Why Fear of the Dentist Is Causing an Oral Health Crisis in Saudi Arabia

A visit to the dentist is filled with unusual sights, smells, and sensations. But it does not have to be traumatic. Find out how to conquer your dental phobia.

Why fear of the dentist is causing an oral health crisis in Saudi Arabia


Image from Army Medicine on Flickr.

According to a recent study, around 40% of people in Saudi Arabia are missing out on essential dental treatments and care because they are too afraid to visit the dentist. Remarkably, this is a situation that is played out all over the world, even in the most developed nations with the highest quality healthcare resources and provisions.

From fearful parents who allow their children to avoid routine check-ups to older patients who worry about the condition of their teeth after long lapses in dental care; there are many different reasons and many different types of people who are afraid of the dentist. For lots of Saudi communities, worries about pain, sedation, and shame are mixed up with issues of family, tradition, and superstition.

In rural areas and more isolated communities, some people still believe that illness and sickness is a spiritual condition and that prayer is the only way to solve it. The general attitude towards things like infection are that they represent a punishment for a wrongdoing, either of your own or a family member. So, there are all kinds of conflicts preventing some sections of the Saudi Arabian population from seeking dental treatment.

These issues can make it very difficult for dentists to provide care too. They often struggle to keep track of patient conditions, particularly in cases where no treatment is sought and attendance at routine check-ups is very low. In cases where the main issue is a dental phobia, very little can be done to help a patient if contact is not made. Until they decide to visit a clinic or speak with a dental specialist, there is no real way to help them conquer the fear.

The Benefits of a Friendly Dental Partnership

This idea is a very important one, but it tends to get overlooked. Whether in Saudi Arabia, the UK, or the USA, dental phobias require contact to be solved. If a patient never becomes familiar with the inside of a dental clinic, with the sights and smells of a treatment room, or the words and terminologies used to describe dental problems, their anxieties will always prevail.  

While getting a phobic patient into a clinic is often easier said than done, it represents the first step in a chain of trust. This is why patients with phobias and intense fears should not be expected to undergo any kind of treatment or invasive contact during their first session. In fact, it is useful for a dentist to simply spend time with the patient, in the treatment room if possible.

Yet, even this can be a compromise at first. It could help a patient to make very small steps. For example, their first visit to a dental surgery could involve a consultation or discussion outside the treatment room, away from tools and instruments. Then, with each subsequent visit, the patient should try to get closer to the treatment room. Once there, they should spend some time familiarising themselves with the sights and smells.

The problem with this ‘softly-softly’ approach is, of course, that it takes a long time. It requires a lot of patience from a dentist who is likely to have a heavy workload already. But again, with friendly and compassionate contact, consultations and sessions can be properly scheduled for the maximum benefit of both the specialist and the patient.

In other words, it is not enough to just expect a phobic patient to ‘grin and bear it’ during check-ups. In the long run, it could be of much greater benefit to give them the space and time needed to approach dental treatment on their own behalf. If treatment is rushed or too invasive, too quickly, it can end up intensifying anxieties about visiting the dentist. This is true not just in Saudi Arabia, but all around the world.

The Problems Posed by Phobic Patients

If you have a serious phobia or fear about visiting the dentist, the best thing to do is talk directly to a dental health specialist as soon as possible. This does not have to be at a clinic, as the most important thing is that you just make contact. The information that your dentist has about you comes from the insights that you give them. If you do not attend appointments and choose to go without treatment for infections and periodontal disease, they will not be aware that you are in need of urgent dental attention.

This is exactly how so many patients fall through the cracks, so to speak, and end up suffering with severe bone degeneration and irreversible damage before seeking care. While it is the responsibility of a dentist to provide the best possible dental care, they cannot force a patient to accept it. And therein lies the problem for dentists, particularly in countries with high ‘no turn out’ rates. For example, in America, around a fifth of older citizens have not visited the dentist in the last 5-7 years.

This means that a dental health crisis is quietly brewing among the elderly population of the USA. It requires a targeted and broad ranging solution that promises to make dental treatment easier to reach for older people. The good news is that the government has made this a top priority. It is currently looking into a number of different schemes designed to bring medical provisions to the elderly, rather than the other way around.

It is likely to be an effective approach for patients who have mobility problems, but can it work for those with severe anxieties about visiting the dentist? Or, should the answer be looked for in a completely different place? Well, interestingly enough, dental science has made some truly ground breaking discoveries over the last decade. And many of these developments could make visiting the dentist a more comfortable and relaxing experience for us all.

Why the Future Looks Bright for Dental Procedures

The best example of this is Electrically Accelerated Enhanced Remineralization (or EAER). It is an emerging technology that was designed by two researchers in London. If they have their way, it will make it onto the market in around three years. If you are wondering what is so special about EAER, the answer is likely to please. If EAER successfully reaches the market, it could entirely eliminate the need for dental drilling.

This is very important, because the drill represents everything that phobic patients hate about the dentist. It is loud, unnatural, unpleasantly metallic, and it makes a person think of pain and uncomfortable sensations. In reality, dental drilling is almost never painful. It is a routine part of fitting fillings and bridgework and carrying out root canals. Yet, despite this, millions of patients still get very anxious when the subject of drilling is raised.

The fear is almost entirely psychological and this makes it tricky to conquer. Unless a patient can be practically shown that the drill does not cause any pain, they are unlikely to ever believe it. And as getting this proof involves actually allowing the drill to enter their mouth, a kind of stalemate is reached. For many phobic patients, the answer is just to give up. To give up, let appointments lapse, and hope for the best. Of course, teeth rarely play along with this choice.

What EAER promises to do is make dental drilling redundant, by using the natural abilities of teeth to regenerate. Not a lot of people know that teeth have healing properties, but they can remineralize weakened spots in enamel. The downside to this ability is that it cannot keep up with the rate of wear, tear, and general decay that our diets throw at our teeth. So, your gnashers can heal themselves, but they can only do it very slowly.

With EAER, very mild pain free electrical currents are sent through the teeth. These currents stimulate the remineralization abilities and kick them into overdrive. The healing powers speed up and the tooth can actually end up completely repairing a cavity in a couple of hours. As such, the EAER treatment method requires no artificial intervention whatsoever. For the first time, cavities can be treated by simply ‘regrowing’ the damaged tooth.

Visiting the Dentist in a World without Drilling

For patients with anxieties about drilling, the technology could transform visits to the dentist. All that is required of a patient is the ability to sit still, allow the electrical currents to be applied, and follow strict aftercare instructions. There is no noise, no buzzing metal instruments, no unpleasant vibrations in the mouth, and hopefully, no fear. Plus, EAER treatments do not have to be repeated or replaced like regular fillings do.

So, not only could this technique make dental appointments less scary, it also promises to give patients stronger teeth, even after a ‘filling.’ As the actual enamel is grown back and regenerated, the tooth is likely to look whiter and shinier after the treatment. At the moment, no real downsides have been identified, so the technology is likely to hit the market soon. It will take longer to appear in the US, as the regulators place stricter rules on medical resources.

Fortunately, the FDA and the inventors of EAER are working closely together to prepare the technology for sale and widespread use in clinic and surgeries. Once it becomes an established piece of equipment in the US and Great Britain, there is a better chance that it will make its way to countries like Saudi Arabia. According to its creators, the possibilities are endless. As no artificial materials need to be used, the technology could represent a way to provide cheap dental care in underdeveloped regions.

On the other hand, the typical dental invention or innovation takes around twenty five years to be fully embraced by the industry. This long delay happens for a number of reasons, but the main one is cost. It costs time and money for dentists to upgrade their equipment and train staff to operate new machines. The private and premium clinics will be the first to get their hands on new technologies, but it could be some time before low income and subsidised services are afforded the same privilege.

Helpful Hints and Tips for Phobic Patients

As aforementioned, the first step for a phobic patient needs to be contact. It is your responsibility to ask for help, particularly if you are dealing with periodontitis, tooth decay, or serious cavities. If any of these conditions are allowed to remain untreated, they can lead to irreparable damage. So, the question is not really whether you should seek treatment, but when you seek it. Generally speaking, sooner is better, just to make sure that chronic problems do not get worse or lead to pain.

Do not be afraid to talk to your dentist. Open up about your concerns. This is the one person who knows more about the reality of dental treatments than anybody else. They must tell you the truth and they have to answer your questions. This means that if a dentist promises you that a procedure will not hurt, they can be trusted. While there is no way to guarantee a pain free recovery, the actual dental procedures are almost never painful or traumatic.

The misconception about things like root canals being painful dates all the way back to a time when there were no anesthetics. During the seventeenth century, these treatments were carried out without any kind of numbing, so of course people feared them. These days, however, you are much more likely to find the process boring. A root canal can be fussy and complex for the dentist, but you are not required to do anything but sit still.

If it helps, ask your dentist if you can squeeze a stress toy, watch television, or listen to music while they poke around in your mouth. As long as your coping technique does not get in the way of their exam, there is no real reason for them to refuse this request. For some patients, it can actually help to watch the treatment or procedure in a special dental mirror. This makes them feel more in control and calms their nerves, because they know what is happening.

Ultimately, your coping strategy will be unique to you. Whether it is bringing a friend for moral support, squeezing a small toy, listening to relaxing music, or counting sheep in your head, it if helps you to relax, it helps the dentist to perform their duties smoothly and safely. The thing to remember is that fear of the dentist, though intense, can never really be an excuse for not visiting or attending regular check-ups.

Conquering a Fear of the Dentist is Essential

It may sound cruel, but your teeth simply do not care about your dental anxieties. They will continue to age and wear, as teeth do, no matter how difficult you find keeping up with a good dental health routine. This is the harsh reality of the situation and its impact on your life and future health. Nobody can take care of your teeth on your behalf and once they are gone, you cannot get them back, so a little bit of fear might just be worth the eventual rewards.

And, even if it sounds implausible, you will see that regular contact makes the dentist and everything that comes with it seem a lot less scary. The more time that you spend sitting in clinics and waiting for routine exams, the faster you will come to see that they are a chore. They can be as eventful as doing the washing up, just so long as you deal with the symptoms of emerging oral conditions as quickly and efficiently as possible.

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