1. Dental phobia describes a fear of dentistry. It may also be called dental anxiety of simply “fear of the dentist.”
2. People develop dental phobia for a variety of reasons. The majority of dental phobic people have experienced one or a series of really bad and/or painful in-office experiences with one or more dentists. Some have had really bad results in the actual dentistry – rather than in-office experiences – that have resulted in severe pain and/or failure of their dentistry. Physically strong men are frequently more fearful of dentistry as are Masters of the Financial Universe. In addition men don’t experience the vulnerability of seeing a gynecologist so they tend to frequently fear dentistry than women. People who have habituated to drugs and/or alcohol are frequently afraid of dentistry because they need higher amounts and different chemistry of novocaine. Patient experiences in higher volume dental practices are also associated with a higher incidence of dental phobia. Our YouTube channel, The Center for Special Dentistry, has a twelve part discussion on this topic.
3. Dental phobic people are frequently most afraid of the injection, then the sound of the drill, then pain during and/or after the actual dentistry. The first and most important thing for me to demonstrate to a patient is that I give really gentle injections.
4. We offer all therapy in-office via dental phobia behavioral modification, many different anesthetic techniques including published methods for painless injections, atypical novocaine chemistries, allowing longer times for novocaine to take effect, nitrous oxide (laughing) gas, anti-anxiety medication pills, intravenous (IV) sedation and of course, excellent dentistry. Many of these things are not possible to offer in high-volume dental practices. A low percentage of our patients may also need help with alcohol and/or other drug dependency and we offer near-complete overall medical & psychiatric coverage with affiliated MD’s in our office building.
5. I personally always liked my dentist when I was a child so it helped me consider it as a career.
6. I studied Biochemistry at UPenn and had many career interests besides dentistry and including psychology. I studied with Dr. Martin Seligman who is an expert on helplessness and depression and I incorporated his teachings early on in my practice of dentistry. I remained at UPenn for dental school.
7. Our practice draws patients from around the world seeking what I trademarked “Creative Solutions for Complex Dentistry.” That is frequently not dental phobia and instead may just be difficult dentistry. However many people who suffer dental phobia have complex dental needs. We also treat many patients who love the highly personalized level of care, attention to detail and having all sixteen cosmetic dentists, specialists and lab techs in one office. Over thirty years in practice we have built a significant reputation and offer the biggest private practice predental training program in the U.S. We receive students (and patients) from around the world. Students and patients hear of our practice from our patients and students and also from the 4,400 page website I wrote, NYCdentist.com, that is read in more than 200 countries plus other writing and lectures. I’ve been writing online since 1998. I also held pro bono professorships at both Columbia and NYU dental schools for over 20 combined years so a lot of students have been locally exposed to my teaching.
8. A lot of our patients are from the greater NY metro area but we frequently receive patients who visit from many exotic places around the world. These people will visit for one or two weeks over one or more occasions. Regardless I personally prefer long-term patient relationships that I have had with many of our patients for decades. The average age of our patients is older, e.g. 30+, because our practice is most attractive – and valued – by people who are old enough to recognize bad life-experiences with other dentists and are therefore willing to pay the higher fees our type of dentistry demands.
9. I teach Dental Philosophy which involves personally catering the entire dental experience for each patient. There is a very positive energy one can feel when entering our office because it is an academically oriented, high end private practice filled with a lot of staff and students who share a genuine interest in providing the highest level of dentistry. I view myself as a member of the Board of Directors giving advice to my patients who are CEO’s of their own bodies. Therefore I see my role as an academic to teach the nature of a problem and then offer as many creative solutions how to solve that problem including various treatment options, duration of treatment, aesthetic options, possibility of pain and/or aesthetic limitations based upon treatment options and cost. I can spend hours discussing this information over several visits depending upon the needs and desires of each patient. Some people want to get to work quite quickly and I am also hope to oblige them.
10. IV sedation is usually safe if performed by medically qualified people in a healthy person. We offer it as an option to all of our dental phobic patients so that they (not me) can make choices as to their treatment however we always recommend more conservative methods of comfort if at all possible. IV sedation does involve risks.
11. IV sedation is only offered by an Oral Surgeon or an MD-anesthesiologist for dental procedures that I personally perform that require it.
12. Our office fees are the same regardless of whether we treat someone who suffers from dental phobia or they are just seeking excellent dentistry and an amazing overall experience. Our office fees are high and we do not participate as in-network with any insurance plan. We cannot offer our level of dental care at standard insurance fee schedules. In fact I think the high volume dentistry dictated by managed care insurance plans is one reason for the high incidence of dental phobia.
13. Many patients do overcome dental phobia. I can’t honestly say that they will ever enjoy dentistry more than a walk on a Caribbean beach during sunset but we are very successful with our patients.
14. Sensitivity to dental phobia is the basis for creating an office environment conducive to successfully treating these patients.
15. The worst cases of dental phobia that I have successfully treated include: 1) a woman who was raped by a dentist in a dental chair as a teenager, 2) another whose well-intentioned neighbors extracted her painful, bad teeth with a pliers while holding down her arms and legs while living in France during WWII where access to medical care was difficult, and 3) a woman who was so afraid that her non-patient husband came to the first visit without her to see that it would be safe for her.
16. The majority of our practice is focused on treating people who do not have dental phobia but who are seeking a very high level of dentistry.
17. I like getting to really know my patients and in turn sharing my life with them. A lot of my patients become social friends over time so basically my daily work involves seeing my friends all day long. My dental visits start at 60-90 minutes so there is plenty of time for patients to get really numb before we begin treatment and this allows a lot of time to just talk and get to know each other.
18. Yes a lot of patients send gifts of infinite variety. None are necessary but all are most sincerely appreciated.
19. Our practice performs low volume dentistry in a 3,000 square office space on Madison Avenue and 49th Street that only has five dental treatment rooms. In comparison a typical dental office would likely have ten treatment rooms in that size of a space. Accordingly, on average we only see about 15 patients a day across all treatment rooms. My favorite days are frequently when I only see two or three people for much longer than average visits.