Medical and Dental Tourism in India - Part 4

Part 4 - Dental Tourism

In the previous posts we have discussed the pros and cons of medical tourism as well as practical advice for those considering travelling for medical treatment.

In the section we will look specifically at dental tourism, drawing on our experience at Smile Station in Bangalore, India.

What is Dental Tourism?

Dental tourism is a subset of medical tourism. Sometimes also called a "dental vacation" when people combine a foreign holiday with seeking dental treatment.

Why is dental tourism becoming more popular?

Many people who have private, or government provided, medical insurance do not have dental coverage and therefore have to pay the full cost of treatment. Even those who have dental insurance are not covered for many treatments, such as implants and cosmetic dentistry. Extensive reconstructive or cosmetic treatment can be expensive. In the USA and Europe, comprehensive dental treatment has become unaffordable for many.

Travelling for dental treatment is popular, largely due to wide variations in treatment costs between countries.In some cases treatment may be much more affordable in a neighbouring country, such as in Mexico compared to the USA. People from the UK may travel to Hungary or Poland in Eastern Europe where treatment costs are considerably lower.

India is popular with individuals who have family in India and are living abroad as they may seek dental treatment whilst visiting relatives. Others visit for work, vacation or a spiritual retreat and take advantage of quality, affordable dental care whilst in India.

India offers a rich cultural experience and a full range of options, from budget to 5 star hotels, for those looking to combine dental treatment with an unforgettable vacation. 

Depending on the procedure, it is possible to make savings of 50-90% compared to the cost of treatment in the USA or Europe. Even after adding travel and accommodation costs, big savings can be made. 

Developing countries are able to offer more affordable care due to lower overhead expenses, such as the cost of labour, insurance and less bureaucratic red tape. However, there is also generally less regulation of the dental profession.  There is currently no independent, international inspection committee for dentistry, unlike the Joint Commission International (JCI) which accredits hospital and medical care providers. Therefore, it is vital to do your research well in order to find a well qualified, experienced and ethical dentist.

Which procedures are suitable for dental tourism?

The most popular procedures for dental tourists are:

• Dental Implants
  
• Tooth coloured filllings
• Crowns and bridges
• Veneers
• Dentures
• Implant retained dentures
• Root canal treatment
• Periodontal (gum) treatment
• Tooth whitening
• Smile design and makeover

Procedures are usually elective (planned in advance) although emergency treatment may also be sought by those travelling for business or pleasure.

What do I need to consider if I am planning dental treatment abroad?

The tips and advice for those considering medical tourism in the previous part of this blog (click for link) also apply to dental tourism.

In addition:

• Do your research and get recommendations and reviews from verified patients.
• Check your dentist's training and experience and whether they have international qualifications or certification.
• Make sure that the clinic is clean and sterilization protocols are followed.
• Find out about the treatment and how many visits will be required.
• Discuss the best treatment option for you and any risks or precautions.
• For complex restorative treatment, such as implants, crowns and bridges, the timing of multiple visits will need to be carefully planned.
• Find out what travel and activities may be advised or avoided in the post treatment phase.
• Enquire about treatment costs and any guarantees for implants, crowns and bridges etc.
• Consider whether you will be able to return for follow-up or maintenance, or whether you will require follow-up treatment in your home country.

The Smile Station Experience

At Smile Station, in Bangalore, we are regularly welcome international clients, as well as those from other parts of India. Our team of internationally trained and certified consultants are able to provide a full range of dental treatment under one roof. Treatment options, along with their risks and benefits are fully explained so that you can make an informed choice. We have a proven track record in providing high quality, professional and ethical care. 

The clinic environment is relaxed and welcoming and we specialize in helping those who are anxious about dental treatment. The practice is well equipped with the latest technology and materials and a strict sterilization protocol is followed. We used internationally acclaimed dental laboratories to provide world class restorative treatment at an affordable cost. We are also able to arrange airport transfers and travel and accommodation in India.

We have received great feedback from our international clients, many of whom return to Smile Station whenever they are in India.

Here are just two testimonials:

“What an incredible experience! I needed four crowns Dr. Gurudev & his staff went out of their way to accommodate me in the short time I was in Bangalore. Friendly and Professional service at a fraction of the cost in the US.” 

Linda Busi, Santa Fe, New Mexico, USA

Dr. Guru Dev is one of the best dentist I have ever been to....and I've had a lot of excellent dentistry in my life....with having 26 gold porcelain crowns in my 20's. While in India for a long time I had some serious dental problems that I saw 2 dentist for...both of whom said that the tooth needed to be pulled. Being extremely emotionally sensitive to dentistry and feeling no trust in either of them a friend suggested I go see Dr. Guru Dev. He took charge right away with calmness, and gentleness through every procedure. He saved that tooth through a very complicated root canal, and then came the crown. He became my dentist from that point on ....through an extraction, and eventually to an implant which I was very scared to have done. Now back in the US every dentist I see asks who did it and how well done it is. I have had no problems since. I only wish Dr. Guru Dev had a dental practice on the West Coast of the US! Thank you Dr. Guru Dev for all your care and professionalism. Lucky people in Bangalore! 

Christinea Johnson, California, USA


If you would like to know more, please check the Smile Station website (click for link)

Medical and Dental Tourism in India - Part 3

Part 3 - Tips and Advice

In the previous section we looked at the pros and cons of medical tourism. 

If you are considering travelling for medical treatment it is important to know your options and prepare well.

 

Do your homework

Find out about the proposed procedure, the benefits and risks.  Research which destinations and treatment centres have a proven track record and good reputation for the specialty. The Patients Beyond Borders website has a lot of good information (click for link). 

You can also check the Joint Commision International's service World Hospital Search to find JCI accredited health care organizations (click for link).





If possible, get reviews or talk to others who have had the same procedure or been to the same clinic or hospital. Find out if the medical staff speak your language or whether you will require an interpreter.

Finding the best doctor or physician

If possible, get personal recommendations of doctors from those who have been treated by them. Do not rely on reviews on the internet as there is no way to check if they are genuine.

You can check a doctor's qualifications, licence to practice and membership of professional associations. Find out where a doctor did their training and how many years they have been in practice. Check if the doctor is board certified (USA), or on the specialist list (in other countries) for the area they are working in. For example, if a doctor or surgeon trained in the USA, they may be American Board Certified and working in another country.

Doctors who are well known in their field have often published research papers, which you can search for on-line.

Find out which hospitals or clinics the doctor or surgeon practices in, and whether these are internationally accredited.

Ask questions

You should be able to speak to the doctor or surgeon before you travel, either by phone or on-line consultation.

Here are some questions to ask:

• How many of this type of procedure have you performed and what is your success rate?
• Where and how will you perform my procedure?
• Is the surgical facility accredited?
• What are the risks associated with the procedure and how can these be minimised?
• What is the cost of treatment?
• What is the expected recovery time, what kind of help would I need in the recovery phase and when would I be able to return home?
• How do you deal with any complications, if they arise?

  

Know your rights

Find out how the medical profession is regulated in the country you are travelling to and who you could contact in case of any concerns or complaints. Check your doctor's qualifications and membership of professional and licencing associations. Find out about travel insurance for your trip and what it will, and will not, cover.

 

Have realistic expectations

A good doctor will advise on various options for treatment as well as expected recovery time and possible side effects. Beware of those who offer miracle cures.

 

Consult with local physician or surgeon and arrange follow-up care upon your return

It is important to inform your local physician of your intention to travel. They may be able to give you valuable advice in addition to arranging any follow up care you may require.

Medical records

You will need to take records of your complete medical history, or have these transferred to the doctor who will be treating you. It is also important to obtain the medical records of your treatment for your physician in your home country.

 

Travel with a friend or relative

It can help to have moral support and someone to help you, especially in the recovery phase.

 

Find out about visa regulations

If you need a visa you need to allow sufficient time for the application process. Some countries allow for visa on arrival at the airport.

 

Budget for all associated costs

Whilst calculating savings for your medical care, don't forget to budget for all costs such as flights and transfers, visas, food and accommodation and vacation activities.

 

Pre-travel health advice

Consult a travel health provider at least 6 weeks prior travel to arrange any necessary vaccinations and any other precautions, e.g. antimalarial measures, which may be required for your destination. You should also discuss the risks of travelling, and especially flying after surgery. Air travel is not recommended for at least 7-10 days following many types of surgery.

 

Plan timing of any travel and vacation activities

Depending on the planned treatment, you will need to allow enough time for rest and recovery. It may be better to plan sightseeing and other activities before, rather than after surgery.

 

Consider using a medical tourism facilitator

A medical tourism facilitator can help in all the arrangements, from the planning stage right up until follow-up care in your home country. Be aware that there is no standard regulation for medical tourism facilitators. Choose a facilitator who is highly recommended by previous clients and has international accreditation.

In the last section, we will look more specifically at Dental Tourism

Medical and Dental Tourism in India - Part 2

Part 2 - Pros and Cons of Medical Tourism 

and India as a destination

Benefits of Travelling for Medical Care

• Cost Savings
• Less Waiting 

(both discussed in part 1 of this blog)

• Availability of world class health care

Many countries have hospitals and health care centres which are internationally recognised for clinical excellence and high quality care. Joint Commission International (JCI) is a not-for-profit organization, based in the USA, who assess organizations according to exacting standards on patient safety and high quality practices and procedures. Currently, 659 health care organizations around the world have achieved JCI accreditation, which is viewed as the gold standard in the global health care community.

• Combining medical treatment with a vacation

As an added bonus to travelling for medical care, many people use the opportunity to take a break from their every day routine whilst seeing a new place and experiencing the local food and culture. Many destinations also offer alternative therapies at a lower cost which can be beneficial in the healing process and rejuvenation. 

• Discretion

Some people may prefer the anonymity of having a procedure done whilst abroad and therefore not having to reveal details to family, friends and colleagues. 

Some difficulties to consider

• Need to do research

The decision to go abroad for treatment should never be taken lightly. It is important to do your research on the physician and hospital or clinic you are planning to visit and prepare properly. Medical tourism facilitators can help with planning but the medical and practical aspects of your trip. This will be discussed in the next section.

• Lack of Regulation 

There are currently no distinct laws or guidelines to regulate international medical tourism. 

The Medical Tourism Association is a non-profit, membership based association for the medical tourism industry which seeks to work with providers and consumers around the world to promote high quality, transparent healthcare. However, membership is purely voluntary. 

• Language and cultural differences

There is the possibility of misunderstandings due to language and cultural differences. These can be minimised by using a good interpreter where required and making sure any questions or concerns are addressed, especially when giving consent for a procedure.

• Travelling 

Depending on the destination visas and vaccinations may be required. You will need to check advice on how soon you are able to fly after surgery and plan accordingly.

• Follow up care and post-treatment complications

It is important to consider follow up care after you return to your home country and discuss this with your physician before you travel. Individuals should be aware that physicians in other countries do not practice under the same laws as in their home country and therefore seeking legal remedies would be much more difficult and complex should medical negligence occur. 

Medical Tourism in India

India is one of the worlds top destinations for medical travel. Whilst other destinations tend to specialise in one or two areas, India offers the comprehensive solution for the full range of medical and dental needs. Due to India's growing economy and private health care sector there are many world-class hospitals with highly skilled staff and the latest technology and facilities. In the large cities, such as Bangalore, Mumbai, Chennai, New Delhi and Hyderabad, there are many centres which specialise in various types of surgeries, such as joint and heart surgery. These hospitals have excellent pre- and post- surgical care as well as international patient services who can help with arrangements, such as travel and accommodation.

The number of internationally accredited (JCI) medical centres in India has increased rapidly and currently stands at 21, from only 2 in 2005. Unlike other Asian medical tourism destinations, who aggressively recruit specialist physicians from other countries, India produces some of the world's finest physicians and surgeons in it's own excellent teaching hospitals and research centres. Also, whereas in the past, many Indian doctors have emigrated looking for better opportunities, more recently there is a trend for foreign based and trained doctors returning to India.

Potential cost savings, especially for more complex surgeries, are also the greatest in India. Patients can save between 65-90% for many procedures, compared to the cost in the USA.

Even after taking into account associated costs, such as travel, accommodation and visas, patients can still make big savings. The recent fall in the value of the rupee against international currencies has resulted in relatively lower cost for those from abroad. Many patients will also choose India to avoid long waiting times for surgeries in their home countries.

Another advantage for English speaking patients, is that English is widely spoken in India. All doctors and most nurses and other health professionals are trained in English. Those travelling to large cities, where most of the world-class facilities are located, will be able to get around easily using English.

Although the visa process for visiting India has at times been complicated, India will soon be extending visa on arrival to all, barring eight "prior reference" countries including Pakistan, Iran and China.

India is also a popular destination due to its rich cultural heritage, natural beauty and interesting places to visit.

In the next section we will discuss tips and advice for those considering or planning health care overseas.

Medical and Dental Tourism in India - Part 1

What is Medical Tourism?

Medical tourism is the term used when someone travels for the purpose of obtaining medical treatment. Although some definitions include domestic medical tourism, within the same country, the term is mostly used for foreign medical travel. The number of medical tourists is on the increase. Although it is difficult to obtain reliable statistics, it is estimated that currently between 8 and 12 million people travel abroad annually for healthcare. The medical tourism market is thought to be growing at a rate of 15-25% annually.

In the past, the majority of medical tourists were from less developed countries travelling to seek treatments that were not available in their home country. Whilst this is still the case, more recently, the trend is for people to travel abroad to seek treatment at a lower cost. 

The phrase "medical tourism" may be relatively new but the practice of travelling for health reasons dates back to antiquity. One of the earliest known destinations is Epidauria, in ancient Greece, which was believed to be the birthplace of Apollo's son, Asclepeios, the healer. From the 6th century BC or even earlier, those who were sick would travel long distances to seek healing. 

In Israel, the Dead Sea is believed to be one of the world's first health resorts, dating back to the time of King Herod the Great. For over two thousand years up to the present time people have traveled to the Dead Sea for health therapies, due to the high mineral content of the water and beneficial climatic features.   

Why do people choose to travel for healthcare?

There may be many factors involved in a person's choice. Here are some of the most common reasons:

Cost

Treatment abroad may be available at a fraction of the compared to the USA or Europe. It is estimated that 40 to 45 million Americans (one in seven) do not have health insurance and many more may be under-insured. Some people are unable to get insurance for a pre-existing condition. Even for those who have insurance, certain treatments and procedures may not be covered (eg. cosmetic surgery) and for some treatments the deductible amount the patient has to pay may be higher than the total cost of travelling abroad for treatment. 

Less Waiting

In countries with nationalized health services, such as the Canada, Australia, the UK and many other European countries, there may be long waiting lists for important surgeries. By seeking treatment abroad, individuals may be able to get treatment with minimal or no waiting.

Treatment not available at home

Some treatments may not be available due to lack of resources. Other procedures may be unauthorised or even illegal, in the person's own country eg. new, experimental treatments, some reproductive technologies or surrogacy. People also travel for traditional medical practices, such as Ayurveda, in India.

Tourism

People may use the chance to have a vacation see a new place whilst also receiving medical treatment.

Which specialties are popular with medical tourists?

• Orthopedics - including hip and knee operations
• Heart Surgery
• Fertility and Reproductive Health
• Cosmetic and Reconstructive Surgery
• Oncology (cancer treatment)
• Weight loss surgery
• Ophthalmology (eye surgery)
• Dentistry

Where are the top medical tourism destinations?

• Malaysia - burns treatment, health screening
• Thailand - cosmetic surgery
• India - surgery, especially heart surgery and orthopedics
• Brazil - cosmetic surgery
• Singapore - many surgical specialties and stem cell treatments
• Costa Rica - cosmetic surgery, dentistry
• Hungary - dentistry
• Mexico - dentistry and cosmetic surgery
• Turkey - ophthalmology

amongst many other countries.


In further posts we will look more specifically at the pros and cons of medical tourism, tips and advice for those considering medical care abroad and more specifically at medical and dental tourism in India. 

Mouth Cancer - What you need to know

April is Oral Cancer Awareness Month.  

What should we be aware of and why is it important?

The bad news:

Oral cancer is defined as cancer of the lip, mouth or tongue. It can be a devastating disease. In India it is one of the most common forms of cancer, accounting for between 30% and 40% of all malignancies (higher than in other parts of the world). Although the prognosis can be good if spotted early, the majority of those with the disease are diagnosed too late. This type of cancer is very malignant, meaning that it can spread quickly if not treated early. 

People are dying because of lack of awareness.

The good news:

Many types of mouth cancer are preventable by avoiding the known risk factors. It is also possible to spot signs of early signs of mouth cancer or conditions that can lead to cancer by regular, thorough mouth examinations. If people are aware of the possible signs and symptoms they can be alerted to see a dentist or doctor as soon as they spot these. The earlier a lesion is diagnosed and treated the better the outcome. 

Risk factors and prevention

Tobacco use has been shown to be the biggest risk factor for developing mouth cancer. Tobacco contains carcinogens (substances directly involved in causing cancer) and causes approximately 85% of all cancers of the head and neck. Tobacco is a risk factor whether it it smoked or chewed. One of the reasons for the higher incidence of mouth cancer in South Asia is the widespread use of tobacco in paan, gutkha or betel quid. These are typically kept in the cheek and chewed or sucked for some time. 

Other risk factors include:

• Heavy alcohol consumption (particulary when combined with tobacco use)
• UV radiation from sun exposure can cause lip cancer (as well as skin cancer)
• Infection with Human Papilloma Virus (HPV)
• Chronic trauma from a sharp tooth or ill-fitting dentures
• Poor diet, lacking in fruit and vegetables
• Genetic factors

Early detection

Oral cancer can start in the floor of the mouth, gums, lips, inside the cheek or on the tongue or palate. Some cancers may start as "pre-malignant lesions" - these are areas which have a risk of developing into cancer and so need to be monitored.

The most common early signs are:

• An ulcer with no obvious cause which does not heal after 2 weeks
• A white, red or speckled patch which cannot be rubbed off                                                                                                                                                 These are usually not painful in the early stages.

                (Photographs courtesy of http://www.oralcancerawareness.org)

Other signs and symptoms to look out for:

• Unexplained pain or numbness in the mouth or ear area
• Lump in the neck 
• Difficulty swallowing or opening the mouth

If you have any of these, it doesn't necessarily mean you have cancer. It just means that you should get checked by your dentist or doctor. They will either be able to reassure you, or arrange for further tests if necessary.

Regular check-ups with your dentist will enable them to examine your whole mouth (not just your teeth). No one wishes or expects to get cancer but if early signs are seen, treatment can be far easier and more successful than if cancer is diagnosed at a later stage.

Overcoming Dental Anxiety - Part 4

In this blog so far, we have discussed causes of dental fear and anxiety and ways to overcome them. 

In this concluding section we will look at some more issues, in particular the importance of good pain control and techniques for relaxation.

Fear of being awake for treatment

One major difference between dentistry and other medical specialties is that, most of the time, patients remain awake for treatment. Many patients with a dental phobia say that they would like to be "knocked out" (have a general anaesthetic) for treatment but there are reasons why a general anaesthetic (GA) is not used routinely, but only as a last resort, in dentistry. There are risks associated with having a GA and it is required that general anaesthetics are only carried out in a fully equipped hospital. Weighing the risks against the benefits, GA is generally only justified for complex oral surgery or for urgent treatment when other methods, eg. psychological techniques and sedation, have been tried unsuccessfully. In addition, having treatment while asleep will not help a person with dental phobia overcome their fears and it will not be possible to keep having treatment under GA in the future. It is much better to find a good, sympathetic dentist who will work with you as we have discussed in part 2 of this blog.

Fear of "the drill"

For many people, even the sound of the dental handpiece (or drill) can make them very anxious. This may be due to a previous bad experience where the tooth was not sufficiently numb and/or the dentist did not stop treatment when they felt pain. 

When a tooth is properly numb, the only sensations that should be felt are vibration and slight pressure (see more about this in under subheading "fear of pain"). However, for some, the vibration itself can be uncomfortable. If this is the case, using an electric tooth brush at home may be help you get used to the vibration sensation. 

Many people do not like the sound of "the drill". Music can be helpful to blend out unpleasant sounds. Some dentists have music in the treatment room, or you could bring your own mobile device with your favourite songs or music for relaxation on. Of course, you would need to turn the music off when you need to speak to the dentist.

Other distractions, such as watching a video, either on a screen above the dental chair or by wearing virtual reality goggles, may also help. Sometimes it is helpful if your dentist tells you that they will need to use the handpiece for 5 or 10 seconds at time and even counts this out loud. Don't forget, you can let your dentist know that you need to take a break by raising your hand. This is called the "stop signal" which we discussed in part 3 of this blog

Fear of Pain

If you have had a past experience of painful treatment at the dentist this will have most likely have led to fear and anxiety. 

The reason for pain could have been:

• Not having local anaesthetic (LA) to numb the tooth when it was required.
• The dentist starting treatment without allowing sufficient time for the local anaesthetic to work - this can take between 5 and 15 minutes, depending on the tooth and procedure.
• Infection in the tooth or surrounding area may prevent the LA working properly. This can sometimes be a problem during root canal treatment and antibiotics or a sedative dressing placed in the tooth between visits may be required.
• Painful injection (see next paragraph).
• The dentist not stopping when you felt pain to make you comfortable or give more local anaesthetic.

All of these problems can be overcome with a combination of good communication and using the right techniques. Don't be afraid to tell your dentist if you experience pain so that they can do something about it.

Fear of injections

Maybe when local anaesthetic injections were mentioned in the last paragraph, you thought "but that is my biggest fear!" This is quite common, to the extent that some people would rather suffer pain during treatment that have the numbing injection. Generally, the thought of having an injection is much worse than the reality and there are ways that your dentist can help you:

• A good relationship with a dentist you can trust goes a long way in relieving anxiety.
• A topical gel or spray can be used to numb the gum first, this takes a couple of minutes to work.
• Injection should be slow and gentle - fast injection can cause pain.
• Distraction - your dentist may talk to you or you may listen to music or watch a video.
• Relaxation techniques (discussed below).
• Try to think about the benefits of your tooth being numb so that you will not have pain during treatment.

Fear of choking or gagging

Some people have a strong gag reflex or have a fear of choking while at the dentist. There is a physical aspect to this but anxiety will also cause these problems to be worse. The following solutions may help:

• Discuss the problem with your dentist so that they can find ways to help you.
• Slow breathing through your nose. For those who have a problem with this, a nasal spray used beforehand may help.
• Your dentist could use a numbing throat spray to make the area less sensitive. Some people also find rinsing with salty water or putting salt on the tip of their tongue has a similar effect.
• Desensitization - you could ask your dentist if you can borrow a mouth mirror to practice placing it in your mouth at home.
• Distraction or humming to yourself.
• Relaxation techniques (discussed below).
• Inhalation sedation using nitrous oxide mixed with oxygen (discussed below) is also known to reduce the gag reflex as well as anxiety.

Relaxation Techniques

Relaxation is the opposite of anxiety and it is impossible to be relaxed and anxious at the same time. There are various relaxation techniques that you can try to see which works best for you. All of these need to be practiced regularly at home. They will not work if you start while in the dental chair.

Click on each for a link with more details:

• Deep breathing techniques
• Aromatherapy
• Music which aids relaxation
• Yoga and meditation
• Progressive muscle relaxation
• Self hypnosis and visualisation

Sedation

So what if you have tried the techniques suggested and you still can't cope with dental treatment? 

This is where conscious sedation comes in. Sedation is used to reduce anxiety and aid relaxation, making dental visits more comfortable. You will still be awake but less anxious. You can discuss the options with your dentist. If they do not offer the type of sedation which is right for you, they may be able to refer you to someone who does.

There 3 types of sedation commonly used in dentistry:

• Inhalation sedation - a mixture of nitrous oxide (laughing gas) and oxygen is inhaled through a rubber cup which fits comfortably over the nose throughout treatment. The sedation reduces anxiety so that you feel happy and relaxed. This is the safest and gentlest form of sedation with few side effects and fast recovery time. It can be used for children and adults. Inhalation sedation is available at Smile Station in Bangalore. You can contact the practice for more details.

• Oral sedation -  a medication (usually a benzodiazepine) prescribed to be taken in the hours before a dental appointment, or sometimes the night before, which has sedative and anti-anxiety effects. These should only be taken on the advice of your physician and/or dentist as they have side effects and may interact with other medication. You should not drive or operate machinery after taking oral sedation. 

• Intravenous (IV) sedation - a sedative drug is administered into the bloodstream through a vein. This induces a deeper state of relaxation but you will still be awake. It may give either partial or full memory loss during the time of sedation. IV sedation is only recommended for adults and impairs ability to drive or operate machinery.

Remember, sedation is never a substitute for a good, caring dentist who will work with you to overcome your fears.


Finally, here is a testimonial from Chelsea - a patient at Smile Station who has been able to overcome her anxiety:

"Smile Station, a place I never thought would actually be pleasant to go to. Simply because it was a dentist's clinic. but my experience here made me change my entire opinion and made me feel extremely comfortable. A root canal from what I had heard was supposed to be the most painful thing, but Dr. Gurudev being so experienced made it feel like a cake walk. He was extremely gentle and helped me get over my fear of the dentist. The facilities are extremely good too! I am so happy I chose to come to Smile Station and I would recommend this clinic to anyone!''

If you have any comments on this blog, or would like to see any other topics covered, please post a message below.

Overcoming Dental Anxiety - Part 3

As we discussed in the first part of this blog, dental anxiety is common. However, individuals may face different issues depending on their personalities and past experiences.

In the following 2 sections we will cover some specific fears and anxieties and look at ways of overcoming them.

Loss of Control

A big issue for many people is the feeling of loss of control when visiting the dentist. You may feel like you do not know what is going on in your mouth or that you are not able to have a say in what the dentist does.

You may have had bad experiences in the past with a dentist who did not explain what they were doing or why. This may have given you the feeling that dentistry is something that "is done to you" rather than you being a partner in your dental care.  As discussed in the previous post - finding a good dentist who you can communicate well with is vital in overcoming anxiety. A good dentist will explain treatment options, along with risks and benefits in a way that you can understand. You may need to take some time to consider your options before agreeing to treatment. 

Dentists are required to obtain "informed consent" before treatment. Sometimes you may be asked to sign a consent form. Only sign this if you feel you have enough information to agree to treatment - if not then ask questions. A good question to ask your dentist is what would they choose if it were their tooth or mouth. You should also know the likely consequences if you choose to have no treatment. Remember, you should be in control and always have a choice in your treatment.

Similarly, a good dentist will explain what is involved in your treatment from your point of view, what sensations you are likely to feel and how to let them know if you want them to stop or take a break. Some dentists may ask you to raise your hand if you have any discomfort or need a break. This enables you to give a stop signal to your dentist when you are not able to talk easily without suddenly moving your head. Another option is to agree to take a break after an agreed number of minutes, this can be useful if you are afraid to interrupt the dentist while they are working. However, if you have any significant discomfort, don't be afraid to raise your hand to let the dentist know. If you have a good relationship with a dentist you can trust they will stop and try to make you comfortable. 

Often, it is helpful if your dentist not only explains the procedure but also demonstrates any tools or materials before using them. This technique, called tell-show-do, is often used for children but can also be very beneficial for adults who are anxious. For example, you can feel the dental instrument on the back of your hand or your finger nail before it is used in your mouth so that you know what it feels like.

As we discussed in the previous section of this blog, it is best to overcome anxieties one step at a time. You should become comfortable with having a check-up, or cleaning before moving onto longer or more complex procedures. Relaxation is important in this process. In the next section, we will also discuss some relaxation techniques.

The Dental Chair

For some people with a dental phobia just the thought of lying in the dental chair can be terrifying. Lying down can make you feel exposed or vulnerable. It is often possible to do a check up with the dental chair upright, or even in a normal chair. For treatment, you can ask your dentist if is possible to leave the chair in a more upright or semi-reclined position. For some procedures, especially if working on the back or top teeth, the dentist will need the chair to be more reclined but you can ask for this to be done gradually, so that you can get used to it. If you don't like the feeling of being tipped back then you can ask for the chair to be put into the correct position before you sit or lie back.

Fear of "the diagnosis" or embarrassment

If you have a dental phobia you will probably have put off visiting the dentist even when you have pain or know that they need urgent treatment. This can lead to embarrassment and the feeling that you have the worst teeth the dentist has ever seen. You may also fear being "told off" or receiving a lecture from the dentist. You may also fear that you need a lot of extensive treatment.

Dentists will have seen a wide variety of people and their mouths so it is unlikely that anything in your mouth shock them. These days, most dentists realise that scolding or lecturing their patients is counter-productive. A sympathetic dentist will understand how difficult it has been for you to visit a dentist after a long time and will want to work with you to overcome your fears and improve your oral health. 

Also, dentists should maintain confidentiality and not discuss your diagnosis or treatment in front of other patients or members of the public. You can ask to discuss your treatment in a private setting and have the door closed during treatment if this is an issue for you.


Here is the experience of one patient, Garima, from Smile Station, Bangalore who has been able to overcome her dental phobia:

"I had dentist phobia and there was so much of work to be done on my teeth, but I was always afraid of visiting dentist, in fact I had never visited one. I randomly walked into Smile station for a check up, and Dr Guru did not make me nervous. He would be so patient throughout the treatment which is commendable, given the fact that he is always busy. But what I experienced was he would never ignore or take any patient lightly. Another very good thing is he will exactly tell what needs to be done, gives various options and explains pros and cons of each treatment, so that a person is involved and knows what is going on. I feel that every service / treatment at Smile Station has a personal touch in it. I have now shifted to London, but make sure that on my way back India, I see Dr. Guru as well as get the check up done. I just feel that I / my teeth :-) are in safe hands."

In the next section we will look at more factors which can cause anxiety and techniques which can help. 

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