The White Coat Syndrome

whitecoatBy Farid Noie DDS, DICOI, FAGD, AFAAID

Throughout my 20 years of practicing dentistry, I have encountered numerous cases of fear of dentist. I have eye witnessed the onset of “white coat syndrome” phobia.

Naturally, I have become curious and, at the same time, amazed by this protective mechanism.
A legit fear is a powerful and vital primitive human emotion that plays an important role in keeping us safe. It helps us get out of situations that can potentially harm us. Fear can be classified into two types, biochemical and emotional. The biochemical response is universal, while the emotional response is highly individualized.

Either way, when danger is detected, our brain releases a powerful hormone called Adrenaline into our circulatory system which induces a wide array of responses such as sweating, increased heart rate, and muscle contraction.

This physical response is sometimes known as the “fight or flight” response, in which the body prepares itself to either enter combat or run away. This biochemical reaction is an autonomic response and is crucial to survival. Fear is usually based on a negative personal experience with the matter in question. Sometimes fear is learned from someone else, such as a child who is afraid of the dentist because of his parents’ or friends’ reactions.

While a legit fear is induced by a clear and present danger, emotional fear is normally triggered by perceived or probable danger. This type of fear is not as straight forward as legit fear. Probable fear is subject to personal interpretation, which is heavily influenced — not necessarily by facts — but often by our unique perception of fact. Under normal circumstances, fear can be managed through reason and logic. It will not take over our lives or cause us to act irrational.

While it is useful to drive defensively to avoid accidents, it is harmful to be so worried about getting in a car accident to avoid driving all together. At some point any legit fear can becomes irrational. Many people get nervous at the thought of needles in their mouth. Others shriek at the sight of a mouse. Still some others get woozy when they see blood. Most people learn to manage these fears. But a phobia is an intense emotional fear of something that, in reality, poses little or no actual danger.

Some of the common phobias include fear of dentist, closed-in places, heights, highway driving, flying, insects, snakes and needles. Most phobias develop in childhood, but they can also develop in adults. Many confuse the phobia with the silly and senseless fear and view it in a negative way. This common belief has caused many with phobia to feel ashamed of their condition and either avoid or deny it.

In case of a dental visit, even if you go through with it, you will sweat, shake, cry or have other serious physiological responses. You will likely be miserable during the entire appointment. If your phobia is more severe, you will simply be unable to go. You will go far out of your way to avoid a dental office.

It is important to consider the source. If you have a simple fear, you will not spend much time thinking about that fear. It will only affect you when you are forced to confront it. If you have a phobia, you are likely to develop a fear of fear itself. You may begin to worry that something will happen to trigger your fear. You may start to change your daily routine in an effort to avoid any possible triggers. If you know that you have an upcoming appointment with your dentist, you will likely dwell on it, perhaps obsessively. You may have trouble sleeping or focusing on important tasks, particularly as the day of appointment draws closer.

These emotional fears or phobias are highly personalized. Repeated positive exposure to situations that normally lead to phobia, gradually changes the perception of them. This greatly reduces both the fear response, and, over time, results in elation. It also forms the basis of some phobia treatments, which depend on slowly minimizing the fear response by making it feel safe.

In case of phobia of dentist, I have found that performing the necessary dental work under deep conscious sedation can achieve that goal. Many of my patients with severe phobia were able to overcome their emotional fear after several dental treatments under the positive experience of I.V. Sedation.

If you or your loved one is avoiding routine dental check up and essential treatment due to fear of dentist please contact my office at 281-332-4700 and schedule a complimentary consultation to determine if I.V. Sedation dentistry is right for you.

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