Dentophobia (Autistic Style)
Or how I NEVER learned to love the dentist...
TRIGGER WARNING: If you have a phobia of dentists, you may not enjoy this one.
The more I read about autism, the more I become convinced that trying to separate those parts of my personality which are due to autism from those parts that are not is a futile exercise. The majority view seems to be that autism has a direct influence on just about everything we think, feel and are. It makes sense, I suppose. Autism is a system of processing the external and internal worlds we live. How could it not touch everything we input and output?
I started thinking about phobias. These are things we all experience, whatever our neurotype, right? Well, it turns out that certain phobias are more common among the autistic community. I suppose it should come as no surprise given the many sensory issues that we have.
I have three major phobias. The first two are spiders and heights. Spiders freak me out, but not to the degree that they used to and it’s not debilitating. I feel uncomfortable in their presence, slightly panic-stricken, but I have reached a point where I can catch them in a glass and put them outside (I refuse to kill them). The fear of heights is a relatively new one for me and is rather inconsistent. I find myself gripped with fear when standing on the balcony of, say, the 19th floor of an apartment building, but I am fine flying at 38,000 feet across the Atlantic, gazing out of the window. Go figure. However, I currently live in that 19th floor apartment and I have gotten much better with it.
Both of these phobias I can, and have, faced down more than once because I do believe in facing your fears and conquering them.
Well, mostly…
There is still one I haven’t even begun to conquer, my timor primarius and a phobia that is more common in people with autism: dentists!
Autistic people are naturally more prone to dentophobia by virtue of their inherent sensory sensitivity. Light, touch, sound, physical pain. It’s almost as if dentists were designed to terrorize us. And they apparently know it. I found many dentist websites and online advisories that have a section on easing the experience for neurodivergent patients. This is really encouraging to see.
Because I am absolutely, paralyzingly, terrified of visiting the dentist. And while my fears of spiders and heights are ultimately groundless, that is to say when I do manage to face those fears I discover they’re really not so bad, my phobia of dentists is absolutely grounded in reality. For me, as (apparently) for many autistic people, dental appointments are sensory hell. No, that’s not hyperbole.
For me the nightmare starts before I am even in the chair. As soon as I enter the building I am being assaulted by the sounds coming from each surgery room. The sounds of the suction tools, the sonic cleaners or, worst of all, the drill. That sound sends me into fight or flight mode. In fact, my wife had a dental appointment last week and I went with her. As I sat in the waiting room I suddenly heard the drill start up. My pulse sped up, my breathing sped up, my stimming started up. Outwardly, I’m sure I seemed relatively calm but I was imagining all manner of infernal torments.
Then I’m in the chair and that’s when the elevator really begins to descend into Hades. I have a bright light shining in my face, I can smell all the dental accoutrements, and on top of all this I have to make nice with my torturer. You think social interaction is hard for an autistic person in a regular setting? This is that x100.
Almost everything from this moment involves some sort of invasive foreign object in my mouth (no sniggering at the back, please). I gag when I have to bite down on the various assorted X-ray devices. I have a hypersensitive gag reflex and when those pieces of plastic reach for the back of my throat I can’t help myself. Then it’s the turn of the various metal implements and, of course, fingers. Eeeek! It’s truly awful. It’s an invasion of personal space, it’s the feel of the rubber-gloved digits, the smell of it all, the cheery voice, the face leaning inches from mine. And, of course, the dread that it is going to hurt, or he is going to hit a nerve and I will end up like Dustin Hoffman in Marathon Man. Sometimes it does hurt. Oh, and the screeching sounds in my ear from the tools...
Deep breaths…
Needless to say, I don’t go to the dentist unless I absolutely have to. I have never come out of a dentist appointment thinking to myself ‘that wasn’t as bad as I thought it would be’. It is always as bad as I think it’s going to be, and sometimes worse. That said, I did go to a dentist in New York who was amazing. He took my phobia seriously, he taught me how to breathe through my nose to avoid the gag reflex and he had a very soothing manner. It didn’t stop any of the procedures from being as insufferable to me as they always are, but he did at least ‘get it’ and do his best to keep me calm. I’ll always appreciate that.
My biggest fear is that one day I will find myself trapped in a dentist chair facing a giant spider with a drill, in his 30th floor, glass-floored surgery.
Stim, stim, stim…
I think it’s very easy for those of us with autism to view the world through a lens of fear. We have good reason to expect the worst in many situations, especially those that are sensory loaded. I’m not saying I have the miracle cure for anybody’s phobias, autistic or otherwise. I haven’t found a way to make going to the dentist any easier, that’s for sure (I’m probably due a cleaning but just the idea of it fills me with panic and dread as I have amply illustrated).
Phobias, on top of autism itself, can sometimes seem like one thing too many we need the world to take seriously. But while there are no cure-alls, there is a growing understanding out there, as I discovered researching this post. And there is also community in here. Sometimes just knowing you are not alone in your fear can be immensely heartening.
What are your phobias?
I loved this piece! I don't experience dentophobia BUT I did avoid going to the dentist for many years because of a lot of anxiety around the dentist. I'm going to share my experiences at the dentist but feel free to not read if it feels unpleasant/triggering to read about.
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I remember the first time I went to a dentist who mentioned that I had a cavity and he was like "but don't worry, we'll just give you novocaine and you won't feel a thing." When he explained that he would be injecting a shot IN MY GUMS...I mentally thought "absolutely not" and then didn't go back from so many years. I've very sensitive to pain and the thought of a shot in my gums felt horrifying to me. Since moving back to the U.S. I've been lucky to have dentists who are caring, make time to pause when I need that and don't shame me for not having gone to the dentist for years.
I now go to the dentist regularly (and unfortunately have had to get a fair amount of cavities filled due to so many years of not going ) and it's not a pleasant experience but I do some of the following things to help me: 1.) I wear headphones/ear buds and listen to a playlist during the experience. My playlist is called "Dentist" and is all Taylor Swift songs-my comfort music. 2.) I share that I'm autistic and ask for them to explain things before they do them. 3.) I try to self soothe and regulate as much as possible before and then rest a lot to recover after. The first time I got novocaine this very sweet dentist assistant held my hand and celebrated me for doing it-which felt so kind. I also kind of just tell myself "this is sensory hell" and brainstorm ways I can make it a little bit easier.
I work at a dentist office and I want to 100% validate your feelings here. Of course I think we do as much as we can to help all of our patients with their fears and anxiety. And I think we do pretty well.
But there is no getting around some basic truths. You are in a prone, vulnerable position in the chair. Your mouth is open and foreign objects are being introduced to it.
The sounds ARE an issue. The drills are tiny objects spining at very high speeds. Physics dictates that this will produce a high-pitched whine that is penetrating and unpleasant at best. And of course, absolutely terrifying for many.
On top of this, I would say at least half our patients suffered real trauma with dentists in the past, often during childhood. That shit is real and it is not easy to process or move past.
So…. What can you do. Research online to find dentists with a reputation for kindness. Frankly, female dentists are generally better at this aspect of dentistry.
You might try a weighted blanket. We have one at the office and it really helps some patients.
Bring your stim, if you have one. We have squeezy balls, but some patients have something else.
Ask if you can have someone there to hold your hand. We’ve had partners in there for this. I’ve held the hand of many a patient while the doctor works. The right human connection can really help.
Wear earplugs or listen to your favorite calming music via noise-cancelling headphones.
Ask if you can have prescribed a single pill of Valium to take beforehand. Even for a cleaning. Or use your favorite herbal calming remedy. Do NOT try using alcohol for this though.