AN old schoolmate asked me what the general opinion dentists express of patients when they (the dentists) meet to socialise. Well, to a large extent, dental phobics (people who fear dental treatment) may dominate the conversation.

If we are to believe women’s magazines and bar room chats, the world is almost solidly composed of people who are dental phobics and who hate dentists. Except for the United States, where lawyers are in the number one slot, dentists are the professionals that people hate to consult. But patently, it is not true. So where does all this phobia stuff begin? There is no doubt when you are in the presence of a dental phobic. They enter the surgery with much the same technique as a well-trained combat soldier while sussing out a room potentially full of snipers or a presidential bodyguard reconnoitring for assassins. With their backs to the wall, they shuffle in, eyes rebounding off everything that moves.

“You’re not going to hurt me, are you?” they say, quivering. You are tempted to answer with something like, “not from this distance, no”, but you refrain. “What’s that then?” they ask, feverishly pointing to something you are holding, partly inadvertently behind you, in your hand. “That,” you reply sympathetically, “is what we dentists call a registration form. “Well, it breaks the ice, at least.

Then you smile as broadly as possible without seeming leery and invite them to take a seat. The chances are that your surgery is not particularly spacious, at least mine isn’t. It is taken up almost completely with the infamous dental chair and scary-looking apparatuses perhaps reminiscent of a modern torture chamber (or so most patients think) and computer equipment. So what is the question that the patients ask next? “Where shall I sit?”

Very often, they apologise for being silly, and you start to take pity on them a bit as you plunge into their medical and dental history. Then comes the moment when you have to do something to them. The chat is over for now, and it is action time. They sense it immediately “what are you going to do to me now?” they quiz. Explaining that you, first of all, have a look around inside their mouth. They then try the next ploy. What about having a needle in the arm and going to sleep?

It does sound like a marvellous solution. The only trouble is that the patient means for them to put out for the duration, not you. Again you patiently explain that all you want to do (for now anyway) is to examine the mouth. “All I’ve got in this hand is a mirror. Ok?” “Okay, but what’s in the other hand?” and then they apologise again. Eventually, you get to have a peek in their mouth. This is accompanied by the mandatory amount of arm grabbing, asking you to stop for a moment while they swallow and the occasional cough thrown for good measure.

When the examination is finally completed, you explain the treatment plan and the cost. You get the impression that with the extent that the patient may be prepared to cooperate and allow you to work properly, the sessions could stretch to your retirement party.

Dentists value the quality of work they produce, and since the overall behaviour of the patient in the chair has a lot to do with the final product and, therefore, the dentist’s reputation, dental phobics could represent an occupational hazard. How many patients realise that the more they fear the dentist and resist the dental procedures is the worse the general outcome of their treatment? Usually, when we talk about dental phobia, the assumption is that we are referring to patients’ fear of the dentist, but how many times is it really the other way around?