a long overdue dentist visit...once again

I'm in the middle of what's going to be a long and painful dental treatment right now - one that is, for the second time, a result of denying the problem for years. The past may teach you things but you also have to learn. It seems that I have not...yet.

I have been terrified of the dentist for as long as I can remember. I mean, nails leaving half moons etched into palms-shaking uncontrollably-breaking into sobs before appointments-dying of nausea, terrified of the dentist. It would be cute if I were a child but I am 23 years old and my description is of how I was two weeks ago before my appointment that didn't even involve any pain.

I got a root canal a few years ago (as a result of me waiting until 3/4th of my tooth decayed into nothingness before I thought, hmm, a dentist visit is mayhaps due). When the anaesthesia wore off, I was in my Top 3 Painful Moments of All Time. I had taken two painkillers already (and I'm not one to pop pills routinely even on the second day of my period), and I wanted to break off my lower jaw from my face like one dismantles a crab before cooking it. So now the dentist memory in my brain looks like the letters P-A-I-N in Times New Roman 20, with the text "must avoid at all costs" written below, in pretty italics.

There may also have been an incident of me having a full-blown panic attack at age 13 in the dentist's waiting room, before my session to extract teeth in order to get braces. Of course, that has nothing to do with my current anxiety. (I never got braces.)

I am a counselling psychology student and I've been taught for approximately two years that avoiding pain (or really, any unpleasant emotion) doesn't do jack shit. In fact, it's probably the worst thing you could do. So imagine the dissonance. It is not a fun place to be in.

Two weeks ago, I had to get my teeth cleaned (scaled?) before the doctors could recommend the proper treatment. Mere minutes before my appointment, I was at home, on my bed, sobbing. I mean, naturally. Rocking back and forth. Feeling like throwing up. The whole package. My mother tried to console me by reminding me that the procedure really was painless. I already knew that! I'd done it before! Anxiety is not rational. It doesn't listen to logic. It doesn't make sense. You don't reason with it. You simply let it take its course and be done with you. I am only just learning this. It's taking a combination of getting therapy, learning about therapy, and learning from my own past experiences. And it is happening at glacial speed. (How do I know it's happening, that I'm getting better? This time, instead of telling my grandmother to call the dentist for me, I did it myself. Small wins are also wins.)

I arrive at the the clinic with puffy eyes. They call me in, my friend waits outside for me. I rest my butt only lightly on the chair with one leg hanging, ready to run. I clench my fists even before the dentist enters. My whole back never even touches the chair. She looks at me and probably senses that I would prefer even transcribing my 1-hour long dissertation interview than be in that chair. I tell her that I have anxiety. She nods. I expect her to say, "don't worry, it won't hurt". She looks at my teeth and asks me why I didn't get braces when I was younger. I look at her sheepishly. How do you tell your dentist that you were in fact going to get braces but ended up having a panic attack at the dentist's clinic? I tell her in those exact words (something you learn when you're going to work in mental health - name everything you feel). She says, "what happened?," and I am simply too shocked to process her question.

Usually, the reaction to "I am feeling anxious" or "I had a panic attack" ranges from mild concern to alarm. Most times, people don't know what to say, so they quickly find a new topic or end up saying things that they think will make you feel better. But here is this doctor, asking me what happened that resulted in a panic attack. I take too long to respond, so she prods, "what were you most scared of?" and I am shocked even more. Because in asking me more about my experience, she is acknowledging that I had an anxious experience in the first place. She is asking questions about my experience without invalidating it, being dismissive, or bombarding me with overwhelming medical information.

I immediately recall a bit from Sohaila Abdulali's What We Talk About When We Talk About Rape, where she discusses why dentists (and in my opinion, anyone who has to deal with people intimately on a daily basis) absolutely must be trauma-informed. Bear with me on this one. Trauma-informed care involves practices that assume that it is more likely than not that the person in front of you has gone through trauma, and therefore puts a lot of effort into screening for trauma as early as possible in the interaction or intervention. This makes it possible for practitioners to be sensitive towards the client's needs from the very beginning. Abdulali argues that dentists need to be trauma-informed because their hands are in your mouth, and for most of us, our mouths are a sacred place. They are also a place where trauma can be inflicted. And dentists are right up in that space, with their hands and metal instruments and injections - something that is potentially anxiety-inducing in the first place. Being trauma-informed means that you actively recognise the anxiety-inducing potential of this situation.

Whether my dentist(s) are formally trauma-informed, I don't know. I do know that they are trauma-informed in their practice. And it made all the difference in the world to me, and I haven't even experienced abuse or violence of any kind.

In the two weeks since then, I have gone to the dentist twice. Both times, for a possibly painful procedure. I went by myself. I didn't cry before. Or after. Didn't have a dry throat and sweaty palms and didn't feel like I would combust from all the anxious restlessness. Didn't dig my nails into my palms. Settled on the chair and crossed my feet comfortably. I was still anxious, but not a mess.

It wasn't all pretty. I forgot to breathe once during the treatment and activated my gag reflex, though. Twice, actually, only in the first ten minutes. Asked for a break a couple of times. Jerked my jaw closed as a reflex once. But with a couple of reassurances that I won't die from cotton balls in my mouth and 'you're doing great's from the dentist, the session was almost bearable. Imagine that! A dentist visit that you can actually endure?! Alien concept.

Did I mention that this is all the work that I have to get done with before I get my braces? All these years later, we're back in the same place. It's still terrifying. Only we're armed with therapy now.

(Special shout-out to therapy as a concept and to my therapist without whom I would probably die because of decaying teeth or something.)