Dental Phobia - Not sure, could be physical too.

[mommysboy]

Over the past decade a trip to the dentist has become increasingly problematic. I can't say I suffer a phobia for sure, but of course I have the same reticence as I guess everyone has at the prospect. In my younger years I just got through. I have had a heck of a lot of work done over the decades. And some of my teeth can not be numbed.

Last Friday I had some dental work done. The drilling itself was not a problem as the injection worked 100%. I didn't feel a thing. But water kept shooting down on to my tonsils and I kept gagging. It got worse and worse. I felt like I was choking. But it was short lived and got the job done.

Today I went for a de-scale. It was problematic from the outset and I was very soon unhinged. Every time that drill got near my gums I was wincing. What was worse is that the gagging started immediately and was more intense than before. I think something produces a very bad post nasal drip. I can't swallow and I almost feel like I am drowning/choking. And when some spray hits the back of my mouth, I am in real trouble. The dentist was very good and suggested freezing a part of my mouth and doing it in stages. Unfortunately this made the swallowing problem even worse. It feels like paralysis. It was quite frightening.

Thinking about it now, I think the main problem seems to be the post nasal drip. It's been a constant problem for the last 30 years and is untreatable and unstoppable, but thankfully mainly low level.

Anyway we had to stop. I just couldn't continue and I doubt it was doing the dentist much good either. I don't suppose there is anything I can do and it looks like I'm in for a world of dental pain here on in. Currently my teeth are pretty well up together. I was just posting hoping someone could come up with an idea or two to get me through the odd bit of dental work every year or two.

[phetphet]

Maybe search for a dentist that specialises in treating patients with phobia. Or maybe consider mild sedation.

Not much info, but there was a similar thread: http://www.thaivisa.com/forum/topic/785862-dentist-for-very-nervous-patient/

[mommysboy]

Maybe search for a dentist that specialises in treating patients with phobia. Or maybe consider mild sedation.

Not much info, but there was a similar thread: http://www.thaivisa.com/forum/topic/785862-dentist-for-very-nervous-patient/

Thanks for your information and interest.

I have done a bit of googling and it seems likely that part of the problem at least comes under the general heading 'gagging and choking' and blocked airways seems to be a primary cause. There are a number of worthwhile looking strategies and cures at dentalfearcentral.org, which looks a sound site.

The 'phobia' aspect is worth looking at. For the moment I just need to settle down a bit. Dentistry has always been a bit hit and miss for me. Being unhinged by the drill seems nearly always to be the root antagonist (pun intended). Getting panicky probably worsens the gagging. I can tolerate some pain, for instance the injection is hardly pain in my books, nor the odd slip of the drill.

I paid for today's work and apologized for the situation, so at least I don't need to feel so guilty.

It could be a simple solution like a good nasal rinse and a squirt of nasoline.

I feel utterly stupid at present. What a bother!

Edited April 10, 2016 by mommysboy

[phetphet]

I hate needles, and my old dentist (a) used to rub some sort of anaesthetic gel on my gums to deaden any sensation, and ( block my view with his other hand before putting the needle in my mouth.

The last guy was nowhere near as good, and I was trying to slide out the top of the chair.

Another option might be hypnosis, if you believe in it, which I think is a big part of its effectiveness.

Or you might ask the dentist to let you hold and use the suction tube yourself. For descaling, they are not using a drill, but normally an ultrasonic water pick.

Like a small, high pressure water pistol which loosens and blasts away the tartar. I say that in case knowing it's not a drill might help you relax.

Edited April 10, 2016 by phetphet

[johnatong]

As a matter of fact deaths from gagging, choking or blocked airways occurring in modern day dental practice are virtually non existent.

You have a problem, which if severe, might be helped by consulting a psychologist.

[ripstanley]

I also suffer from the feeling of gagging and choking. It is especially when the drill is in operation. I had one dentist say to me "If I had 10 patients like you I would quit" This was on a remote island in Australia.His solution was to prescribe me valium. I would take one tablet before my dental visit and it relaxed me. This solved my problem. I now how you feel. I hope this helps.

[mommysboy]

I hate needles, and my old dentist (a) used to rub some sort of anaesthetic gel on my gums to deaden any sensation, and ( block my view with his other hand before putting the needle in my mouth.

The last guy was nowhere near as good, and I was trying to slide out the top of the chair.

Another option might be hypnosis, if you believe in it, which I think is a big part of its effectiveness.

Or you might ask the dentist to let you hold and use the suction tube yourself. For descaling, they are not using a drill, but normally an ultrasonic water pick.

Like a small, high pressure water pistol which loosens and blasts away the tartar. I say that in case knowing it's not a drill might help you relax.

Interesting! 'a high pressure water pistol'. Did this come in about 10-15 years ago, because this is when the problem started? It feels like apray is hitting the back of my tongue.

It really is genuine gagging and choking on water and phlegm. I can't breathe, it's like when you have a cold and can't swallow for an awful couple of seconds. I don't think it is psychological really.

Regarding injections: personally it doesn't bother me at all, but I can understand why people are squeamish.

[inbangkok]

I agree with the above post. Valium or another sedative should fix the problem. Personally, does not sound like a phobia to me..... Just someone who has a very tough time at the dentist.

Many dentists in America will provide Valium for issues like this.

Edited April 10, 2016 by inbangkok

[mommysboy]

As a matter of fact deaths from gagging, choking or blocked airways occurring in modern day dental practice are virtually non existent.

You have a problem, which if severe, might be helped by consulting a psychologist.

But we're not talking about death!!

We're talking about a gagging response from the build up of water and phlegm. How can a psychologist help?

I suppose if I walked past a clinic and experienced the symptoms, or broke out in a panic attack at the white coat then that would be a phobia proper. Perhaps I should have chosen th thread title a little more wisely.

Edited April 10, 2016 by mommysboy

[phetphet]

These show what I meant: https://www.youtube.com/watch?v=BcHH8xdyvhM https://www.youtube.com/watch?v=ZG6cBDuXXLE

[lemonjelly]

I always close my throat with the base of my tongue and breathe through my nose.

[mommysboy]

These show what I meant: https://www.youtube.com/watch?v=BcHH8xdyvhM https://www.youtube.com/watch?v=ZG6cBDuXXLE

Well having that thing in my mouth is the primary cause of the problem. My gums are receeding a bit and I can't have it at the base of my teeth at all, and it seems to produce a hell of a lot of spray. Progress for who ? For much of my life I just went along to a hygenist. It wasn't a pleasant experience but nothing on the present scale.

When it comes to matters dental, if it wasn't for bad luck I would have no luck whatsoever. My teeth decayed quickly, and I seem to have irregular nerve patterns. I used to feel sorry for my gran when she explained they gave her gas and took all her teeth out when she was young. Reckon, it saved her a lifetime of bother.

Still, I can see a strategy. But I don't think they easily give out valium in Thailand. I have never taken it before. Hopefully that will temper the psychological side. perhaps being treated at the hospital dentist would be better. I imagine they can provide a wider service.

[Bantex]

Last Friday I had some dental work done. The drilling itself was not a problem as the injection worked 100%. I didn't feel a thing. But water kept shooting down on to my tonsils and I kept gagging. It got worse and worse. I felt like I was choking. But it was short lived and got the job done.

I have a friend who has this problem. He spoke to the dentist about it and they agreed that if my friend felt he was about to gag, he would raise his hand and the dentist would either stop briefly or use the suction nearer his throat. My friend still has the problem but now knows he's in charge whilst in the dental chair and can relax a little.

[DogNo1]

Yeah, I had a cleaning the other day and I had trouble getting the dentist and her assisant to suction away the water that collected at the back of my throat. I coughed up quite a lot of phlegm for the afternoon and evening after that procedure. My dentist did use a DRILL to clean around the teeth. My dentist in Japan uses an ultrasound device whic is less irritating.

[senor123]

Last Friday I had some dental work done. The drilling itself was not a problem as the injection worked 100%. I didn't feel a thing. But water kept shooting down on to my tonsils and I kept gagging. It got worse and worse. I felt like I was choking. But it was short lived and got the job done.

I have a friend who has this problem. He spoke to the dentist about it and they agreed that if my friend felt he was about to gag, he would raise his hand and the dentist would either stop briefly or use the suction nearer his throat. My friend still has the problem but now knows he's in charge whilst in the dental chair and can relax a little.

I have a similar problem with the Dentist suggesting the same solution. Now the Dentist puts some sort of rubber dam in my mouth to stop everything going down my throat and I also breath heavily through my nose. I sympathise with you and I just put my hand up when I feel I can't control it anymore. Seems to work, more or less.

[ricklev]

I have a similar problem. I've found that holding the suction wand myself really helps.

[Tapster]

@mommysboy

What a username........if you hadn't more than 3,000 posts to your name I might have thought that you chose this name just for this thread.

Anyway, despite the above comment (I mean, you left yourself wide open to it!) I have been a dentist in the UK for 24 years and would be happy to exchange a few private messages and maybe help you with this.

For instance..........I never have my teeth cleaned by a hygienist or dentist. It hurts me too much. My teeth are quite sensitive after many years of brushing 3 times a day (when working as a dentist, it's necessary...I think.)

But, unless you have gum disease and need scrupulous maintenance, it may be possible to avoid all that unpleasantness. I maintain my teeth and gums without professional cleaning.

And, if the local anaesthetic works, and you don't feel a thing, and you're OK with that, the rest can be dealt with relatively easily.

No more for now, unless you want to discuss this in 'open session'.

All the best.

[arjunadawn]

Of the few things you mentioned one stands out to me, as I have something similar. You describe something regarding the posterior throat, the oropharynx. What you describe is similar to my own situation and while I go to the dentist and suffer through it, it is not the pain, its the distress that I am drowning in the back of my throat, cant swallow, cant breath, etc. Its not just that the gag reflex is sensitive its as if it really is gagging- closing. I have a possible cause.

The internal diameter of a pipe, a tube, a needle, a throat... is called a lumen. A lumen is the inside space. A typical 90kg male should have a certain size (this is evident from the endotracheal tube sizes that paramedics carry). However, some people, like me and maybe you, have a smaller lumen size. Someone like this would suffer more from post nasal drip as the nasopharynx and oropharynx are continuous.

I am just telling you brother. Your complaints sound exactly like mine. It would be curious to know about your sleeping- snoring, etc. I would imagine its quite robust if you struggle to breathe through that lumen/airway after your tongue has relaxed. Hope not but...

In any event, you should always ensure your dentist is 100% aware you operate just this side of that border called distress. Ask to use the min amount. Better to have more little injections then one long lasting one. Good luck. I feel for you.

[1FinickyOne]

Ever since these high speed drills, with plenty of water, I have had a gagging issue as well... though I could have a gag reaction to an x-ray going in at my back teeth... I think a gag reaction is not unusual... I have found that some dental assistants are better at keeping the water levels very low and others not..

I can tough it out but if I begin to feel like I am going to gag, I just hold up my hand - and the dentist will give me a moment to take a break... it is nice to be a good patient but you are also a customer... and you are surely not the first to have a gagging problem.

[bazza40]

Gagging is a reflex which seems to increase with age. I ask the dentist to instruct the assistant to use the suction wand below my tongue, not above it. Or ask to use the wand myself.

[mommysboy]

Of the few things you mentioned one stands out to me, as I have something similar. You describe something regarding the posterior throat, the oropharynx. What you describe is similar to my own situation and while I go to the dentist and suffer through it, it is not the pain, its the distress that I am drowning in the back of my throat, cant swallow, cant breath, etc. Its not just that the gag reflex is sensitive its as if it really is gagging- closing. I have a possible cause.

The internal diameter of a pipe, a tube, a needle, a throat... is called a lumen. A lumen is the inside space. A typical 90kg male should have a certain size (this is evident from the endotracheal tube sizes that paramedics carry). However, some people, like me and maybe you, have a smaller lumen size. Someone like this would suffer more from post nasal drip as the nasopharynx and oropharynx are continuous.

I am just telling you brother. Your complaints sound exactly like mine. It would be curious to know about your sleeping- snoring, etc. I would imagine its quite robust if you struggle to breathe through that lumen/airway after your tongue has relaxed. Hope not but...

In any event, you should always ensure your dentist is 100% aware you operate just this side of that border called distress. Ask to use the min amount. Better to have more little injections then one long lasting one. Good luck. I feel for you.

One main factor for me is post-nasal drip. I should never have gone ahead with the appointment. I think my sinuses were clearing right at the point of treatment. I really should have been more aware and responsible. Put myself through needless discomfort and I really let the dentist down too. Not good at all, but it was a genuine oversight. I have apologized to the dentist.

Yes I can relate to what you are saying, however, the poiny of extreme blockage seemed to be around the adenoids. It was a peculiar and quite disturbing experience. In the end I was quite frightened I must admit. Waterboarding move over.

[mommysboy]

@mommysboy

What a username........if you hadn't more than 3,000 posts to your name I might have thought that you chose this name just for this thread.

Anyway, despite the above comment (I mean, you left yourself wide open to it!) I have been a dentist in the UK for 24 years and would be happy to exchange a few private messages and maybe help you with this.

For instance..........I never have my teeth cleaned by a hygienist or dentist. It hurts me too much. My teeth are quite sensitive after many years of brushing 3 times a day (when working as a dentist, it's necessary...I think.)

But, unless you have gum disease and need scrupulous maintenance, it may be possible to avoid all that unpleasantness. I maintain my teeth and gums without professional cleaning.

And, if the local anaesthetic works, and you don't feel a thing, and you're OK with that, the rest can be dealt with relatively easily.

No more for now, unless you want to discuss this in 'open session'.

All the best.

I don't know why I chose mommysboy all those years ago, but it was a bit tongue in cheek. It would incite some to immediate hatred, and kind of suited at the time as I used to indulge in some fearsome exchanges.

I've never really looked after my teeth in a pro-active way, just 2-3 brushes a day. In the future I will take your advice. The appearance is secondary anyway, and the main thing is to keep on top of the important work. Over the decades pretty much all my molars and a couple of front teeth have been drilled, filled, redrilled, refilled, and I now mostly have crowns, some of which are second crowns. Mostly injections worked, but I had a few very nasty experiences with lower jaw teeth that simply could not be numbed. There was no apparent reason.

I now really find myself with very limited tolerance to the drill. I go there with resolve, but after one, two, or three shocks, I must admit my resolve completely crumbles and I start shaking. I think it is all too easy for me to be effected by the few occasions when I really did suffer. I really ought to be able to ride a bit of pain, but can't and this is the main issue. In this sense I have a phobia, but I don't think it can be classified as such.

I do have a great deal of admiration for dentists and I realise it is a really tough job.

[mommysboy]

Of the few things you mentioned one stands out to me, as I have something similar. You describe something regarding the posterior throat, the oropharynx. What you describe is similar to my own situation and while I go to the dentist and suffer through it, it is not the pain, its the distress that I am drowning in the back of my throat, cant swallow, cant breath, etc. Its not just that the gag reflex is sensitive its as if it really is gagging- closing. I have a possible cause.

The internal diameter of a pipe, a tube, a needle, a throat... is called a lumen. A lumen is the inside space. A typical 90kg male should have a certain size (this is evident from the endotracheal tube sizes that paramedics carry). However, some people, like me and maybe you, have a smaller lumen size. Someone like this would suffer more from post nasal drip as the nasopharynx and oropharynx are continuous.

I am just telling you brother. Your complaints sound exactly like mine. It would be curious to know about your sleeping- snoring, etc. I would imagine its quite robust if you struggle to breathe through that lumen/airway after your tongue has relaxed. Hope not but...

In any event, you should always ensure your dentist is 100% aware you operate just this side of that border called distress. Ask to use the min amount. Better to have more little injections then one long lasting one. Good luck. I feel for you.

I neglected to answer about my sleep issues: once or twice a year (more often when I lived in Bangkok) I wake up in quite some fear, as I can't swallow or breathe. My throat and andenoid area feels seized, and my mouth is as dry as a bone. I have to force myself to swallow. I don't snore much if at all, only when my nose is very blocked, which is not often now. Quite often when I lie down to go to sleep at night, I have an unpleasant but fairly low level post nasal drip, of the sort one experiences after a cold.

I have been a regular poster about non-allergic rhinitis and sinus blockage. I have sought help many times and chronic infection has been ruled out. The common remark is very inflamed nasal passages. Come to think of it nasoline helps, and Beconase for longer term use. I haven't used either for a while, hasn't been any real need.

[inbangkok]

Of the few things you mentioned one stands out to me, as I have something similar. You describe something regarding the posterior throat, the oropharynx. What you describe is similar to my own situation and while I go to the dentist and suffer through it, it is not the pain, its the distress that I am drowning in the back of my throat, cant swallow, cant breath, etc. Its not just that the gag reflex is sensitive its as if it really is gagging- closing. I have a possible cause.

The internal diameter of a pipe, a tube, a needle, a throat... is called a lumen. A lumen is the inside space. A typical 90kg male should have a certain size (this is evident from the endotracheal tube sizes that paramedics carry). However, some people, like me and maybe you, have a smaller lumen size. Someone like this would suffer more from post nasal drip as the nasopharynx and oropharynx are continuous.

I am just telling you brother. Your complaints sound exactly like mine. It would be curious to know about your sleeping- snoring, etc. I would imagine its quite robust if you struggle to breathe through that lumen/airway after your tongue has relaxed. Hope not but...

In any event, you should always ensure your dentist is 100% aware you operate just this side of that border called distress. Ask to use the min amount. Better to have more little injections then one long lasting one. Good luck. I feel for you.

I neglected to answer about my sleep issues: once or twice a year (more often when I lived in Bangkok) I wake up in quite some fear, as I can't swallow or breathe. My throat and andenoid area feels seized, and my mouth is as dry as a bone. I have to force myself to swallow. I don't snore much if at all, only when my nose is very blocked, which is not often now. Quite often when I lie down to go to sleep at night, I have an unpleasant but fairly low level post nasal drip, of the sort one experiences after a cold.

I have been a regular poster about non-allergic rhinitis and sinus blockage. I have sought help many times and chronic infection has been ruled out. The common remark is very inflamed nasal passages. Come to think of it nasoline helps, and Beconase for longer term use. I haven't used either for a while, hasn't been any real need.

I am having nasal surgery after Songkran due to chronic, non allergic rhinitis. One of my nasal passages is often swollen completely shut. It is called turbinoplasty surgery. It is supposed to be pretty minor and the Dr said he should be done in 30 min (60 min at max). I will let you know how it works out. The Dr said most patients get pretty good results.

[DogNo1]

As I've gotten older, the ability to close my glottis and just breathe through my nose has weakened. My problem is complicated by a hyatal hernia and GERD. Various medical websites say that it is common for older people to have weakened control of the throat.

My problem with getting water into my lungs when I recently had my teeth cleaned was that neither the dentist nor the assistant seemed to comprehend what I wanted despite various stops and detailed instructions. I won't be using that dentist again but I was in a dilemma about whether to continue with the cleaning or stop it and walk out. I always feel lousy after I do something dramatic so I chose to continue.

[Sheryl]

Dear MB,

Having just been through a root canal, I know exactly what you describe...but it is, indeed, a mind trick (though one that if you don't overcome it, may cause you to actually start gagging)

I too immediately feel like something is at the back of my throat almost as soon as they lower the chair. I find if I allow myself to focus on that and believe I can't swallow/can't breathe, it juts gets worse and worse. If I force myself to think of something else, it helps. It also helps to keep telling myself that although it feels like I can't breathe, in fact I am breathing just fine through my nose (and take a few deep conscious nasal breaths to prove it to myself). And though it feels like I'm choking, in fact I am not, and furthermore it is even still possible to swallow deeply in the throat (again, test it out to prove to yourself...the swallowing will not remove the feeling of something in the back of your throat, that you just have to live with for the duration of the procedure, reminding yourself constantly that while it feels alarming there is in fact no cause for alarm. But you will be able to make a swallow motion deep in your throat despite your mouth being out of commission, and I found that fact reassuring).

It is basically a matter of mentally talking yourself through it. What is happening is that you are automatically reacting to certain physical sensations with alarm, which is natural, but in this situation those sensations do not mean what your brain is hard wired to think they do.

Try it. I was able to get through 3 sessions of 1 1/2, 1 1/2 and 2 hours like this, so can you. The alternative is unnecessary sedation which does in fact add risks (and should only be done in a hospital).

The principal is the same as managing anxiety. In anxiety, you have physical sensations identical to those you have when in physical danger. Your brain automatically interpret this to mean you are in danger and releases more epinephrine, making you more anxious and it becomes a spiral. The way out is to mentally step in and firmly tell yourself that despite these sensations there is, in fact, no threat present, it is all just a misunderstanding between the brain and the nervous system.

[NickJ]

I developed an exagerated gag reflex over the last few years. When I was having a crown done and had to do the mold. I had the chair brought up a bit and lifted my arms above my head. Sounds stupid but for some reason it can supress the reflex to a degree.....maybe hard to do for a long time though.

[NancyL]

Recently, I had a series of extensive dental procedures that involved at least three sessions of three hours or more in the dental chair. I found the two techniques that Sheryl and NickJ mentioned helped much, along with taking an antihistamine/decongestant before the appointment to cut down on post nasal drip. I did take a xanax before one appointment, but found myself falling asleep and the dentist kept telling me to open my mouth wider, so I decided that wasn't really necessary for future appointments.

They put a cloth over my face with just an opening for the mouth. That keeps my face clean and also serves to keep me from seeing what's going on. I'm OK with this, as long as my nose isn't covered.

[mommysboy]

Dear MB,

Having just been through a root canal, I know exactly what you describe...but it is, indeed, a mind trick (though one that if you don't overcome it, may cause you to actually start gagging)

I too immediately feel like something is at the back of my throat almost as soon as they lower the chair. I find if I allow myself to focus on that and believe I can't swallow/can't breathe, it juts gets worse and worse. If I force myself to think of something else, it helps. It also helps to keep telling myself that although it feels like I can't breathe, in fact I am breathing just fine through my nose (and take a few deep conscious nasal breaths to prove it to myself). And though it feels like I'm choking, in fact I am not, and furthermore it is even still possible to swallow deeply in the throat (again, test it out to prove to yourself...the swallowing will not remove the feeling of something in the back of your throat, that you just have to live with for the duration of the procedure, reminding yourself constantly that while it feels alarming there is in fact no cause for alarm. But you will be able to make a swallow motion deep in your throat despite your mouth being out of commission, and I found that fact reassuring).

It is basically a matter of mentally talking yourself through it. What is happening is that you are automatically reacting to certain physical sensations with alarm, which is natural, but in this situation those sensations do not mean what your brain is hard wired to think they do.

Try it. I was able to get through 3 sessions of 1 1/2, 1 1/2 and 2 hours like this, so can you. The alternative is unnecessary sedation which does in fact add risks (and should only be done in a hospital).

The principal is the same as managing anxiety. In anxiety, you have physical sensations identical to those you have when in physical danger. Your brain automatically interpret this to mean you are in danger and releases more epinephrine, making you more anxious and it becomes a spiral. The way out is to mentally step in and firmly tell yourself that despite these sensations there is, in fact, no threat present, it is all just a misunderstanding between the brain and the nervous system.

This a very astute posting which seems to 'hit the nail on the head' for me.

In particular, the following seems to resonate throughout my life to a greater and lesser extent : "The principal is the same as managing anxiety. In anxiety, you have physical sensations identical to those you have when in physical danger. Your brain automatically interpret this to mean you are in danger and releases more epinephrine, making you more anxious and it becomes a spiral. The way out is to mentally step in and firmly tell yourself that despite these sensations there is, in fact, no threat present, it is all just a misunderstanding between the brain and the nervous system".

In some way then, the difficulty in the chair is no more no less the difficulties I have in overcoming difficulties in life.

But there is a physical element and I do feel hopeful the breathing techniques will help. You know, I simply wasn't breathing through my nose. I'd gone in to panic mode, like I used to do before I learnt to swim.

There is a breathing exercise I can practice at home, which is simply lying down with mouth wide open, and exercising the same sort of thing Sheryl describes as the phlegm builds up. Ironically, the post nasal drip might actually come in handy for once.

[Sheryl]

May also help to practice very deep, slow breathing through the nostrils