I’m Using Cognitive Behavior Therapy and Exposure Therapy To Overcome My Severe Dental Phobia

The dentist became my Bogeyman, his tools too frightening to contemplate.
Publish date:
April 8, 2015
teeth, phobias, dentist, cognitive behavioral therapy

(I am writing this with the assumption that there are many, many people who can relate. Phobias can be embarrassing and cause so much anxiety, we often keep silent about them. The person next to you could have their own crazy irrational fear, and you wouldn’t know it.)

A few years ago, I gathered a truckload of emotional fortitude and made an appointment to consult with a dentist. I researched and found one who claimed to work sensitively with phobic patients. I got myself to the appointment, into the chair, into what I thought would be a conversation about how we’d manage my anxiety so I could endure treatment at a later date.

Then the doctor said, “Let’s have a look,” and came at my face with the metal hook of horror. I broke out in a sweat, hyperventilated, started crying. An adult woman in her 30s, thank you very much, I cried while a stranger poked around in my mouth. The kind assistant at my shoulder asked if I was OK, called me “sweetie” in a way that was unusually welcome. I was embarrassed, whispered that I didn’t expect him to use the metal tool.

The doctor wrote me a prescription for lorazepam, to be taken before my next appointment. The pill wore off mid-procedure, and I was launched into another panic attack before a second dose could take effect. I left jittery and even less trusting than I had been before.

In recent years, my dentist phobia has taken root and left me at times unable to tolerate any discussion of the subject. I have gone silent when the subject of teeth comes up. I have told people, “I’m sorry, I can’t listen to you talk about your root canal” because of the hot fear it spreads across my torso. I have — very unpolitely — walked away from conversations when they refused to drop the subject.

Where did this fear come from? I can’t remember any anxiety or traumatic events associated with my childhood dentist visits. My dentist was funny, and I remember the way he poked my arm as he talked. I remember the time in elementary school when I lost a filling to a piece of saltwater taffy — it was more silly than scary. But then my recollection darkens when I think of the dental hygienist who shamed me during a cleaning: “I can tell you’re not flossing.” Already, my young ego was too fragile to have my imperfection so bluntly acknowledged.

The first time I panicked over a dental event I was in college, still going back to my childhood dentist when necessary. Somehow I became convinced I had a broken tooth and went to have it checked out. I was consumed and obsessed, way out of proportion with the reality of a broken tooth. A phantom broken tooth, as it turned out — there was nothing wrong. My irrational fear of dentists and dental maladies was just budding. It would grow to the point where I could only deal by completely avoiding the subject, while internally obsessing over imagined problems.

(Here’s the point where I had planned to include some statistics about how many people have dental phobias. As you can imagine, quoting those statistics meant I had to Google “dental phobia.” I found one helpful slideshow of reasons people are afraid of the dentist, and then I had to remind myself to start breathing again.)

It turns out these statistics (like most) are hard to pin down because of differing definitions between fear, anxiety and phobia. Here is my personal interpretation of terms:

  • Fear — “Ugh, I hope this root canal doesn’t hurt too much.”
  • Anxiety — “The sound of the drill always makes my heart race.”
  • Phobia — “I’m just going to take a different street so I don’t have to drive by that D-place; no big deal, I can leave the room whenever someone on TV brushes or flosses or talks about their teeth; really, I would love to have my teeth cleaned, but last time I vomited the whole night before and had two panic attacks in the office.”

Colgate says 9-15% of people “avoid seeing the dentist because of anxiety or fear. I found many similar statements, from academic papers to homemade websites, all of them vague enough to be meaningless. All I can gather is it’s likely you or someone close to you is affected.

I have only recently worked up the courage to bring up the issue with my psychiatrist. First I did what I always do when faced with a problem — I found some books. Hypnotherapist James Bracken lead me to examine my most fearfilled dentist memories until I could think or talk about it without panicking. Later, I picked up The Fearless Smile, which I haven’t read yet, but seems to advocate ALL THE SEDATION. I am not necessarily recommending either of these books, but they are examples of the self-help resources out there for dental phobia. I was a little surprised by how few books there are on the topic.

After working on my own for months, I was finally able to bring it up with my therapist. She told me the way to get over a phobia is to tolerate more and more exposure to the feared situation. This is what I had been doing by making the decision to change and seeking more information. At first, I had to build up courage to just read about dental visits. From there, I worked up to talking about it, taking action, and writing openly about it here.

Even though I started working on my dental phobia before talking to my therapist about it, I was using skills that she taught me to deal with other sources of anxiety.

For me, these were the keys to taming my fear:

  1. Anxiety management — When anxious, I tend to stop breathing and get tunnel vision. My best tool is deep breathing.
  2. Sticking with it — I call my cognitive behavior practice “studying.” So when I’m using CBT to work on some issue, I “study” 10-15 minutes every night or a few times a week. I read the books I’ve gathered, journal about it, do research online. The study habit stops me from avoiding topics because they make me uncomfortable.
  3. Tell someone — The more people I tell, the less power the anxiety has. I started by talking to my husband and my closest friend, knowing I could be shameless with them.
  4. Break it down — At first I could only commit to reading one page about dental phobia, then doing one exercise from the book. I had to work up to putting “schedule dentist appointment” on my to do list. A year ago, I would have been very uncomfortable just thinking about it. I had to travel this road focusing on the few small steps right in front of me.

Overcoming this fear has been on my To Do list for two years, but I found excuses to put it off. Finally, when my daughter started to sprout teeth, I found the determination to not pass my anxiety on to her. Is it too much to hope dentist visits are always a treat for her?

This week, I made dentist appointments for both of us. She will visit a highly recommended pediatric dentist whose office looks like an aquarium; I will see the sedating dentist whose office looks like a spa. Ideally, in six months we will do it again like it’s no big deal.