Helping a Teenage Patient Overcome His Dental Fear

I recently saw a patient of mine who’s been with me since the summer after I got out of dental school. I know that I’ve grown a bit (a lot!) since those early days, but is there anything cooler than seeing our patients grow and mature, not just as dental patients — phobias and all — but as people, adults and role models? I’ve been at this for a short six years, so I can only imagine what some of you have experienced in your careers. 

So about my patient, Bob*.

Bob came to me so scared of dentists that he barely let me use an intraoral mirror during my initial exam. He also was a teenager, 17 years old, and his fright was compounded by an attitude of not really caring to be at the dentist in the first place. As I peeled back the layers, I found that there was more under the surface.

Bob had been to see a general dentist who didn’t really care to know more about him than, “This patient in room five needs a mesiocclusodistal (MOD) on No. 14 and a crown on No. 3, with nitrous — lots of nitrous.” This certainly didn’t help to improve Bob’s demeanor. After a visit to said dentist, his mom brought him to me for a second opinion. As I talked Bob through his fear, I realized that he didn’t care about the cavities in his mouth. “Yeah, so what,” I remember him saying. Then, “It doesn’t hurt, so I’m not letting you do anything.” Bob was congenitally missing Nos. 7 and 10 and had been through an ill-fitting flipper for years, only to be told he didn’t have room for implants by his last dentist. That pushed him further into his mistrust and unhappiness with dentists. He was unwilling to go through ortho again, so we discussed his options, and it was clear to me then that this esthetic issue was central to his disdain for dentists in general.

I outlined a plan for Bob. We prioritized his issues with some caries control restorations on posterior teeth, allowing us to delve into his anterior esthetics sooner. I saw him six months after we completed the anterior stage, and he was a different person in my chair. He called to schedule the appointment (not his mom!) and said, “Take care of whatever needs to be fixed.” This was a vastly different response from the ones he gave me as a 17-year-old! We continued with definitive restorations and have been ever since.

Fast-forward to now: Bob, who I remember as the shy, angry teen who shook at the thought of an intraoral exam or X-ray, was dressed to the nines! Dress shirt, shoes, new glasses and a smile on his face! He shook my hand, and I honestly did a double take at my computer screen schedule to make sure I was in the correct operatory. This was not the Bob I remembered. We sat and chatted for a bit. He’s now 23, just bought his first house and is moving to Rochester, Minnesota, to work in information technology at Mayo Clinic. He eventually would like to take classes to become a nutritionist there. I was blown away!

Sure, we play a pretty tiny part in people’s lives. But you know what? We’ve had the opportunity to do dentistry with a purpose. It’s not just about an MOD on No. 4 and a crown on No. 3 (sans nitrous for Bob now, by the way); it’s about fostering mutual respect with the people under our care with a positive attitude. It’s not just about production, overhead and profit. It’s about improving the lives of these individuals, however small of an influence we may have — so that one day when we sit down beside them to chat, we are blown away at the person sitting in front of us. How rewarding is that?!

I didn’t do anything special with Bob. Heck, I don’t do anything special with most of my patients. I just treat them with respect. It’s the least they deserve, and you’ll be impressed at the consequences of your actions — not just to your patients, but to yourself — when you do that.

*The patient’s name has been changed for publication.



Donald Murry III, DMD