Dental Anxiety and The Role of Providers in Facilitating Approachable Care

“I love our pediatrician, but I pray that he doesn’t leave our area because there are so many providers leaving,” said Rachel, a mother of two who lives in Wayne County, North Carolina. “It’s going to be hard for our family if he does.”

“For me personally, if my son were sick, I would not be able to get an appointment today. I would have to wait for an emergency appointment or take him to the emergency room,”
said Rachel. “We just have a lack of providers here, and we’re losing providers. They’re leaving our state to get paid better elsewhere, to get treated better elsewhere.”

Rachel’s sons have had Medicaid insurance for their entire lives, but Rachel herself went uninsured until recently. She qualified for Medicaid in 2020 after a severe case of COVID-19 that left her with long-COVID symptoms.

Gaining access to Medicaid insurance has allowed Rachel to focus on her own health, which she had to deprioritize partly due to the cost of accessing care without insurance.

“I wasn’t able to work much of the year as a result,” said Rachel. “So, I got Medicaid, and I didn’t lose it when I went back to work because of the pandemic supports. And I would have lost it if North Carolina hadn’t expanded Medicaid last year.”

Gaining access to Medicaid insurance has allowed Rachel to focus on her own health, which she had to deprioritize partly due to the cost of accessing care without insurance.

“I’ve transformed these past three years because I’ve finally been able to care for myself,” she said.

Rachel grew up with a single mother. Family financial constraints made dental care and primary care luxuries throughout her childhood. To get to where she is today, Rachel faced a long journey navigating a health care system often ill-equipped and, at times, seemingly hostile to her needs.

“I had to be very sick to see a doctor or dentist,” she said. “Even though I wasn’t seeing a dentist, I was very good about brushing. I wasn’t flossing like I should, but I was brushing. And what got me into it was preschool. They were all about dental care. They gave us visuals, and we brushed our teeth at school.”

In her early 20s, Rachel decided to see a dentist for the first time. Her wisdom teeth were causing pain and needed to be removed. She had never been to a dentist for a cleaning or any other service, but she had to address the pain she felt.

“The dentist referred me directly to an oral surgeon, and I will never forget how mean he [the oral surgeon] was,” said Rachel. “I think he thought I wanted pain medicine. I didn’t, I wanted to understand why I was in pain. I couldn’t eat, I was losing weight. And that experience scared me. I didn’t want to go back for that next cleaning with a dentist because of what I experienced with the oral surgeon.”

After that, Rachel avoided returning to a general dentist for her first cleaning. When she did make an appointment, her provider laughed at her for being scared in the office.

“At first I kind of brushed it off,” said Rachel. “But then they brought another dentist in, and one of them pointed at me and said, ‘Look how red she gets.’ I let them do the cleaning and fix one cavity, but I didn’t go back for several years after that.”

In 2020, Rachel needed to see a dentist again. She had an infected tooth that needed to be removed. She credits the dentist she saw then with helping her overcome her fear in dental offices.

“I said, ‘Would your staff be willing to talk me through everything? Walk me through it like I’m a toddler because I’m so scared,’” said Rachel. “The lady that he had assist him during the procedure had been through my experience herself. I thank God he did that because I needed someone with that experience to know what I felt.”

Today, Rachel and her entire family continue to see that same dentist. She credits his caring approach with helping her adjust to regular appointments and improve her overall oral health.

“After that experience, I stopped being scared of dentists,” she said. “I’ve been going to the dentist ever since.”