Sensory Overwhelm

Whenever Scott thinks about going to the dentist, he feels anxious.

“The sound of the drills, the bright lights, laying on my back in front of strangers. It’s like a horror movie,” he says. “I know this isn’t rational, but there’s really nothing worse.”

Diagnosed with ADHD in his late 20’s, Scott is learning that his visceral fear of the dentist is an aspect of being neurodiverse.

It took a recent painful experience to motivate him to seek help managing his reactions.

His hands tremble as he tells the story of his recent dental experience. He says it started with creeping pain on the lower left side of his mouth.

He says it felt like a simple cavity at first. Leery about going to the dentist, he gargled with some salt water, took some Tylenol, and started searching for home dental remedies online.

He hoped it would pass. But three days went by and he woke up in the middle of the night, drenched in sweat and pain so sharp it brought tears to his eyes.

“It was the worst pain I’ve ever known! I actually thought my jaw was going to fall off.”

Dental infections are no joke and can lead to serious health complications. For folks living with ADHD, the combination of anxiety about being in the dental chair and procrastination can be a worrisome mix.

Scott is lucky to have dental insurance and find a dentist near his home to book an emergency appointment.

One of his molars was infected and he had to make the difficult decision of having it removed. Had he visited the dentist sooner, it may have been salvageable. He was also prescribed antibiotics to clear the infection that had taken hold in his mouth.

“I feel like such an idiot,” he says. “I should have gone to the dentist so much sooner, but like I said, it’s such an awful experience.”

Part of what makes Scott so sensitive about the dentist is sensory overload. It’s when one or more of the senses become overstimulated and the brain has difficulty processing.

​Too much, all at once

There are several ways that the physical senses of ADHD folks can be triggered. They include touch, texture, smell, sight, sound, taste.

Visiting the dentist has all of them! It’s no wonder Scott struggles.

Touch: imagine how when the dentist has to pry open your mouth to examine your teeth. It can feel invasive and scary. Touch that is too firm can also lead to sensory overload.

Texture: the gritty paste the dentist uses to hold fillings in place can feel agitating. The strong stream of water that is used to rinse out the mouth can feel too cold, alien and alarming.

Smell: most ADHD’ers have a heightened sense of smell. The medication used by dentists and even our own breath — especially if there is an infection present — can feel horrible and lead to feelings of shame.

Sight: the bright lights at the dentist can be jarring for anyone, but for ADHD’ers it can be extra intense.

Sound: the piercing sound of the dentist drill can cause even more distress than the procedure itself. Auditory stimulants are one of the most intense causes of sensory overload for neurodiverse people.

Taste: the various gels and pastes that are part of getting dental work often have a harsh taste and this can trigger nausea and even more anxiety.

Ways to cope

Going to the dentist isn’t pleasant for most people, but there are some ways to minimize the discomfort of sensory overload.

1: A weighted blanket can help you feel calm and secure while the dentist works. If you don’t have one, you can request they leave the x-ray blanket on for the duration of the procedure.

2: Noise cancelling headphones: blotting out the sound of the drills can reduce anxiety and help you feel more in control.

3: Discuss your challenges with the dentist before they get started so they know how you are feeling. They may be able to reduce the brightness of the lights or use different tools.

4: Medication can help reduce anxiety and should always be discussed with your doctor to ensure it doesn’t interact with your ADHD medications if you take them.

5: Request a freezing agent without Norepinephrine. It’s a common agent used to help freezing last longer, but can have serious side effects, including increased anxiety.

The stress of going to the dentist can feel like too much sometimes, but developing some coping tools can go a long way in making the experience less overwhelming.

Early intervention is key for dental problems. Not everyone has extended health benefits and it can be costly. Many dentistry schools, including UBC offer reduced price dental services provided by recent graduates. In BC, there are several community dental clinics that also offer reduced price dental services.