Dental Anxiety: Dealing with Dental Insurance and Providers

If you have dental anxiety, you know how stressful a dentist appointment can be. Dealing with dental insurance and dentists can just make it worse. As someone who has fairly prominent dental anxiety, here are some tips that will make you feel less alone, and hopefully help make that dental anxiety easier.

First though, what exactly IS dental anxiety?

There’s a clinical term for the fear of dentists: dentophobia. (There’s also odontophobia, but I only saw that one on Google, I’ve never heard it used.) It’s all about fear and anxiety about visiting the dentist.

If you don’t like the dentist, you’re pretty typical. None of us really like to get dental work done, even if we say “hey, it’s fixing the problem.” But if you find yourself incredibly stressed about visiting the dentist, to where you don’t visit at all, or you need to take deep breaths to physically lay still in the chair, you’ve likely got dental anxiety.

It’s important to add here, I am NOT any professional in the field of therapy (any longer) and I was never a dentist or anyone in the dental industry at all. What I’m sharing with you is NOT medical advice in any way, shape or form.

With that out of the way…people with dental anxiety are often very shaky, jumpy or rigid while in the dental chair. We can develop headaches from holding our jaws tight. We may be so jumpy that we accidentally bite the dentist and we may require special accommodations in order to get work done.

Dental anxiety is not just being nervous. It’s being so nervous that you’re freaking yourself out.

What can I do about dental anxiety?

• Tell your dentist and dental team, first and foremost. You are paying them to take care of you, so give them ALL the information they need to do it in the best way possible. It’s not just about your mouth, but your whole body.
• Ask questions about your dental work. If it helps, ask for photos or to see the equipment. (I realize that not everyone wants to see a needle, but the reality is often not as bad as the imagination portrays.) Ask about prep before the procedure, what will happen during the procedure, and all of the after, not just care but how you will feel, look like and how it will impact your life while it heals.
• Even if you are concerned solely about a routine exam or cleaning, these are still valid concerns. Do not let anyone make you feel otherwise. If a dentist or staff members makes me feel ridiculous or dismisses or diminishes my concern, I do not let them do the work, and I find a new dentist.
• If you need to find a new dentist, do a fact-finding phone call. Explain your dental anxiety enough for them to understand what they’ll need to do. They may not be the place for you, and some may tell you that. You may save yourself a visit and/or co-pay by weeding out a facility on the phone.
• Take someone with you, if at all possible. They can encourage you and distract you both before/after. If they are a legal driver, even better. This gives you the option of different sedation if your provider finds it necessary.
• Do your best to relax. I know that the last thing that helps someone relax is being told to do that, but it’s still going to benefit you if you can. You will be able to hold your mouth open further and listen to their instructions better.
• Speaking of holding your mouth open further — I broke my upper jaw/cheek bone years ago. I’m unable to open my mouth as far as they’d like, so I make sure every single person in the room is aware of that. There are pieces of equipment they can use to help make it at least a little easier, and if none are appropriate, they are at least aware and won’t get frustrated with you.
• If you sense frustration before they start, talk to them about it. It’s okay to ask them “I have extreme dental anxiety. I will do my best to do what you need to get this tooth fixed, but I also get super nervous and jittery. Are you good with that?”
• Handle insurance issues BEFORE you get to the office. Make sure you’re aware of any co-pays or deductibles in advance, and ask about contingency or plan B, just in case something goes wrong. The worst time to be handed an $800 bill is when you’re numb and drooling and just want to get home.
• If you are left with any cash outlay, be prepared with your debit card, credit card, or CareCredit card. (That’s a special credit card with just a few purposes, and it’s an odd mix: doggy vet care, and human dental/vision care. Strange, yes, I know, BUT it’s a game changer, as it’s interest-free for a period of time.) If you don’t have funds/cards or don’t want to use them, inquire in advance about a payment plan. A lot of offices offer interest-free monthly payment plans, but handle this before the work is started.
• Know about the pain before it hurts. Ask if it requires solely novocaine, or if you can get nitrous/gas. Often, insurance will not cover nitrous but it can be worth the extra cost. (Last time I paid for it, I believe it was about $110, which for me was worth it.) You probably can drive home after nitrous, which makes it even more appealing, but inquire beforehand. (Again, this is NOT medical advice.) General sedation means you will entirely be asleep, so you will need someone there to take you home. I’ve had offices tell me that that person must be present the entire time of your procedure, not just picking you up; others will call the person 10-20-30 minutes in advance. Ask about this.
• Ask your insurance about coverage of nitrous and/or sedation in advance also. Some will cover depending on your personal medical situation. (For example, we had one cover it years ago for my child with autism, because it was a medical necessity that he get the dental work done but autism doesn’t necessarily allow a child to cooperate as someone neurotypical would.)
• Tell the dentist your personal experience as it applies. I sometimes still feel pain after the typical number of novocaine shots, so now they wait until the initial ones are working, and they give me another. Also, while I do not hate needles and I can tolerate a stick or blood draw without an issue, needles IN MY MOUTH are a different story. They use numbing gel where the shots will go, which does decrease pain somewhat.
• Be sure that the dentist is aware of any/all health issues you have/may have, any current treatment you’re getting and any medication you’re on, in addition to any allergies. One omission could mean a reaction, a contraindication or worse.
• Let your pride go away. Now is not the time to feel you need to be brave. Bravery is great, but if you need headphones or darker glasses or whatever, speak up. They won’t always be able to accommodate you, but at least you can ask. One of my prior dentist offices let me choose the music; another gave me headphones, and another had a TV in my line of sight. If these make the difference between you getting through the appointment or not, speak up.
• Kick your shoes off. Seriously, sometimes little things can be a game changer. Put a blanket on your legs. Hold a fidget. Try to relax. You may want to cut back on your coffee consumption, as long as you don’t get a raging caffeine headache in exchange. And drink your water. Hydration’s important…just hit up the restroom before you get in the chair. (And if you know you can’t make it through the long appointment, tell them to pick a spot halfway that you can get up safely, if at all possible.)
  

I know that’s a lot, but don’t go into a dentist office unprepared. We all have our things. Me, I am nervous pulling into the lot. I yell at a lot of cars on the way there. (In my defense, I save it for those going 45 in the fast lane and other dumb or unsafe things. There are lot of those anymore.) I talk to the hubs via text until I can’t see my phone anymore; he indulges me, though I’m sure there’s a little bit of ‘really?’ going on. I can get kinda panicky, which makes me hyperventilate; luckily, haven’t had that happen since a tool broke off my mouth during a root canal back in 2001. True story. That stuff happens.

I also cannot stand the disgusting gross gel they use to make molds. I have a really low gag tolerance, so I make sure they know this and don’t tilt my chair back as far as they might normally. I’d rather be upright then having that stuff anywhere closer to the back of my throat than it absolutely has to be. I also do not like mint or cherry flavors for their cleaning procedures or anything. Sometimes I have to suck it up, as this is minor stuff, BUT you can still ask if there are other flavors. (One place used to keep bubble gum flavor on hand for me! There are really cool dentists out there. Unfortunately, they retire or you get new insurance and they’re no longer in-network. Dental work is expensive, so if faced with paying 50% or 80%, I prefer the 80% in-network fees.)

At a recent appointment, I was getting a pesky tooth examined by a new specialist. I told her in advance about my autoimmune disorder and my dental anxiety. She seemed to forget it within 60 seconds, because she was poking around and I jumped. She pulled her hands back and rudely said “What?? I’m not even doing anything!” Yes, the mirror was hitting my infected tooth…and again, I just told you I’m really nervous. Her attitude was NOT appreciated, and I did not have her do the work. This is YOUR DECISION to make. I’m sure she billed my insurance, so there may be a call necessary coming up to be sure I’m allowed a second opinion, and if not, I will explain the situation and find out my options. If someone is rude or mean to you while examining, why risk them being the same and disregarding your pain level when they’re pulling a tooth, you know?

In the end, dental anxiety can be debilitating but doesn’t need to prevent you from getting proper dental care. Whatever you do though, remember this: you are not alone, and you should speak up so your providers can do all that’s necessary to help you get through this, as a TEAM.

Don’t feel silly. Don’t let someone blow it off. If someone can’t handle it, there are other dental offices out there. You are worth the time to find someone you are comfortable with.