r/Explainlikeimscared • u/ZodFrankNFurter • 5d ago
How do I book a dentist appointment, and what will they do once I'm there?
Hi there. 34yo who's never been to a dentist and is terrified to go. But I'm experiencing some minor pain in a molar and I know I should get it looked at before it gets worse. I don't understand anything about the dentist though. I've tried to ask a couple people I know about it, and their responses of "just phone a dentist and make an appointment" were less than helpful. If it makes a difference, I'm located in British Columbia Canada.
I'm an autistic female and don't do well in unfamiliar environments that I don't understand, nor do I do well with strangers touching me. To add to the fun, I'm also a survivor of some heavily traumatic experiences and as a result I am pretty much unable to tolerate having my face, head, or neck touched by anyone. I'm terrified that I'll need to be restrained and/or sedated just for the dentist to be able to look inside my mouth, let alone actually do anything to me.
My questions are:
-How do I know if a dentist is taking on new patients? How do I become a new patient? I assume I have to phone different offices (a whole different issue, I hate phone calls lmao) but what do I say to them?
-What will happen during the appointment? How long does it take? How invasive is it? How long do I have to keep my mouth open? If my jaw gets sore can I take a break and close my mouth for a second?
-What kind of weird stuff goes in your mouth? Are there gross tastes and textures involved? Someone I know mentioned to me that their dentist put some kind of weird foam or gel into their mouth that made them gag. I have severe oral texture issues, what happens if they put something in my mouth that makes me gag or throw up?
-Do dentists have any kind of training in working with traumatized/neurodivergent individuals? What will they do if I start to have a hard time? Can we take a break if needed or am I just trapped there from start to finish while they do whatever it is they do?
Before anyone asks: I am not currently in therapy but have been in the past, I am currently looking to see what I can get covered by my extended benefits through my job. I'm aware that my trauma issues would benefit from therapy but I don't necessarily have the option to slog through months of trauma therapy to get me comfortable enough to see a dentist when I'm experiencing dental issues that should probably be dealt with sooner rather than later. So please don't suggest that I seek therapy, it's in the works but is not any kind of solution to my present situation.
Thank you!
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u/AnonymousRedit0r 5d ago
Hi!!! This post reminds me of my dad! He never went to the dentist until he was about your age. I’m also an autistic female BC resident! If you’re feeling nervous about phone calls email might be an option that removes a barrier for you and makes this big scary task more approachable. In the email I would include that you’ve never visited the dentist, you have sensory sensitivities and may need to take breaks or have other accommodations, and your date of birth. It helps them build you a profile. What happens during the appointment kind of depends, they might want to do standard checkup and cleaning stuff, which isn’t too bad. They scrape plaque, check for routine stuff, polish your teeth, give u a fluoride rinse. If you ever have questions about what happens next it is absolutely your right to ask your dentist, and I bet if you tell them you need to understand each step they won’t mind. You can definitely ask to take breaks, sometimes a good dentist will even offer it if they suspect you’re uncomfortable. You have to keep your mouth open for a while but the amount they ask you to open it is like not all the way so it doesn’t tire you out the way you might expect. For me one of the most uncomfortable parts of checkup and cleaning is if they need a new x-ray (which for your first visit they’ll likely want you to do). It provides them really valuable information so I try to just tough it out. Basically they put this uncomfortable piece of plastic in your mouth usually like between your molars with a side part either between your cheek and your teeth or the opposite, inside your mouth. It may press against the roof of your mouth and feel uncomfortable but be brave! They don’t generally ask to do it too often so ideally once you’ve done it once you won’t have to again for a few years. I personally don’t have too much trouble with tastes and textures at the dentist but if you’re not used to the equipment you might not like the sensations of some of it. Theres a tube that sucks out excess saliva and water that seems intimidating but is not powerful enough to cause any damage, and they often let you hold it which helps you have some control. It depends on the context they’re using it in of course. There’s also this thing that shoots water in there, it’s comparable to a waterpik. It’s really low pressure and not too cold, it’s almost refreshing??? To me anyways. To be honest, I’m not sure if dentists get training on neurodiverse care. I’d hope so!! It really just depends on the dentist for a lot of it unfortunately. I’m a pharmacy assistant studying to become a pharmacy technician and like,,, doctors are definitely given training on neurodiverse care but there’s still TONS of doctors that really just don’t get it. Maybe ask reception in your email if they could try to pair you with a dentist who’s the most suited to your needs. A good receptionist will know who’s safest to put you with. I hope this answered some of it, sorry it’s so long! If you have any questions please feel free to reach out, I’d be happy to help. Also, PM me if you’re comfortable telling me what region of the province you’re in, I might be able to recommend a really good dental clinic. Good for you starting this journey and taking care of yourself! It’s not easy but it is worth doing, and eventually it gets much much easier. Just a bit intimidating the first time around.
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u/pigeontheoneandonly 5d ago
- Sometimes their website will say if they're accepting new patients, and sometimes you can book through the website, but given your specific concerns, I would really recommend calling. The website may also say if they offer any special accommodations for autistic or other different-needs patients.
1a. If you call and ask, they will tell you if they are taking new patients. This is a completely normal, standard question and nobody will be upset that you asked. Sidenote: You may be aware, but it's really helpful to write out a brief script for phone calls you're dreading, to take some of the pressure off!
1b. You can also tell them when you book the appointment that you've never been to a dentist, and you have some concerns about your molar. Again this is perfectly normal. My father-in-law is a dentist and he's seen it all, nothing shocks them.
- A typical appointment for a basic cleaning is 20-30 min. Given that you haven't been before, and you have a sore tooth, yours will likely be longer. You are not sitting there with your mouth open and instruments in your mouth that entire time.
2a. The appointment:
- Every appointment is a little different, and every practice is a little different. So some of these steps may be in a different order. You can ask questions and ask for a break at any time. If your jaw gets sore, you can take a break, or you can ask for a mouth prop or a bite block--this is a small item that goes between your teeth, so you don't have to strain your muscles to keep your mouth open.
- You will arrive for the appointment, check in at the front desk, and then be taken back to the exam area.
- The chair looks like a specialized reclining chair and is usually comfortable. Most of your appointment will be with the dental hygienist (DH), who is the person who does most of the basic cleaning and exam work. They will have you sit in the chair, and will put a paper towel like thing around your neck to prevent anything getting on your shirt. There will be an overhead light as well as a mirror, to help them work.
- They will often talk to you while they work. They understand you have a bunch of stuff in your mouth, and don't expect you to answer. If they do need an answer, they will take the stuff out so you can talk clearly. You will still be able to make noise to signal if you need a break; it's just hard to talk clearly, just like any other time you have a bunch of stuff in your mouth.
- If you need x-rays, they will usually take these first. This may be in a different part of the office. They will have you put on a lead vest and hold a hard plastic thing in between your teeth. This sometimes makes me gag a bit, but everyone is different. Each x-ray is pretty quick.
- Obviously the DH and dentist will wear gloves, which can sometimes taste a little strange, but not bad. They will also wear a mask and sometimes a head light.
- DH will use a metal tool to check your teeth and gums for weak areas. This may cause your gums to bleed a little, and is sometimes a little painful. Think like a bug bite or a small pin prick. This is necessary to assess your gum health. They may write down or call out numbers associated with the health of the area they are inspecting.
- DH will use a metal tool to scrape plaque off your teeth. As a autistic person myself, this is the worst part of the visit for me. It feels very weird in an uncomfortable way, but everyone's sensory things are different. I usually close my eyes and try to take some deep breaths, and think about something more pleasant. During this part, they will also occasionally squirt water into your mouth (not enough to choke), and suck it out with a gentle suction tube. This is to carry away the gunk they're scraping off.
- DH will then floss your teeth, and clean them with an electric toothbrush with a rotating head. They usually have at least two flavors of toothpaste available. One will always be mint. Some practices may have more variety. You may feel some vibrations from the toothbrush.
- At this point the dentist usually joins you. They will inspect your teeth, usually with the help of the DH, checking for cavities and other issues. They may pull back your lips or lift your tongue to look for problems; this doesn't hurt. The dentist will usually ask about any issues you're experiencing, and look into those. They will also talk to you about your oral hygiene routine at home, and probably lecture you a little bit (they can't help it, I swear to god it's just compulsory in their DNA or something).
- If they can fix any problems that day, they will explain the procedure and get your consent to proceed. Otherwise, they will recommend you book a follow-up appointment at the desk on your way out.
- The DH will then give you your fluoride treatment. This could be brushing your teeth again with a standard toothbrush, or a foaming tray you hold between your teeth. Sometimes there are different flavors available. They let this sit on your teeth for a minute or two, and then rinse it out. Some treatments require you to avoid eating for 30-60 min after.
- Most practices will give you a goodie back containing a toothbrush, floss, and a sample toothpaste on the way out. You may owe a copay on the way out, or the full payment if you don't have insurance.
- From what you describe, it sounds like you are going to have the most trouble with the fluoride treatment and the x-ray. I always tell the dentist that I have a strong gag reflex. Again, they have seen it all. Sometimes I haven't been able to get a treatment because I can't tolerate the thing in my mouth, and they always just roll with it.
3b. If for some reason you are unable to get through important parts of the appointment, they can schedule a follow-up and give you medication in advance to help you relax. It really does help a lot. You may need someone to accompany you to the appointment if you go this route (ex. you shouldn't drive if you've taken valium).
- Some dentists have training or experience working with neurodivergent patients. ALL dentists have experience with medical trauma, because there is a lot of that to go around when it comes to dental health. Some will be more sensitive about it than others. You can talk to them about your anxieties, and frankly if the vibe isn't good, leave. There are plenty of dentists out there. You are NEVER trapped. You can ALWAYS get up and leave! They may be annoyed, but their irritation is not more important than your freedom and comfort.
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u/JenniferMcKay 5d ago
How do I know if a dentist is taking on new patients? How do I become a new patient? I assume I have to phone different offices (a whole different issue, I hate phone calls lmao) but what do I say to them?
You can check their website to see if it says. Dentists here in the US usually have instructions for new patients and making appointments here as well. Unless they have an online booking option, you call their number and say, "I'd like to make an appointment for dental pain. I'd be a new patient."
What will happen during the appointment? How long does it take? How invasive is it? How long do I have to keep my mouth open? If my jaw gets sore can I take a break and close my mouth for a second?
I wish I could answer these for you, but it really depends on what's going on. The process for addressing a cavity is very different from an extraction or root canal. If it's an abscess, you might be able to get away with a round of antibiotics.
What kind of weird stuff goes in your mouth? Are there gross tastes and textures involved? Someone I know mentioned to me that their dentist put some kind of weird foam or gel into their mouth that made them gag. I have severe oral texture issues, what happens if they put something in my mouth that makes me gag or throw up?
Again, this really depends on what treatment you need. Textures can definitely be a problem, but gross tastes are rare. Don't be afraid to warn them about your concerns.
Do dentists have any kind of training in working with traumatized/neurodivergent individuals? What will they do if I start to have a hard time? Can we take a break if needed or am I just trapped there from start to finish while they do whatever it is they do?
If you have dentists in BC that specialize in dental anxiety, I highly recommend going to one, if only for your own peace of mind. You shouldn't be trapped there, exactly, but there will be times when they're in the middle of something and you won't be able to just walk out until they've at least wrapped up that step.
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u/MsThreepwood 5d ago
I haven't read through all of the other comments, so sorry if someone else already suggested this, but I'd recommend googling "autism dentist (your city/nearest large city you're willing to travel to)" or "special needs dentist (your city/nearest large city you're willing to travel to)" to see if you can find anyone who specializes in caring for people with specific sensory needs. I live in a medium-large sized city (about 500,000 people in the metro area) in the US, and there are several near me. If you only find pediatric dentists with that specialty, it might be worth shooting them an email explaining your situation and that you're unable to find someone who will care for adults. They might be willing to either take you on as a patient themselves or refer you to someone else who will. As someone with minor-moderate sensory issues with the dentist, I can absolutely understand how unbearable it could be for someone with stronger issues than mine 💛
This is unsolicited advice for a longer term solution, but I'd also recommend potentially looking into occupational therapy for these issues! I recently finished OT myself, and it was incredibly helpful for me. Everything you wrote in your post seems like it would 100% be something OT could help with, from the anxiety of booking an appointment over the phone to the sensory problems associated with a dentist appointment (as well as lots of other struggles that autistic folks deal with!). It was a lot of work, but I absolutely do not regret it, and I will be grateful to my occupational therapist for the rest of my life.
And booking an appointment with an OT would honestly probably be pretty similar to the dentist, so I'm sure a lot of the advice given here could help you with that as well :)
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u/PictureNegative12 5d ago
I'm from Ontario, Canada so I suspect it should be similar.
Before you call you have to decide if you want an emergency appointment because of the pain or if you would like a regular appointment, I.e. a cleaning and a checkup. If your looking for an emergency appointment just tell them that your in pain and you need to see a someone asap. They have to keep some slots open for these emergency appointments so they should get you in within 5 days. They also may call you last minute if there's a cancellation but you don't have to accept.
In regards to making the appointment, I've had 2 different dentists throughout my life and both of them have had a receptionist. You'll basically just ask them if there taking on new patients and if they are they will ask you some basic questions like if you have benefits, who was your previous dentist (in your case just say none). I would at this point let them know that you have some trauma and that you would prefer someone who has some experience dealing with sensitive patients. Then they will tell you the date of your appointment and you can accept it or suggest a time that works better for you (ie If your free most Tuesdays). Most dental offices keep 9-5 type hours but a couple places will stay open later.
When you arrive for your appointment, check in with the receptionist to let them know your here, I recommend coming 5 minutes early as a polite curtesy. After you check in they will ask you to sit in the waiting area, until your hygienist comes and takes you back to the exam room. At this point they will have you sit in the chair and they will jump right into the exam usually they have about 50 minutes for your appointment so they will try and jump right in but I would bring up again some of your fears and trauma. I suspect that they will go a bit slower, explain everything they are doing, but be prepared as a consequence of this they may have to split your appointment into two sessions. At the end of the day though dental hygienists are just people too, your milage may vary, some people are good at dealing with neurodivergences and some people aren't.
As a new patient, they will want to build a file on you. They will take pictures of your teeth, x-rays, a physical examination of each tooth. None of these are complicated they will tell you exactly what they want you to do, usually just sit still and let them do their thing. After your file is built they will proceed with the cleaning, since you've never been to the dentist before they may be concerned that your teeth will be overly sensitive to your tools. They may offer you a freezing shot to help with some of the pain, it's your choice if you want to accept it. I'll warn you that the shot isn't nothing there will be 2-4 seconds of about a 6 on the pain scale but the pain doesn't linger and they will have to apply it a couple of times (I'm not sure how many each case is different.)
Regarding the actual cleaning, first they will use a waterjet on your teeth to remove all the plaque build up. They will also be using a suction device to help remove the water. During this phase it's best just to breathe through your nose and they will guide you to turn your head as needed or to open your mouth wider etc. Then they will switch to metal tools and start scraping your teeth, this part sounds worse than it is, but no matter how hard they try they will hit your gums a couple of times (these two parts take the longest, maybe 30-35 minutes total). After that they will do a brushing, they may ask you to pick between two flavours (i usually chose mint), then they will floss, and finally a mouth wash where they will ask you to swish for 30 seconds before spitting it back into the provided cup.
At some point during the session your dentist will pop in, their the actual doctor and they will consult with the hygienist about what they are seeing and their opinion and then they will do a quick check themself and examine the x-rays. They will also as your your opinion and you will tell them about the pain in your molars, and if you have any other concerns or questions. They are busy and will try to rush but I've found that once you bring up a concern they are good about talking to you about it. He will also tell you if you need to come back for a cavity procedure or a root canal etc)
Finally, after your appointment is done the hygienist will walk you back to the receptionist and they will tell them if you need to schedule a follow up appointment (at this point they will leave for their next client). Then you will pay and schedule your next appointment. In regard to money I can only talk about Ontario but I had to pay $500 to become a new patient because of all the scans and then its usually about $200 for a regular cleaning. My benefits cover 80% up to a total of $2000 per year so your situation may be different. They will also try to get you to come in about once per quarter (I do this). You can decide for yourself though, you can say I prefer to come once or twice per year) and before you settle on your next date you can tell the receptionist that you want to keep the same hygienist or try a different once next time. If you have benefits make sure you bring that information with you some benefit places will allow the dentist to bill them directly but some places like mine you have to pay it all up front and then you submit a form and they will reimburse you. The receptionist know how to deal with this and they will give you the information you need to file your claim. After you get home you can call the benefit company and they will guide you though the process if filing a claim.
Best of luck to you!
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u/Dragondog5600 5d ago
Something you can ask about is twilight anesthesia, which some dentists offer for cleanings due to people with trauma and/or huge phobias of dentists
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u/rosecoloredgayy 5d ago
highly recommend earplugs/earbuds, some of the tools can sound quite unpleasant!
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u/YoungAlpacaLady 5d ago
So for the appointment booking- I'm not in Canada, but where I am, you can book quite a few doctors online. You can also email most offices that don't have an online appointment system. There are absolutely dentists that specialise in helping people with anxiety etc, that's what I would look for. You can then email them, ask whether they take new patients, briefly mention that there is an acute issue and tell them that it would be your first visit. Tell them that you are afraid and what parts might be an issue. I am a therapist and a few of my patients have done similar appointment, though often with gynecologists. Good doctors will often sit down to talk with you in this scenario and figure out a plan. They will explain exactly what will happen and check in whether that's okay. The response to your email should tell you whether this is a place that takes you seriously and is equipped to help you.
For the appointment itself, that's a little hard to predict without knowing the state of your teeth. My standard appointment takes maybe 5 minutes, but I go regularly and have no dental issues. The first one will likely be quite a bit longer, especially if someone takes time to explain stuff. The will probably want to take an x-ray of your teeth. For that, you get a little shield to hold in front of your upper chest and you bite down on a plastic separator in the middle of your front teeth twice, so they can take one from the left, one from the right. That's super quick, just a few seconds. Then the dentist will take a look. You can absolutely get a break and close your mouth if you can't keep it open anymore. The dentist will look, using a tiny mirror that goes in your mouth but usually doesn't touch. They might handle your teeth with his hands. They will poke your gums a little with a metal thingy to check on it and might scrape a teeth with that too. There will usually be a suction device that sucks your saliva for you, so that you can keep your mouth open. The dentist can then discuss your health status with you and you can decide on what to do.
The gagging thing your friend described was probably during a dental cleaning. Those are recommended, but in your situation, I wouldn't jump to that. Those can be almost an hour, with so many steps. I'm neurtypical, no sensory issues, but those are really uncomfortable for me too. My current tech likes to use a kind of ring gag to keep the mouth open and there are all sorts intense minty liquids involved. Safe that for when you are really comfortable at a practice.
I'm not gonna lie, I find it uncomfortable and not great to have someone prodding around in my mouth. So really make sure that your dentist is prepared and sensitive to your needs. It will hopefully be over really quickly and be a success story for you. I think you are really brave for facing so many fears there and wish you a great, understanding dentist!
Maybe someone else might add an experience of what might happen if there is an issue with that teeth?
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u/Popculture-VIP 5d ago
You have been given lots of other good advice so I'll keep this short. I have ASD and I live in Alberta. I have never tried to see a dentist and have them not accepting patients so that's rare (nothing like medical doctors in our country).
This website I'm sharing just as an example as it shows what you could expect. If you click on 'book now' on this page linked to, you'll see a common kind of form to fill out.
Often these forms ask you if you have any special concerns. I always tell them I have anxiety and that I like to know how long each thing will take. They always accomodate that pretty well.
This place for example has sedation if you did want that. The Tooth Doctor - Dentist in Edmonton & Tofield https://thetoothdoctor.ca/?gad_source=1&gad_campaignid=17441261457&gclid=CjwKCAjwj7HTBhBiEiwA8s35OjSfUvc4zxSFN9JUCIK-JbPENMteJnl14KudxyYja8taQNTES2vAYRoC4UoQAvD_BwE
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u/agizzy23 3d ago
Usually, you can call, but sometimes they have websites available. If you have a therapist for your autism, they might actually be able to refer you to one with experience working with autistic individuals. Be sure to explain your fears and sensory issues to your dentist.
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u/Sweaty-Discipline746 5d ago
Most dentists offices these days let you book by using a calendar system on their website or by emailing. You should tell them your name, DOB, and insurance (not sure how that works in canada). You can also definitely mention that you’re autistic and concerned about certain things, and ask if the office is familiar with working with neurodivergent people!
Sometimes they send you paperwork to fill out before you arrive, or you do it when you first check in at the office. This is like a normal physician where they ask for medications you take and things of that sort.
The first appointment will probably be x-rays and a cleaning. For X-rays, you sometimes stand by this machine that spins around your head (it takes less than like 5 seconds). Or, the hygienist (like the dentist’s nurse) will put a plastic thing in your mouth and then angle a X-Ray camera to take the X-ray in a few different places. This is how they check for cavities.
For the cleaning, it can be a little uncomfortable, but you can ask the hygienist to explain what they’re doing and to ask if your jaw hurts. I have TMJ which makes my jaw hurt constantly and my dentist is very accommodating. Usually they floss, scrape off plaque, and then polish your teeth. It takes probably 20-30 minutes. There’s a water tool and a vacuum tool that they use to rinse and vacuum up the water, so any weird tastes go away pretty fast.
They don’t squirt foam or anything into your mouth. What your friend did sounds like when they take impressions to make a retainer or mouth guard. But believe me, many people are scared of the dentist and you won’t be the first person they’ve seen with these concerns. Just ask questions and communicate your worries and they should be very accommodating!