Fear of Needles

17 February 2014

Fear of Needles

Many of those who avoid going to the dentist, or even just thinking about going to the dentist, have been found to suffer some deep-seated fear of needles.

The fear of needles, or needle phobia, is the extreme fear of medical, including dental, procedures which would involve hypodermic needles or injections. Many needle phobics miss out not only with respect to their dental treatments but even on the most basic medical procedures like blood tests and travel vaccinations. Needle phobic patients with potentially fatal conditions such as heart disease and cancer would rather take their chances with their illness than undergo a needle procedure. In fact, needle phobia has actually been recognised as a direct cause of death in several documented cases. Because those with needle phobia tend to avoid contact with the medical profession, treatable conditions worsen until eventually they become serious, life-threatening, and terminal.

There are different types of needle phobia. The most common type is the involuntary vasovagal reflex reaction to the sight, thought, or feeling of needles. It is a genetically inherited condition with symptoms which may include panic attacks, sweating, nausea, high blood pressure and heart rate followed by an abrupt drop resulting in fainting. Another type is “associative” where the sight, thought or feeling of needles triggers either memories of some actual painful traumatic event that happened in the past, or other phobias like the irrational fear of doctors or dentists and the fear of being restrained or controlled by someone else. Less commonly, there are individuals who are needle phobic simply because they are hyperalgesic, that is, they are born with a condition which makes them physically hypersensitive to pain.

Fortunately, all forms of needle phobia can be overcome. However, the phobia sufferer must take the initiative. If you have this inordinate fear of needles, you need to tell your dentist about it, along with your other concerns.  It is advisable to have a brief conversation with the dentist before making an appointment to make sure that your particular needle phobia can be accommodated. As a professional health care provider, he or she will help you overcome your fear.  He or she may offer you some options on how you may want to be given dental treatment. For instance, you can opt to be treated with sleep dentistry or sedation dentistry. In sleep dentistry, the patient sleeps during the whole procedure. On the other hand, with sedation dentistry, one does not sleep, but is deeply sedated to completely forget his fear of needles while the treatment is being done. Both sedation dentistry and sleep dentistry often use nitrous oxide prior to the sedative or anesthetic.

In less severe cases of needle phobia, the dentist may just anaesthetise the site where the injections will be administered using a q-tip to swab numbing gel or topical anesthesia like EMLA to temporarily block the site of the needle procedure from sending the needle puncture signals to the brain. However, most dentists now already use the Wand (or CompuDent and STA) which is a relatively painless computer-controlled local anesthetic dental injection system that does not look like a syringe at all. The self-retracting needle is hidden from the needle phobic’s sight and so will not likely invite an anxiety or panic reaction from the patient.