Experiencing Post Traumatic Stress Disorder in a Dental Office

By Pere Chuliá / stock.adobe.com

Even in a dental practice, post-traumatic stress disorder (PTSD) can happen. This is a sensitive topic that many dental professionals don’t want to think about, but we must. Why? Because even when you do everything right things can go south very quickly.

Serena is a 50-year-old woman with a long history of dental problems. She has always been able to adjust to whatever needed to be done whether it was crown lengthenings, gum grafts, or dental implants, but this year was very problematic for her. Her 2 molars needed implants. Delays because of COVID-19 and other health issues prevented her from being able to take the steps to get her implants done. This was stressful as it caused an impact to her eating, biting her tongue, pain with swallowing, and worries that her teeth would shift. It needed to be taken care of.

Her periodontist was an angel in a dental coat. She was so gentle and so good at explaining everything and making a plan that Serena could agree to. The day arrived and there were problems. The doctor did everything she could to make Serena comfortable, but she just couldn’t numb her. Imagine 7-8 injections and the patient is still feeling everything. Serena asked for Ibuprofen during the surgery because she was in so much pain. Then came the hammering (we call tapping). Serena had never experienced a hammer going into her mouth and pounding on her tooth. She kept thinking that they might damage 1 of her other teeth and that this would continue to spin her dental nightmare out of control. Imagine your tooth being hammered and feeling it all. She calmly called me after the surgery and spoke matter-of-factly about this trauma that she had gone through.

She was traumatized, and this visit really impacted her. Both the doctor and the 2 assistants felt terrible that they couldn’t anchor the implant into her sinus and that now an oral surgeon needed to step in.

The story doesn’t end there. She went home and couldn’t get the image of hammering out of her mind. She reports that she is reliving it repeatedly. This is a patient with no history of mental health problems, yet she keeps thinking about this experience.

I don’t know what the answer is for Serena. Getting to an oral surgeon and getting sedated for the implants is a good plan, but what happens when something unplanned occurs in your office. It is naïve of us to think that things like this don’t or won’t happen. Everyone did their job and did it to the best of their ability, but things can still go wrong. How do you handle things like this in your practice?

Having the periodontist call that evening and check on the patient is a start. Many offices do that. This doctor didn’t until the next day. Perhaps they assumed Serena would call if she was feeling pain. Some patients will never tell the dentist or staff that they are traumatized. Instead, they just never go back to that practice.

Trauma happens in a dental office. I am sure I will get some irate readers arguing that this isn’t true, but you need to see if from the patient’s side. Some patients are prone to anxiety and phobias. Serena wasn’t. Yet, this still happened. An experience in the chair can have serious consequences depending how it plays out.

If the patient shares that she is having trouble getting the image and experience out of her head, ask gentle probing questions such as these…

• How is your sleep?
• How is your appetite?
• Have you ever experienced something like this before?
• How have you dealt with upsetting issues in the past?
• Have you ever had a problem with anxiety or trauma?
• What did you do to cope when you experienced that?
• Is there anyone you can talk to about this?
• If it continues, would you be open to a referral for counseling?

It is very important when something happens in the chair that there is follow up. That means that there should be a call that night. No matter how adjusted the patient seems to be, you need to follow up and document those contacts. There are some patients who will call and share how they are feeling right away. Others may not be as transparent about what they are experiencing. It is our responsibility as health care providers to assess and follow up. You know when something happens in your office. Make sure that you do the right thing and help to minimize the trauma.

Email me at diana2@discussdirectives.com and share with me your experiences when there is trauma in the dental office.

Also, if you are interested in participating in the Dental Products Report Mastermind Group as a guest, contact me at diana2@discussdirectives.com . We are looking for dental hygienists, front office staff, and dental assistants who want to participate in an interdisciplinary conversation that is both fun and extremely thought-provoking. Come join us and get a seat at the Zoom table.