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If you have had difficult dental experiences, you may be among the 150 million Americans who white-knuckle their way through treatment, or avoid the dentist altogether. The fact is, about 80% of the fearful can overcome dental phobia, with a little help from conscious sedation.

Many dentists understand dental fear and where it comes from. And many are becoming trained in forming good working relationships with fearful patients. Your dentist should encourage you to voice your anxiety and discuss your problems with him or her, before he or she touches a tooth in your mouth.

If you (or someone you care about) has an appointment that’s beginning to darken your thoughts, try this: First focus on the specifics of your dental fear. Is it the procedure in general, or a particular piece of equipment, or a vague sense of invasion of the privacy of your mouth? Once you’ve got it pinned down, talk with your dentist about it. If it’s general dental anxiety, your dentist can help you feel better. If it’s concern over a specific instrument or technique, often your dentist can change the way he does things.

They should listen to your needs, and agree on small things that help you maintain a sense of control – a hand signal works with some patients. But talking about fear with your dentist – being assertive and letting him or her know what bothers you – is the first step. You can help the “pre-op jitters” by avoiding stimulants (coffee, cocoa, sugar) six hours before your visit. And concentrate on breathing naturally; denying yourself oxygen increases anxiety.

Many times, the worst part of a procedure is the anxiety a patient endures before even climbing into the chair. It’s a problem that’s preventable, and your dentist would like to help you with that right now.

If you’re moderately anxious, the dental team can provide distracting diversions to put those concerns to rest. If you’re extremely anxious, they can virtually put anxiety to rest via oral sedation. This approach involves taking a mild sedative before you arrive for your appointment. You remain awake, but extremely relaxed – so relaxed that many patients have all their needed dental work completed in a single office visit. If dental anxiety has kept you from making an appointment you know is needed – a sedation dentist can help!

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The proverbial way of referring to older people as being “long on the tooth” suggests that it is predetermined that as we get older our teeth get “longer” or “no longer.” This is not true. Periodontal disease and loss of teeth is not an inevitable aspect of aging. Loss of attachment or bone support around a tooth is the result of a bacterial infection. What is true is that as we get older, we have more exposures to these infectious organisms, and more probability of being infected and developing periodontal disease. Half of the people over 55 have periodontal disease.

Risk factors that make older adults more susceptible to periodontal disease include:

Systemic diseases:

Certain systemic diseases such as diabetes may decrease the body’s ability to fight infection and can result in more severe periodontal disease. Osteoporosis also can increase the amount and rate of bone loss around teeth. Systemic illnesses will affect periodontal disease if it is a pre-existing condition. To reduce the effects of systemic diseases on the oral cavity, maintain meticulous plaque control and visit your dental care provider routinely for examinations and professional cleanings.

Medications:

Heart medications can have a direct effect on the gums by creating an exaggerated response to plaque and resulting in gum overgrowth. Antidepressants may create dry mouth and reduce the saliva’s ability to neutralize plaque. Immunosuppressants and other disease-fighting medications may reduce the body’s ability to combat infection, increasing the risk for periodontal disease. The dental care provider needs to be aware of any medications you may be taking and you need to maintain meticulous plaque control and visit your dental care provider routinely for examinations and professional cleanings.

Dry mouth:

Lack of saliva can result from the use of certain medications or as a result of illness. If there is not enough saliva available to neutralize plaque it can result in more cavities and periodontal disease. Also, dry mouth, or xerostomia, can make dentures more difficult to wear and may also complicate eating, speaking, or swallowing of food. Oral rinses or artificial saliva can be very helpful with these problems. Frequent sips of water or eating candy may be helpful as long as it doesn’t contain sugar. Fluoride rinses and gels are helpful in reducing or preventing the cavities that can be caused by having a dry mouth.

Dexterity problems:

Physical disabilities can reduce dexterity and the ability to remove plaque on a daily basis. Poor oral hygiene can increase the risk for cavities and periodontal disease. Electric toothbrushes and floss holders are helpful in improving plaque control. Frequent professional cleanings combined with oral anti-microbial or fluoride rinses also may be helpful in reducing the incidence of cavities and periodontal disease.

Estrogen deficiency:

Older women may have some special concerns in relation to periodontal disease. Scientific studies have suggested that the estrogen deficiency that occurs after menopause may increase the risk for severe periodontal disease and tooth loss. Estrogen replacement therapy may reverse these effects.

It is important to keep teeth as we age because every tooth has an important function in chewing and speaking. They affect our appearance and self esteem. Having dentures or loose or missing teeth can restrict our diets, resulting in poor nutrition and systemic complications. With the advances in modern dentistry and with current prevention and treatment techniques, we must count on keeping our teeth for a lifetime – no matter how “long” that may be!

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