Being mindful in dentistry to help dental phobes – a Q&A with Dr Wilfred Koon
Why did you decide to focus on dental phobia, and how were you introduced to ways to help people overcome this?
I have always been someone who cares for other people’s feeling. Whenever I do something I would try to put myself in that person’s shoes and try to imagine how they would feel, and what they would be thinking. So it comes quite naturally for me to be able to relate emotionally to my patients.
What I found common among most dental patients is that almost everyone has some sort of fear or anxiety when visiting the dentist. What is interesting is that everyone’s fear is different, it can affect anyone. Some can endure nine hours of tattoo procedure with no problems, but can’t stand the word dentist. Some are in the military who are trained to endure pain but can’t stand stepping foot into a dental clinic. Some rather suffer the pain from an infected tooth for many months than coming to the dentist to get rid of the pain.
What I realised is that many patients’ dental fear is not only because of pain or needles or drills, but it’s something deeper emotionally. There is a fear of being judged by the dentist, fear or embarrassed to smile, fear of not understanding the treatment explained by dentist or fear of the unexpected. Because of this, dental fear has been misunderstood by many people even dentists themselves, and they are very difficult to identify. Most people will think that someone is scared to go to the dentist because they are a coward, they are a ‘chicken’, or they are being irrational. Even family members can think this. Due to this social stigma and lack of understanding, their dental fear can become even worse.
What is important to understand is that dental fear, like all other types of phobias, is uncontrollable, so its difficult for the patients to control their fear. Hypnosis and psychology sessions may be helpful, but they involved getting patients to control something that is uncontrollable.
At The Point Dental, we never expect patients to control their fear because we know its difficult, we get them to recognise their fear and try to embrace them. What I found really work almost universally to all dental fear patients, is TRUST. By being able to build that instant trust, a patient would be able to really let go of their fear, really be themselves and let the dentist they trust to guide them to achieve optimum dental health.
What percentage of people presenting to a dentist are dental phobes, and what is the prevalence of people avoiding the dentist due to fear?
About one in three have some sort of dental fear, and among those with dental fear, half of them have severe dental fear. (i.e. one in six have severe dental fear).
A clear linear relationship can be found between time since last visit, and the prevalence of severe dental fear. Fear prevalence can increase from approximately 20% for those who visited in the previous two years, to 31% for those who last visited more than 10 years previously.
Can you give us details about your approach?
My passion in helping patients to overcome their dental fear has lead me to explore different ways to make patient’s journey as relaxing as possible. This has been from the way we talk to patients, the treatment plans we organise, our vision for their teeth and their smile, all the way to how we carry out the actual treatment itself. All these would not be possible, if we are unable to put ourselves in patient’s shoes.
To build the trust and help patient with dental fear, a team approach is required. We hire staff based on their personality and the ability to relate to other people. We try to create an environment that is relaxing and welcoming for patients; through design of the clinic, lighting and music. We try to create a very happy and stress free working environment for the staff so that this positive vibe can be passed on to our patients. We take our time so that we are never rushed. We also invest in technology to help patients feel more comfortable. Our dental chairs have memory-foam cushioning.
For patients who are more anxious, we offer sedation to calm them, or for patients who have severe dental fear, we offer in-house general anaesthetic so that all procedures can be completed while they are fully asleep. Our goal is always to minimise the discomfort, and get all the dental work completed at the shortest number of appointments as possible, without compromising the quality and long-term prognosis of our treatment.
Can you tell us about how you transformed your approach?
Prior to setting up my own dental fear centre, I was not able to practice what I wanted as all the clinics that I previously worked in, have a standard ‘drill and fill’ or factory mentality where we see many patients in a day. It was constantly rushing between patients. Whereas now, since starting my centre almost four years ago, I was able to take my time with all my patients. We chat with them, get to know more about them and their fear, organize a proper treatment plan and take our time with all our treatment so that we are not under any pressure. This will ensure we get the best outcome for everyone, and patients really appreciate all these extra efforts.