Are you Afraid of the Dentist?

By: Munir Gomaa, D.M.D.

What’s not to fear?

gomaa-munir

Author: Munir Gomaa

Four years of dental school, a license to practice dentistry in hand…and the thought of going to the dentist still gives me the chills..
I get it. Dentists are mysterious creatures who reveal only 50% of their face at a time, poke you with sharp instruments and drill through your teeth like it’s butter. When taken out of context, they actually make for a perfect villain.

It thus comes as no surprise that 5-8% of Americans are so consumed by fear of the dentist that they avoid going altogether, only to experience an abundance of oral health problems that work to fuel this fear. Around 1 in 5 Americans possess a degree of dental anxiety that prevents them from seeking out dental care unless it becomes absolutely necessary, generally due to intolerable pain or lack of proper functioning. And by the time they do seek care, it’s often too late to save the teeth in question.

Dental fear and anxiety has been, and continues to be, a widespread problem among all populations. It has inevitably contributed to a “vicious cycle dynamic”, in which fear of dental treatment, lessened use of dental services, and consequent oral diseases continuously reinforce one another.

Munir-Gomaa

Munir Gomaa Figure 1

A collection of variables are commonly responsible for establishing a lasting fear of the dentist. Some of these variables are discussed in this article. According to several studies, the onset of dental fear and anxiety usually occurs in childhood. Oftentimes the reason is directly related to traumatic dental experiences in the past. Sometimes this fear is deeply rooted in entirely non-dental experiences, such as childhood sexual abuse (rather disturbing findings implicating this relationship can be found here), post-traumatic stress disorder, general anxiety disorders, or even substance abuse. However, just as often, personal trauma has little or nothing to do with it.

A rather frustrating fact of life demonstrated by several studies is that parents can easily transmit their fears and anxiety to their children. Children actually learn from their parents to become fearful of spiders, social situations, or the dreaded dentist, and the mechanism of this transmission is subtle yet powerful. One study demonstrated that parents’ degree of vulnerability to certain general, non-dental related perceptions, namely uncontrollability, unpredictability, and dangerousness, reliably predicted their child’s level of dental fear. Another study found evidence that there is a genetic component to dental fear in addition to environmental influences. This study demonstrates that fear of pain is a genetically heritable trait, and that this fear is significantly associated with dental fear.

Munir-Gomaa

With the presented knowledge in hand, I’m prescribing a less intuitive approach to battling dental phobia. Since vulnerable perceptions of adults can be so easily and unintentionally inherited, both socially and biologically, by their children, it’s important for dentists to focus on alleviating fear and anxiety present in their adult patients. When treating the fearful adult patient, most dentists assume that fear is so fortified that it’s useless to try and address it. Instead, they focus on temporary solutions, such as distraction techniques or compromising the treatment plan, to allow for resolution of immediate dental needs. The fear lingers and is nurtured until the next visit.

It’s also important for dentists to inform their adult patients of this very apparent risk, as they can play a large role in preventing transmission by concealing their fears or reservations from their children, or even their younger siblings or relatives, as they work on eliminating or minimizing these qualities in themselves. It’s crucial to take cautious advantage of the openness and moldability of a child’s brain by encouraging a positive attitude towards the dentist and oral hygiene, preventing a plethora of dental problems down the road.

By Munir Gomaa

Insightful read for dental practitioners–keep your patients happy

Posted by Munir Gomaa

I ran across this article and thought it’d be useful for new dental practitioners out there. Included are creative methods, some more obvious than others, that might help give dentists an edge in building healthy, lasting relationships with their patients.

My personal favorite is perhaps the most obvious one–likely why it’s the first to be listed–and that is remembering who they are! Not just their names, but their stories–to the extent which they’ve felt comfortable sharing with you during past appointments, of course. Remembering their interests, fears, and families among other qualities will help build positive, comfortable and trusting relationships, ultimately helping you deliver the best quality care you can while maintaining a warm, friendly environment.  Seems rather intuitive, but it can surely become a difficult task when you’re seeing over a thousand patients! Documenting highlights of your conversations with patients along with your post-op note is always a good idea.

Click here for another recent post on “Stress in the Dental Profession and…Horses” by Munir Gomaa

Stress in the dental profession and…horses

By: Munir Gomaa

It’s certainly no secret, especially to dentists and their families, that the dental profession is an inevitably stressful career. The multifaceted role that a dentist plays–as a clinician, an entrepreneur, a manager, a lab technician (perhaps dental students like me assume this role more than actual dentists), a therapist, and in several ways, an artist–establishes a natural tendency towards perfectionism. After all, financial success for the dental business owner does depend on the dentist’s ability to succeed in all of these facets. Proper fulfillment of these roles demands paying continuous and precise attention to detail during diagnosis and treatment, satisfying patient’s and staff’s evolving needs, and, perhaps most importantly, nurturing the dentist’s own mental health.

Juggling all of these responsibilities in a productive and time-efficient manner takes an incredible toll on the mental health of dentists. It’s no surprise that dentists rank #2, after medical doctors, in careers with the highest suicide rates.

An interesting article I ran across uses empirical data to prescribe a most natural kind of medication to alleviate stress–for dentists, physicians and, quite frankly, anyone with a stressful career or lifestyle–called horses.

horse_png2558

Yup.

Apparently, this mysterious creature’s heart emits an electromagnetic field five times larger than the human heart (which translates to a field extending 40-50 feet from the horse’s body!) According to research, a horse’s electromagnetic field directly influences the nearby human’s own heart rhythm by increasing its coherence–and a heart with increased coherence is directly associated with tranquility, happiness and well-being.

In fact, the physiological and psychological benefits of being around horses don’t stop there; research shows decreased heart rate and blood pressure, reduced feelings of stress, anxiety and anger, increased levels of endorphins, heightened feelings of empowerment, patience and self-efficacy, and the list goes on. Several of these effects work together to alleviate depression, which recent research has associated with a higher risk of cardiovascular disease.

Dr. Bethany Piziks, a dentist and certified life-coach, incorporates this surprisingly effective method in coaching her clients. She uses a method called “Equine Gestalt Coaching Method (EGCM)”, in which two life coaches, a horse and a human, work to help dentists alleviate stress, depression and work through longstanding personal-dilemmas to promote self-development. The outcomes achieved by her client’s are pretty incredible. Highly recommend this article to any and all stressed individuals!

Sources: Stress in the dental profession and why a horse could save your life”Top 11 professions with highest suicide ratesDepression and Cardiovascular Problems

By Munir Gomaa

For Healthcare Professionals: Embarking on the road to financial freedom

At some point within the last year, an obvious truth became suddenly apparent as I realized my 20+ year journey in school will soon come to an abrupt halt-I haven’t learned a thing about financial management, investments, or retirement savings. After all, the bittersweet field of science, especially in a doctorate/graduate level program, tends to be a consuming one, demanding most of its victim’s mental energy and focus. While us graduate students certainly must comply with these demands to become competent within our respective fields, it’s an awkward moment realizing that most of our old colleagues have obtained 4-5 years of experience practicing the art of employment and financial management while we’ve spent these valuable years building more debt and being cradled in the arms of our academic institutions.

This crude self-realization sparked an eager craving to stuff these voids with information from blogs and books that have been recommended to me. Though I’m still in the baby stages of this transitional journey, I’ve encountered several pieces of advice/knowledge that have helped me begin to narrow my long-term financial and retirement goals. Although my site certainly isn’t intended to become a business blog, I’d like to pass on a few tips and suggested readings to any students who happen to come across this and have a moment to ponder about real life.

First, I’d like to highly recommend you purchase or borrow The White Coat Investor by James Dahle-a book that, despite its title, is an invaluable resource for anyone in any field looking to build a secure financial future. Its most direct audience, of course, are medical students who will journey through residency, making a modest salary until they become attending physicians. However, its major points can be echoed across all career paths, as it is, in fact, a book about what the heck to do with your hard-earned money. The promise is this-if you can strictly adhere to a few rather straightforward, low to no-risk guidelines, you can establish a secure and flexible retirement and become financially free. Who doesn’t want that?

While I won’t get into too many details (I’ll leave that to more credible sources), there are a few things I feel graduate students need to hear. If you’re like most students, you’ve likely never had a reliable stream of income-and no one would blame you. This, however, means that you haven’t been tasked with the responsibilities that come with having an income. Good for you! No money, no problems. But soon that role will come and, if you’re not careful, can easily turn into a constant uphill battle.

From what I’ve gathered so far, the best piece of advice I can offer is this: don’t grow into your income! Take utmost advantage of your already proven ability to survive on a “student income” (whether that be limited loans or parental help). Chances are you did just fine on a fraction of what you’ll soon be earning. Once the bucks start rolling in, you can probably increase your personal expenses by two to four times and still have excess cash to make wise decisions with.

The danger is that many graduates rejoice at their first paycheck, thinking it’s finally time to cash in on their seemingly endless years of study. They immediately put a down payment on their dream car, drastically upgrade their apartment, or worse, quickly purchase real estate for personal use. Their standard of living increases ten fold before they have a chance to truly realize it. Before long, they’ve effectively delayed and compromised a comfortable retirement, leaving little consideration for the volatile (and consequently, expensive) nature of their current personal lives.

Most advisors will tell you to save 10-20% of your income annually if you hope to live comfortably upon retirement, without having to make serious adjustments to your way of life. According to James Dahle, author of The White Coat Investor, the typical physician can retire comfortably on 25-50% of his or her preretirement income. One approach suggested by Dahle (who firmly advises at least 20% annual savings), is that you “pay yourself” this 20% immediately after receiving your paychecks. This money can then be spread across retirement accounts, such as Roth & Traditional 401(k)/403(b) and Roth IRA, and other relatively low-risk investments. These savings can be reasonably expected to grow at an annual rate of 3-7% after taxes, expenses and inflation are accounted for. While the lowest risk investments will naturally receive the lowest returns, they are also the most reliable. Saving responsibly and having a truly diversified and annually rebalanced investment portfolio consisting of majority low-cost index funds seems to be the surest route to financial success.

I’ll consider this post a success if I’ve encouraged (or confused) even one person into learning more about achieving a secure financial future. Once again, I strongly advise reading The White Coat Investor (if you know me personally, you can borrow it!). After each chapter includes a list of recommended reading if you wish to expand your knowledge in that chapter’s topic. You can also check out The White Coat Investor’s blog which contains much of the same useful information and is updated regularly.

A few other resources I would recommend reading (I’ll try to update this as I read more!):

If You Can: How Millenials Can Get Rich Slowly, by William J Bernstein

Investor’s Manifesto, by Willian J Bernstein

The Millionaire Next Door, by Thomas J. Stanley

Your Money and Your Brain, by Jason Zweig

Common Sense Investing, by Rick Van Ness

And a couple short and insightful dentist-specific reads I recently ran across by Reese Harper, CEO at DentistAdvisors.com:

Top 10 mistakes dentists make on their way to retirement

What dentists can learn from John Elway about investing

By Munir Gomaa

Insightful read for dental practitioners–keeping your patients happy

I ran across this article and thought it’d be useful for new dental practitioners out there. Included are creative methods, some more obvious than others, that might help give dentists an edge in building healthy, lasting relationships with their patients.

My personal favorite is perhaps the most obvious one–likely why it’s the first to be listed–and that is remembering who they are! Not just their names, but their stories–to the extent which they’ve felt comfortable sharing with you during past appointments, of course. Remembering their interests, fears, and families among other qualities will help build positive, comfortable and trusting relationships, ultimately helping you deliver the best quality care you can while maintaining a warm, friendly environment.  Seems rather intuitive, but it can surely become a difficult task when you’re seeing over a thousand patients! Documenting highlights of your conversations with patients along with your post-op note is always a good idea.

 

Are you afraid of the dentist?

What’s not to fear?

gomaa munir.png

3.5 years into dental school and going to the dentist still gives me the chills..

I get it. Dentists are mysterious creatures who reveal only 50% of their face at a time, poke you with sharp instruments and drill through your teeth like it’s butter. When taken out of context, they actually make for a perfect villain.

It thus comes as no surprise that 5-8% of Americans are so consumed by fear of the dentist that they avoid going altogether, only to experience an abundance of oral health problems that work to fuel this fear. Around 1 in 5 Americans possess a degree of dental anxiety that prevents them from seeking out dental care unless it becomes absolutely necessary, generally due to intolerable pain or lack of proper functioning. And by the time they do seek care, it’s often too late to save the teeth in question.

Dental fear and anxiety has been, and continues to be, a widespread problem among all populations. It has inevitably contributed to a “vicious cycle dynamic”, in which fear of dental treatment, lessened use of dental services, and consequent oral diseases continuously reinforce one another.

fig1

A collection of variables are commonly responsible for establishing a lasting fear of the dentist. Some of these variables are discussed in this article. According to several studies, the onset of dental fear and anxiety usually occurs in childhood. Oftentimes the reason is directly related to traumatic dental experiences in the past. Sometimes this fear is deeply rooted in entirely non-dental experiences, such as childhood sexual abuse (rather disturbing findings implicating this relationship can be found here), post-traumatic stress disorder, general anxiety disorders, or even substance abuse. However, just as often, personal trauma has little or nothing to do with it.

A rather frustrating fact of life demonstrated by several studies is that parents can easily transmit their fears and anxiety to their children. Children actually learn from their parents to become fearful of spiders, social situations, or the dreaded dentist, and the mechanism of this transmission is subtle yet powerful. One study demonstrated that parents’ degree of vulnerability to certain general, non-dental related perceptions, namely uncontrollability, unpredictability, and dangerousness, reliably predicted their child’s level of dental fear. Another study found evidence that there is a genetic component to dental fear in addition to environmental influences. This study demonstrates that fear of pain is a genetically heritable trait, and that this fear is significantly associated with dental fear.

afraid-of-the-dentist1

With the presented knowledge in hand, I’m prescribing a less intuitive approach to battling dental phobia. Since vulnerable perceptions of adults can be so easily and unintentionally inherited, both socially and biologically, by their children, it’s important for dentists to focus on alleviating fear and anxiety present in their adult patients. When treating the fearful adult patient, most dentists assume that fear is so fortified that it’s useless to try and address it. Instead, they focus on temporary solutions, such as distraction techniques or compromising the treatment plan, to allow for resolution of immediate dental needs. The fear lingers and is nurtured until the next visit.

It’s also important for dentists to inform their adult patients of this very apparent risk, as they can play a large role in preventing transmission by concealing their fears or reservations from their children, or even their younger siblings or relatives, as they work on eliminating or minimizing these qualities in themselves. It’s crucial to take cautious advantage of the openness and moldability of a child’s brain by encouraging a positive attitude towards the dentist and oral hygiene, preventing a plethora of dental problems down the road.

By Munir Gomaa

Stress in the dental profession and…horses

It’s certainly no secret, especially to dentists and their families, that the dental profession is an inevitably stressful career. The multifaceted role that a dentist plays–as a clinician, an entrepreneur, a manager, a lab technician (perhaps dental students like me assume this role more than actual dentists), a therapist, and in several ways, an artist–establishes a natural tendency towards perfectionism. After all, financial success for the dental business owner does depend on the dentist’s ability to succeed in all of these facets. Proper fulfillment of these roles demands paying continuous and precise attention to detail during diagnosis and treatment, satisfying patient’s and staff’s evolving needs, and, perhaps most importantly, nurturing the dentist’s own mental health.

Juggling all of these responsibilities in a productive and time-efficient manner takes an incredible toll on the mental health of dentists. It’s no surprise that dentists rank #2, after medical doctors, in careers with the highest suicide rates.

An interesting article I ran across uses empirical data to prescribe a most natural kind of medication to alleviate stress–for dentists, physicians and, quite frankly, anyone with a stressful career or lifestyle–called horses.

horse_png2558

Yup.

Apparently, this mysterious creature’s heart emits an electromagnetic field five times larger than the human heart (which translates to a field extending 40-50 feet from the horse’s body!) According to research, a horse’s electromagnetic field directly influences the nearby human’s own heart rhythm by increasing its coherence–and a heart with increased coherence is directly associated with tranquility, happiness and well-being.

In fact, the physiological and psychological benefits of being around horses don’t stop there; research shows decreased heart rate and blood pressure, reduced feelings of stress, anxiety and anger, increased levels of endorphins, heightened feelings of empowerment, patience and self-efficacy, and the list goes on. Several of these effects work together to alleviate depression, which recent research has associated with a higher risk of cardiovascular disease.

Dr. Bethany Piziks, a dentist and certified life-coach, incorporates this surprisingly effective method in coaching her clients. She uses a method called “Equine Gestalt Coaching Method (EGCM)”, in which two life coaches, a horse and a human, work to help dentists alleviate stress, depression and work through longstanding personal-dilemmas to promote self-development. The outcomes achieved by her client’s are pretty incredible. Highly recommend this article to any and all stressed individuals!

Sources: Stress in the dental profession and why a horse could save your life”Top 11 professions with highest suicide ratesDepression and Cardiovascular Problems

By Munir Gomaa

‘Pain, Fatigue and My New Normal’ — Longreads

For many, chronic pain and fatigue is a norm. Can you imagine living with pain? Can you imagine how that life would look like? Can you imagine working, eating, sleeping with chronic pain?

-Munir Gomaa

 

A travel writer confronts her battle with chronic pain.

via ‘Pain, Fatigue and My New Normal’ — Longreads

Photographs of ‘strangers’ from all walks of life. These are your patients: From Stranger to Intimate Portraits — Discover

In this collection of images from the blog of the Documentary Practice and Visual Journalism Program at the International Center of Photography in New York City, students try to get closer to strangers. This featured photo is by Mandira Bahl.

via From Stranger to Intimate Portraits — Discover

5 reasons to visit your dentist regularly — Wellness

A good article on how important your dental health is to your mental and physical health.

A trip to the dental clinic or an appointment always intimidates us before the treatment has even started, but as we know that our oral health is equally important to our physical and mental health. Poor dental hygiene can lead to many diseases such as infection leading to cancer. Recent research has revealed that there […]

via 5 reasons to visit your dentist regularly — Wellness