October 1, 2003
by Robert E. Horseman, DDS
A recent issue of Time magazine was devoted to understanding anxiety, citing the 9/11 disaster as an exacerbating factor in correctly labeling us as a nation of anxious worriers. “We live in a particularly anxious age,” Time says, noting that all animals appear to feel anxious, that being Nature’s way of preventing us from feeling too safe. If true, then animals have handled their concerns with more aplomb than we have.
Take dogs for example. Dogs have only two anxieties: when their next meal is scheduled and whether their mouth or back paw is the best tool to get at that place that itches. A human will worry about whether the meal is nutritionally sound, low in calories and free of the botulism and trichinosis that could land him in the ICU. This amount of worrying is way beyond what his medical insurance will pay for, plus it will boost his cholesterol completely offthe scale. Feeling ‘too safe’ is something he’s never known.
You never hear anything about Father Nature. No, it was Mother Nature who decreed that women would be genetically superior as worriers, thus ensuring the species would endure rather than be left to males, who, if they worry at all, do so about the wrong things. If this seems a bit sexist, remember Mother Nature knows best. Males, to their credit, have graciously acceded worry rights to women in all categories except sports and internal combustion engines. It is no coincidence that dogs have been called “man’s best friend.” They are so much like their masters.
Having said that, it is necessary to point out that anxiety can be a useful tool in focusing the mind on potential dangers. It requires a great deal of inexperience to be beyond the reach of anxiety. What is important is to distinguish clinical anxiety disorder from just run-of-the-mill fretting. Let us examine some of the manifestations:
Panic disorder–An attack of acute anxiety such as discovering a major case scheduled for delivery in 15 minutes won’t be back from the lab until the day after tomorrow. Four or more of these episodes in a single week could mean Big Trouble.
Specific phobia–We all have these, broccoli, for example. If a certain name on the appointment book causes elaborate ways to be devised to avoid the encounter, the key is how the anxiety is handled. Cancellation is found to be effective.
Obsessive-compulsive disorder–Never in recorded history have dentists been more anxious about bacteria, cross-contamination, biofilm and barrier techniques. If the anxiety is temporarily relieved by a repetitive hand-washing ritual or a thought ritual such as praying, it may respond to treatment. Probably this is not a covered benefit.
Post-traumatic stress disorder–Defined as a repeated, anxious reliving of a horrifying event over an extended period. Typically, an eight-unit bridge won’t seat because you took a lousy impression, one of the spindly abutments fractured at the gum line, and both the lab and the patient have consulted attorneys and written letters to the Dental Board. Advice: Seek help whenever the symptoms occur.
Generalized anxiety disorder–Characterized by excessive anxiety or worry that occurs more days than not for periods of 20 years or more. Inasmuch as most dentists experience this as irritability, fatigue and muscle tension, it comes under the heading of No Big Deal, or Goes With the Territory. Golf is said to be a diversion, but not a treatment modality.
Dentists, male or female, have evolved into world-class worriers since their early days in dental school. All the recent attention being paid to the rest of the population catching up serves only to call attention to some anxieties veteran dental worriers may have overlooked. Consider these:
If you have ever placed even one amalgam restoration in your career, be aware that you knowingly placed a compound containing a toxic substance, namely mercury, into a patient’s personal body, probably without a signed waiver. You are thus subject to anxieties you never imagined, the worst being having to hear about it interminably from phobic antagonists.
Resin restorations almost certainly have something toxic in them. Just because the components taste bad doesn’t necessarily mean they are good for you. The fatal element just hasn’t been discovered yet, but you can bet they’re working on it.
As a general practitioner, you should have noticed by now that all the specialists you refer to have a more opulent lifestyle than you, take more time out of their offices than you, and indulge themselves with vacations costing more than your annual net. It would be wrong for you to sleep soundly knowing that on average they are 10 years younger than you.
The computer you have in your office confirms that you’re really asking for it. When you least expect it, an asteroid no bigger than a school bus, but with a magnetic field larger than Jupiter’s is going to pass within 20 miles of your office and put you out of business. It happens all the time.
You’d be better off with a tarantula in your undies than having three unattended kids under five on sugar highs left in your reception room with Crayolas and All-Day GobStoppers.
If your curing light is powerful enough to turn something soft into something hard as a bowling ball in 20 seconds, what else can it do?
Patients who are gaggers and allergic to antibiotics and every pain killer known to be effective, will make a bee line for your practice the second they are in trouble –usually about 4:30.
Evidence-based dentistry looms on the horizon. This means dentists may be forced to provide evidence that they are proficient in terms of placing at least one Class III gold foil each year on their birthday and correctly reciting the enervation of every major organ of a dead frog.
If your job or the place you live is making you anxious, Time concludes, you might consider moving to a less stressful environment or finding a different line of work. It is reported that there are entry-level opportunities now available in airport security across the country.