Panic Attacks At Dentist

[TiredofFear]

Just wondering if any of you have difficulties with going to the dentist. I have really bad emetophobia; it's probably about the worst that it's ever been. I've had it for many years. I started seeing a new dentist last year because of my emet. I thought this dentist might be able to help more with my gag reflex. Anyway, one time I was there and had a panic attack when in the chair and was shaking so hard. I don't really know what brought it on. I had to pee bad, and maybe I was worried I'd have an accident or something because I couldn't get up. I don't know why as I never have had an accident before, but anxiety is irrational. Ever since then, I have a panic attack every single time I go to the dentist. I'm nervous that I'm going to have a panic attack...which leads to a panic attack. While the first panic attack was not related to my emet, it seems that any panic attacks that have followed are. I have this fear of vomiting, and to me it is literally the worst thing in the world. Even worse to me than vomiting, is the thought of vomiting in public. I know that isn't rational, but I can't help it. I have this fear that laying down in this confined space with whatever equipment the dentist has in my mouth that I will vomit. I just had an appointment yesterday and was shaking "like a leaf" (the girl said). Ugh. It's horrible. Every time I go to the dentist now I'm worried that I'll have a panic attack (which I do), and then I'm worried that I'll vomit. It's embarassing because I shake so hard and can't stop.

Does anyone else have trouble at the dentist due to emet?

[rakastan]

I sometimes have trouble, and sometimes don't. It sounds like you've conditioned your brain to see the dentist as a dangerous place. I'm not sure how you'd get out of that loop. Maybe keep reminding yourself that you've always been fine. Or have someone give you a ride, and take so much Benadryl (an antiemetic as well as allergy medicine) that you can barely stay awake. Then, if you don't have a panic, you're on the road to not seeing it as dangerous. Of course, I'm not a professional. So that might not be the healthiest way to deal. But it's what I'd do!

[Maddie-_-]

Funny you say this, I went to the dentist today. Brilliant. I have to have something like 3 fillings, that new blue stuff and a brace but on. WHOOP WHOOP right? I have never liked the dentist though, but me being vane I will put up with it for nice teeth

[staystrongxx]

I have an extreme fear of the dentist. I cry when they try to do x-rays. I had some bad experiences at the dentist when I was younger, as a child I had a creepy dentist who would not allow parents in the room. They yelled at me when I spit fluoride out onto the floor because it made me gag (I was 8). A year or 2 later I went back because I had a tooth that had migrated down below my other teeth instead of falling out. They gave me numbing gel and made me pull it out myself, in the waiting room. We never went back. I have a lot of cavities, and getting them filled was hell...I had to take Ativan and Benadryl in order to be calm enough to go.

You are definitely not alone on this.

[TryingToBeBrave]

My advice is to talk to your dentist. My mom had a hard time being confined and panicking, and I believe they had an agreement that she knew she could get up at any time. It helped her feel better. Also, some will use the laughing gas to help your anxiety. A TON of people fear the dentist. You are not alone!

[MaybeBaby]

Oh man do I know how that feels. I had a really bad experience when I was younger, they sent me and my step sister in at the same time. She was getting a mold done of her teeth for a retainer and gagged with the stuff in her mouth and then v*ed everywhere. Ever since then I get scared I'll do the saaaaame thing. Even though my emetophobia has caused me not to have a gag reflex. I think it's just the fear of being stuck in one place unable to run to the bathroom. Buuuut I have always come out the other side totally fine.

[Hilvil2]

I manage a dental office and I was always afraid. People v all the time and it scares me half to death but I realize that they're not sick. I also try to figure that's the only place in the world that u can just lay there, relax and do nothing. Also, the adrenaline in the novacaine can cause panic, nausea and shaking. Ask for something called citnist plain.... It just numbs the area without all the side effects!!

[NaiveAndTrue]

As someone who TAKES impressions, I promise you, it does NOT happen often than people v*. In the 5 1/2 years I've been at it, I think I've seen actual v* maybe 4 or 5 times. People gag often, but gagging does NOT Always lead to v*. . . especially in an emet. If you are nervous, and have to get an impression I have tips!


*Keep your head down, chin as close to your chest as you can.
* Lean forward not back. Let the assistant know you gag easily and would like to lean forward. Their arm can follow you. I promise, none of us want to make you v*, and we'll do anything you tell us that will help you feel better. These two will help keep the pressure off of your soft palate and away from your reflex areas.

* If your feet are touching the floor, press them into it as hard as you can. It gives you something else to focus on, AND engages your abdominals in another activity... they can't do both at once. If they won't let you sit to the side or on the edge, bring your knees up and press your feet into the chair that way.

*Breathe through your nose, and swallow if you need to. Alginate won't make you sick if you swallow a bit. It just tastes blah.

*Ask the assistant if she can use warm or even hot water. That sets the impressions WAY faster.

*There's always the numbing spray, but I never found it to make a difference, and it takes a while to wear off, sometimes making an anxious person more anxious.


If it's any consolation and you do V*, I've noticed that even for the most upset kids the whole experience (From start, through trouble, to two complete impressions) is less than 5 minutes. It's not like feeling ill for hours. . . it's all done and dusted rather quickly.

This is all coming from an Emet ortho tech who actually personally enjoys getting impressions! LOL.

[TiredofFear]

I sometimes have trouble, and sometimes don't. It sounds like you've conditioned your brain to see the dentist as a dangerous place. I'm not sure how you'd get out of that loop. Maybe keep reminding yourself that you've always been fine. Or have someone give you a ride, and take so much Benadryl (an antiemetic as well as allergy medicine) that you can barely stay awake. Then, if you don't have a panic, you're on the road to not seeing it as dangerous. Of course, I'm not a professional. So that might not be the healthiest way to deal. But it's what I'd do!

Yes, I think I have conditioned myself that way. The first panic attack I had made my mind see the dentist as a dangerous place. Now the fear of having a panic attack leads to a panic attack. I've thought about taking my Phenergan prior to an appointment as my Mom can drive me home, but I know that Phenergan and epinephrine from the novocaine can't be mixed. I actually didn't need novocaine for the teeth whitening I had done, but I do need if I have a cavity. I have a long appointment coming up in two weeks. I have to get composites done on my front teeth and impressions for a mouth gaurd. I may go to my doctor and ask her for an anti-anxiety medication to take for my appointment.

[TiredofFear]

Funny you say this, I went to the dentist today. Brilliant. I have to have something like 3 fillings, that new blue stuff and a brace but on. WHOOP WHOOP right? I have never liked the dentist though, but me being vane I will put up with it for nice teeth

The procedure I had done was actually teeth whitening, and I put up with it because I wanted my teeth to look whiter.

[TiredofFear]

I have an extreme fear of the dentist. I cry when they try to do x-rays. I had some bad experiences at the dentist when I was younger, as a child I had a creepy dentist who would not allow parents in the room. They yelled at me when I spit fluoride out onto the floor because it made me gag (I was 8). A year or 2 later I went back because I had a tooth that had migrated down below my other teeth instead of falling out. They gave me numbing gel and made me pull it out myself, in the waiting room. We never went back. I have a lot of cavities, and getting them filled was hell...I had to take Ativan and Benadryl in order to be calm enough to go.

You are definitely not alone on this.

It sounds like you had a horrible experience as a child. What kind of dentist has a patient pull out a tooth themself in the waiting room? Ugh. I hate the x-rays too. When I was a kid, my gag reflex was so bad that I would cry and fight the dentist. One time, I actually got sick. I was little at the time, though, and this was before I had emetophobia. It didn't even bother me that I got sick on them. I thought they deserved it for trying to put the x-ray in my mouth. LOL. I guess I have changed a lot because an experience like that now would really traumatize me. Now the x-rays don't bother me as I have learned how to breathe to avoid gagging, and the x-rays are very fast.

I might have to get something like Ativan to help me get through an appointment.

[TiredofFear]

My advice is to talk to your dentist. My mom had a hard time being confined and panicking, and I believe they had an agreement that she knew she could get up at any time. It helped her feel better. Also, some will use the laughing gas to help your anxiety. A TON of people fear the dentist. You are not alone!

I feel embarassed talking to them about it, but it's obvious because I shake. I do tell them I get nervous, but maybe I'll have to get an agreement where I can get up if I need to.

[TiredofFear]

Oh man do I know how that feels. I had a really bad experience when I was younger, they sent me and my step sister in at the same time. She was getting a mold done of her teeth for a retainer and gagged with the stuff in her mouth and then v*ed everywhere. Ever since then I get scared I'll do the saaaaame thing. Even though my emetophobia has caused me not to have a gag reflex. I think it's just the fear of being stuck in one place unable to run to the bathroom. Buuuut I have always come out the other side totally fine.

Impressions are frightening for emetophobes with a gag reflex. I know it would freak me out if I saw someone get sick. You're lucky that you don't have a gag reflex. I do have one, and that make everything a little more nerve wrecking for me. The funny thing is that I am always ok. I have IBS, and I think that contributes to my fear because I struggle with nausea all the time. Being in the chair trapped is what freaks me out...even though I'm always ok. Anxiety just is so irrational.

[TiredofFear]

I manage a dental office and I was always afraid. People v all the time and it scares me half to death but I realize that they're not sick. I also try to figure that's the only place in the world that u can just lay there, relax and do nothing. Also, the adrenaline in the novacaine can cause panic, nausea and shaking. Ask for something called citnist plain.... It just numbs the area without all the side effects!!

You're stronger than I am being able to be around people vomiting. The sound of vomiting terrifies me even if I know the person isn't sick.

The first time I had my panic attack, the dentist thought it might be from the novacaine. However, I've had it many times before that and haven't had a problem. I never have had a bad reaction to the novocaine where I've felt sick or anything from it. I still have the panic attacks when I don't need to be numbed. I'll keep in mind the citnist plain, though. Thanks.

[TiredofFear]

As someone who TAKES impressions, I promise you, it does NOT happen often than people v*. In the 5 1/2 years I've been at it, I think I've seen actual v* maybe 4 or 5 times. People gag often, but gagging does NOT Always lead to v*. . . especially in an emet. If you are nervous, and have to get an impression I have tips!


*Keep your head down, chin as close to your chest as you can.
* Lean forward not back. Let the assistant know you gag easily and would like to lean forward. Their arm can follow you. I promise, none of us want to make you v*, and we'll do anything you tell us that will help you feel better. These two will help keep the pressure off of your soft palate and away from your reflex areas.

* If your feet are touching the floor, press them into it as hard as you can. It gives you something else to focus on, AND engages your abdominals in another activity... they can't do both at once. If they won't let you sit to the side or on the edge, bring your knees up and press your feet into the chair that way.

*Breathe through your nose, and swallow if you need to. Alginate won't make you sick if you swallow a bit. It just tastes blah.

*Ask the assistant if she can use warm or even hot water. That sets the impressions WAY faster.

*There's always the numbing spray, but I never found it to make a difference, and it takes a while to wear off, sometimes making an anxious person more anxious.


If it's any consolation and you do V*, I've noticed that even for the most upset kids the whole experience (From start, through trouble, to two complete impressions) is less than 5 minutes. It's not like feeling ill for hours. . . it's all done and dusted rather quickly.

This is all coming from an Emet ortho tech who actually personally enjoys getting impressions! LOL.

Thanks for your tips! Impressions used to freak me out as I've had gagging during them in the past. However, my dentist used a numbing spray and this numbing stuff that tastes like salt on my tongue. The girl also used a small enough tray and mixed the impression real thick. I didn't gag at all. I actually kind of enjoyed it. I didn't even have to breathe through my nose or lift my feet as I've had to in the past.

[daffodil]

Yes, I think I have conditioned myself that way. The first panic attack I had made my mind see the dentist as a dangerous place. Now the fear of having a panic attack leads to a panic attack. I've thought about taking my Phenergan prior to an appointment as my Mom can drive me home, but I know that Phenergan and epinephrine from the novocaine can't be mixed. I actually didn't need novocaine for the teeth whitening I had done, but I do need if I have a cavity. I have a long appointment coming up in two weeks. I have to get composites done on my front teeth and impressions for a mouth gaurd. I may go to my doctor and ask her for an anti-anxiety medication to take for my appointment.

I have dental anxiety, too. I hate being stuck in the chair unable to move, and having peoples hands in my mouth. Yuck! Did your dentist say that phenergan an novocaine shouldn't mix? Im prescribed phenergan, and my dentist never told me not to take it before an appointment.

[TiredofFear]

I actually never asked about Phenergan, but I looked up Phenergan and epinephrine (which I think is in novacaine), and I found this interaction:

Serious - Use Alternative

• epinephrine + promethazine
  
  epinephrine and promethazine both increase QTc interval. Serious - Use Alternative.

Significant - Monitor Closely

• promethazine + epinephrine
  
  promethazine, epinephrine. Mechanism: unknown. Significant - Monitor Closely. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.
  
• promethazine + epinephrine
  
  promethazine decreases effects of epinephrine by pharmacodynamic antagonism. Significant - Monitor Closely. Block pressor response to epinephrine, which may result in severe hypotension and tachycardia.
  
• promethazine + epinephrine
  
  promethazine increases and epinephrine decreases sedation. Effect of interaction is not clear, use caution. Significant - Monitor Closely.
  
  http://reference.medscape.com/drug-interactionchecker
  
  
  I might be wrong, though. I have never actually asked my dentist.

[jkl81]

That sounds really dangerous with the phens and epinephrin.

[NicManri]

Are Phenergan and Promethizine the same thing? I never used to have anexity about the dentisit but I haven't had dental insurance and I know I need some work done and that freaks me out. I had to have my wisdom teeth pulled a year ago and was awake during the procedure. Well when they gave me a novicane shot in the top of my mouth I felt like it was swelling up and it caused me to gag. Now I'm afraid that will happen again. Has anyone else experienced anything like that?

[Pigatron]

Yes! I had my four wisdom teeth out with only novocaine and it was injected in so many places I felt like my whole head, including my neck and throat, were blowing up like a balloon. I started having a panic attack and grabbed the assistant's arm and told her how weird I felt. She was very nice and reminded me that even thought it felt weird and like I couldn't feel myself swallowing, I still had the ability to swallow and talk, even if I couldn't feel it. Somehow I calmed down and they were able to proceed. I am not great at dentist either. I detest the numbing gel and the novocaine. I've had several fillings without being numbed because I hate it so much. I'd rather be in pain for a few seconds than feel weird for sometimes hours. I just try to breathe deeply through my nose, swallow when I can, and place my thoughts elsewhere.

[TiredofFear]

Phenergan and Promethazine are the same thing. I believe Phenergan is the brand name. I haven't had trouble with novocaine, but I hate the taste of the gel they use before the novocaine. If you have a problem with novocaine, someone mentioned above and my dentist mentioned this too, there is something without epinephrine if you need that.

[Kaikey]

I was so bad being at the dentist he knew I was freaking out but after a while, he made me feel so comfortable I don't get nervousness going to him. He's great!!