays of mental health issues.

Best wishes.

Emma

charlie79

Good day and welcome. I may have some advice to help but weather its the answer or  works for you is a different matter. I have multiple severe mental illnesses, but before I was a dental nurse for 12 years.
I found patients felt at ease by bringing earphones and listening to music on there phone some even bought them sleeping aids the mask over the eyes to shut out light or distractions. As for the scale and polish if your teeth are severe enough to need a deep deep scaling under certain circumstances if severe enough they can refer you to hospital to have done under GA. Usually though if you explain to receptionist on phone they can explain to dentist when booking an apt. Hope this helps and good luck

OverlyAnxious

Hi Emma,

Thanks for the reply!  I have tried CBT twice but sadly just trying to get to the CBT centre, go inside and then deal with the therapists caused so much anxiety (and in turn stomach & bowel issues) it just made things worse rather than better unfortunately, all I could focus on was getting out of there and was arriving later each time due to not being able to leave the house.  I also find it pretty much impossible to get to the GP for the same reasons, plus the contamination from it being an environment specifically for ill people, so I never can get anything across to them when I force myself there.   

The basis of CBT seems to be that events won't be as bad as you're expecting them to be and that the anxiety will eventually drop if you stay in the situation long enough.  However I haven't found this to be the case with myself, events are usually even worse than I expect and the anxiety never does drop.  It's not like a 'hurdle' where I'm ok when I get somewhere, it just continues to get worse and worse until I get home, and of course every event like that just reinforces it.  I'm not aware of any specific past events causing the OCD & agoraphobia so I'm not sure if something like trauma therapy would be helpful, I haven't been offered anything other than CBT and pills so far.  I cant take pills due to the risk of side effects making me ill.

I have read a few books on overcoming OCD but again, found no difference afterwards. 

charlie79

Dentist do domercilkary visits which is basically home visits. Call your dentist and ask criteria for this request. It's been 10 yrs since I have practiced my dental proffreesion and rules are constantly changing. If they do a home visit can have a friend present

OverlyAnxious

charlie79 said:

Good day and welcome. I may have some advice to help but weather its the answer or  works for you is a different matter. I have multiple severe mental illnesses, but before I was a dental nurse for 12 years.
I found patients felt at ease by bringing earphones and listening to music on there phone some even bought them sleeping aids the mask over the eyes to shut out light or distractions. As for the scale and polish if your teeth are severe enough to need a deep deep scaling under certain circumstances if severe enough they can refer you to hospital to have done under GA. Usually though if you explain to receptionist on phone they can explain to dentist when booking an apt. Hope this helps and good luck

Hi Charlie, thanks for the reply.  Music sounds like a good idea as I often use the radio to help with anxiety & panic in other situations.  

I can't cope with needles or hospitals so I don't think a hospital visit with GA would work for me but it's something to keep in mind if it's the least worst option.

Would you say it's normal for most dentists to accept very anxious patients nowadays or should I try to find one that specifically deals with patients like that?  If so, how would I go about finding one?

EmmaB

Hi @OverlyAnxious
It sounds like you've already worked hard to try to overcome the problems you have but you've not quite found an effective way of reducing the problem/s...
It's hard to imagine the problems just came out of nowhere but perhaps they just started small and just grew and grew until you knew of no other way to feel safe and now it's virtually impossible to conceive of a life without the safety behaviours you have in place?  What would that look like?
@charlie79 suggestion of a home visit from a dentist is a good one - I didn't realise they did that. 
I guess another option would be to talk to your doctor as to whether they have any therapists or some sort of mental health supper worker who would see you at home and/or see if you could find a therapist that would visit you at home which you could fund through PIP if you get that?  I'm not sure if you could get direct payments to pay for something like this?
I hope you find a way forward.
Best wishes.
Emma

OverlyAnxious

charlie79 said:

Dentist do domercilkary visits which is basically home visits. Call your dentist and ask criteria for this request. It's been 10 yrs since I have practiced my dental proffreesion and rules are constantly changing. If they do a home visit can have a friend present

I don't even know who my dentist is lol, it's been at least 8 years since I was last able to go there so not sure if I'll even still have one?  

charlie79

Contact your local pct x they can help

OverlyAnxious

EmmaB said:

Hi @OverlyAnxious
It sounds like you've already worked hard to try to overcome the problems you have but you've not quite found an effective way of reducing the problem/s...
It's hard to imagine the problems just came out of nowhere but perhaps they just started small and just grew and grew until you knew of no other way to feel safe and now it's virtually impossible to conceive of a life without the safety behaviours you have in place?  What would that look like?
@charlie79 suggestion of a home visit from a dentist is a good one - I didn't realise they did that. 
I guess another option would be to talk to your doctor as to whether they have any therapists or some sort of mental health supper worker who would see you at home and/or see if you could find a therapist that would visit you at home which you could fund through PIP if you get that?  I'm not sure if you could get direct payments to pay for something like this?
I hope you find a way forward.
Best wishes.
Emma

Hi Emma,

I never really could cope with being alive, especially being ill or injured and dealing with other people socially, I can trace that all way back to even before primary school, I'd never get dirty with mud or paint etc and never take any risks.  By the end of primary I was really struggling with contamination and food and didn't really get on with anyone my age...and the transition to high school and teen years were really the last straw for my mental health, I just couldn't cope with it at all...and then one of the worst things for an illness-phobic happened, I started getting really bad IBS-D every single day before school, and couldn't eat or drink away from home during the day so felt awful all the time, by that point I really was just trying to get through one day at a time, and hoping I didn't wake up to another one...I never thought I'd have to go through choosing options in Year 9, or GCSEs in Year 11, or learn to drive, and definitely not move out...but it's now been about 15 years of just trying to get through one day at a time and unfortunately I'm still here trying to get through each day, the passage of time has just added a few more phobias, a lot more physical issues (to be expected with age) and safety/avoidance behaviours.  I look back now and wondered how I ever got through school & college! You are absolutely correct in that I can't see a life without safety behaviours, even from the age of 11 (high school transition) I couldn't see any sort of future for myself.

It has made me wonder if OCD may be something we're born with as I can trace it so far back.  And although it wasn't noticed at the time, it's now been suggested a few times that I'm likely to be on the spectrum and may have suffered from an early age.  I am awaiting an ASD diagnosis but waiting lists are very long.

I wouldn't be able to have a home visit unfortunately.  My flat is the one place I can try to control contamination and get some very brief rest occasionally, having any visitors is extremely difficult, I have just one relative over a fortnight for an hour maximum (the visit is for their benefit rather than mine!) which causes me huge amounts of anxiety and I have to disinfect anything they've touched afterwards, it causes days of after effects with my stomach & bowels, as well as muscle aches from excess tension so I couldn't risk having an unknown person over, especially a medical one.

I don't currently get PIP so am also in fairly major financial difficulty now as I have to live alone due to my conditions and try to cover rent, bills and groceries on a very low income.  I failed the first PIP assessment recently which is why I joined this forum....though I wish I'd joined it earlier now!   I have now posted a mandatory reconsideration but it seems these rarely make any difference and I'll have to try and get through a tribunal, but that will be months away if it does happen.

Waylay

Hi there,

I also have severe anxiety about dentists, although I don't have OCD. This must be so difficult for you! I found a dentist who will give me gas and air (nitrous oxide) while working on my teeth. He's NHS, but I have to pay for the gas and air. Basically, it knocks you out, or close enough that it doesn't matter. You recover in 10-15 minutes after it stops. It requires a see-through mask to be put over your mouth/nose/both. Works for me.

Cheers!

OverlyAnxious

Waylay said:

Hi there,

I also have severe anxiety about dentists, although I don't have OCD. This must be so difficult for you! I found a dentist who will give me gas and air (nitrous oxide) while working on my teeth. He's NHS, but I have to pay for the gas and air. Basically, it knocks you out, or close enough that it doesn't matter. You recover in 10-15 minutes after it stops. It requires a see-through mask to be put over your mouth/nose/both. Works for me.

Cheers!

Thank you for that reply, that sounds like something I could probably cope with!  

Do you get any after effects from the gas?

OverlyAnxious

Quick update, I now have an appointment for a check-up for next month...  

If anyone has anymore tips or advice on dentist visits, I'd like to hear them!!

I will have the option of going to a specialist clinic and having gas if I need any treatment but the check is at a normal dentist.  Tbh I don't know how I'm going to get through the check-up! 

crazyjan

I don't have any tips, sorry, but just wanted to wish you the very best for your checkup. I'm terrified of the dentist but have managed to stick with the same one for a number of years now and he knows me and my anxiety! I hope you find a way of getting through this. I feel for you as it's a horrible way to feel. Good luck!

Chloe_Alumni

Hi @OverlyAnxious and thank you for the update.

That's a huge step to have an appointment booked, you should be really proud of yourself. I have always had a huge phobia of the dentist (and needles for that matter!) so I appreciate how much of a big step forward this is.

I too found that music helped, and my dentist is aware of how nervous I am. It's okay to tell them what might help you. I always ask them to just keep talking (about anything) which gives me something else to focus on. 

I really hope you make it to the appointment, you can do this.

Adrian_Scope

It's great you've managed to book in for a check-up @OverlyAnxious! 

EmmaB

That's great news @OverlyAnxious, go for it! It might be useful for you to write down your worries re what you think might happen and then once you've had the appointment to see whether it was as bad as you 'predicted' it would be?  It can be good to realise our predictions don't always happen / aren't as bad as we think they would be... You can also use the list of things you are worrying about to think about solutions to those worries eg if you are worried about sitting in a waiting room - you could call up reception and see if you can have an arrangement  them where you call from outside to let them know you have arrived, then they can call you (or come out to help you in) when your dentist is ready, so you go straight into their room, for example... Thinking things through in this way might help. Good luck with it. Let us know how you get on if you want to? 
Best wishes.
Emma

OverlyAnxious

Well, so far I've just been trying not to think about it...but it's getting closer now and I've written out a short list of worries, it's by no means comprehensive and I'll probably add to it over the next week...

•  Not being able to leave the house on time due to IBS
• More traffic than I was expecting and/or not being able to find a parking space
• Physically freezing outside and being unable to try the door
• Having to use an intercom before the door will open
• The smells and sounds being so overwhelming that I immediately panic and have a meltdown, panic attack, or just run out again
• Not being able to speak to, or understand, the receptionist
• Bringing the wrong paperwork to prove my free NHS entitlement
• Not being able to get up the stairs to the waiting room due to the wobbly, dizzy, motion feeling that I get when anxious
• Finding the waiting room packed with other people - especially if they are making noise, coughing, or appear unwell
• Physically freezing outside the dentists door and not being able to enter the room
• The sight of the dentist, chair and tools being so overwhelming that I have a meltdown, panic attack, IBS attack, or just run out again
• Not being able to understand, or respond to, the dentist - especially if they have a strong accent (I always worry they'll think I'm racist instead of just anxious!)
• Not being able to explain my problems, dislikes and phobias
• Being unable to take the motion of the chair reclining and feeling dizzy/ticking (I can't use lifts or escalators) 
• Being unable to lay flat due to reflux (I can't lay flat at home most of the time)
• Being unable to remain still in the chair, particularly with a nervous tick I have where I suddenly twist my neck (the injuries could be severe if there are tools in my mouth when that happens)
• Gagging before they even get close (if I gag just once I'll have to leave immediately)
• Being unable to open my mouth at all due to 'contaminated air' in the room (Yes, I know that sounds ridiculous, but your nose acts as a filter)
• Being unable to cope with the feeling of metal against my teeth, and excess saliva (can't stand bodily fluids)
• Dentist being too heavy handed, putting too much pressure against my teeth, damaging or loosening them
• Dentist accidentally cutting my gum or tongue (possibly due to me not being able to stay still!)
• Not being able to say STOP if I need him to stop, or him not stopping if I do ask
• Agreeing to something I won't be able to do (X-rays or water jet descale for example)
  
• Terrified that he will find something wrong requiring further treatment
• Not being able to trust his judgement (I can't trust my own mind to give me the correct information, how can I trust anyone elses!?)
• Worried I'll embarrass myself with loud stomach/bowel gurgling, soiling myself or crying etc
• Not being able to stand up out of the chair without being overcome by dizziness and passing out
• Not being able to deal with the receptionist afterwards and just having to leave

Why am I even attempting this...? 

EmmaB

Dear @OverlyAnxious

I guess in answer to your final question - because you are trying to see if you can do this... and it would be a great achievement if you can achieve any part of it?  And if you could achieve all of it it might be a big step towards changing your life because it might mean you could achieve less scaring outings after? 

I'm wondering if you can eliminate any of the fears you have listed eg Have you called the practice and told them of your worries/fears so they are fully aware including the dentist?  Have you got anyone at all who could go with you?  Could you make an arrangement that once you arrive outside the practice that you call to say you are outside and that someone can come out and help you in, guide you to the treatment room etc?  Could you write down a bit of text that explains that you are nervous about your visit and what you would like someone to do to help you ie if you 'freeze' eg "Please could you explain to me what the process is in a calm way and help me through the stages of the appointment..."

It sounds like it would be good for them to know so they can help you as far as possible eg by clearly explaining every step, simply and calmly, which might help?  You could even show them your list so they are fully aware of what a big deal this is for you but what will be every day for them...

I hope you can do this, I'm sending you positive vibes and willing you on here!

Best wishes.

Emma

OverlyAnxious

Thanks Emma,

I think the reason I'm trying to do it is to reduce some anxiety from one area of life...but it won't work even if I can get through it, the constant doubt of OCD doesn't get removed by a professionals opinion unfortunately.  

I can't use phones but have e-mailed the surgery to book, mentioning some of my issues at the time.  I doubt they will pass any of that on to the dentist though.  I thought about trying to write some down to take on the day but I don't think they'll have time to read it, I do understand it's just a job to them and they want to get it over and onto the next one as soon as possible.  

I can't take anyone with me because I can't cope with people regardless of how long I've known them.  My Mum visits me fortnightly but that causes so much anxiety (along with dizziness, reflux, nausea, etc) even in my own home that I have to ask her to leave after about an hour as I can't cope any more.  Then I spend the rest of the evening in a right state, it gets more difficult every time she comes over but as it's for her benefit I don't want to stop it altogether...  I do wish I had an understanding mate in a similar situation that I could meet there but I don't know where to find someone like that or if that would help anyway...I tried a local anxiety group earlier in the year (after 4 failed attempts) and it went horribly wrong, couldn't cope there at all, even though most of them were probably in similar circumstances.

EmmaB

Hi @OverlyAnxious
It really feels like you could benefit from having a support worker who has experience of working with people with anxiety and OCD, it would be long term work but would be worth it if you want to improve your quality of life, I'm making an assumption that that is what you'd like to do?
Another option is to consider working with an online counsellor initially (online counsellors use video call, instant messaging and email) but I think ultimately you would benefit more from face to face work... 
In the meantime I hope you can challenge and overcome some of those unhelpful negative thoughts as they are really not helping, the trouble is that negative thinking is both a habit and a survival mode of thinking so need some hard and consistent work to shift.  A support worker or counsellor could help with this...
Best wishes.

Emma