Oh good, time to visit the dentist

Dental phobia is way out of date. The latest advances mean drills, injections and even fillings will soon be a thing of the past

Cartoons are on the TV, music is playing and the air is heavy with the scent of strawberries. Seated in the large chair facing the screen, a young girl is laughing and trying to concentrate on the cartoon action despite being distracted by the bobbing head of the man standing in front of her who keeps wanting to look into her mouth.

Cartoons are on the TV, music is playing and the air is heavy with the scent of strawberries. Seated in the large chair facing the screen, a young girl is laughing and trying to concentrate on the cartoon action despite being distracted by the bobbing head of the man standing in front of her who keeps wanting to look into her mouth.

It's 10am on Wednesday morning and Dr Tony Newbury is dealing with his first anxious patient of the day. She has already been treated to a few introductory rides up and down in the once-feared chair, but is now sitting comfortably and watching Tom and Jerry as a strawberry gel begins to work on numbing the gum around the tooth that needs filling.

For dentists like Dr Newbury, dealing with nervous and phobic patients has always been part of the job, but new technologies - including needle-free pain relief and drill-free fillings - are promising to take much of the traditional fear out of visiting the dentist.

Not so long ago dental surgeries were a place of last resort where the squeal of the drill, the whiff of escaping gas and the occasional cries of pain from behind a closed door struck fear into even the bravest of souls waiting in line.

But although the Marathon Man era of dentistry may have gone, tens of thousands of people, adults as well as well as children, still suffer with dental phobia, and many more have anxiety or fear at the sound of a shrill dental drill or the smell of an antiseptic mouthwash.

Phobics can suffer panic attacks, heart palpitations, irrational fears, uncontrollable shaking, nausea and blackouts at even the thought of a dental appointment. As a result many put off visiting the dentist until they are in agony, and may have to be given a general anaesthetic.

Much of the fear is thought to be rooted in past experiences of others. Many emanate from older, often toothless generations, who talk nostalgically of pliers, pain, blood and string tied to doorknobs.

"Today's dentistry has changed significantly," says Harley Street dentist Dr Newbury. "Our aim now is to be minimally invasive whereas in the past we were maximally invasive. We are also much more preventive. In the old days we were taught to put fillings in just in case the teeth got decayed.

"There is no need for a child or anyone else for that matter to be frightened. Kids don't like seeing a needle and having an injection, and child-friendly technology is now available. We can do fillings without a drill if we have the equipment, and we can get rid of decay just by putting gel on the tooth. We can also anaesthetise the gum with pleasant-tasting creams. We even have a TV in front of the chair for distraction.

"We can do all sorts of things now. We can bond material to the surface of teeth which means you don't have to be drastic when you cut into teeth, and you don't have to do the great undercuts which we had to do in the past to hold the material in place. We can change the colour of the teeth, straighten crooked teeth, fill the spaces between teeth, re-build chips and so on. It is the most exciting time in dentistry.''

Dr Jacinta Yeo, also a Harley Street dentist and a spokesman for the British Dental Association, says there has been a huge change in dental practices and attitudes over the last 40 years. "It is like the difference between night and day," she says.

"There is now no need for people to feel pain when they go to the dentist. Some people are scared or do have a phobia - the worst case I am aware of was a man who removed his teeth in the bathroom with pliers and a razor blade - but dentists are taught to recognise the signs. I always do a deal with these patients and tell them that if they raise their arm at any time, I will stop. If you give the patient control in that way, they will not be fearful.''

She says that one of the reason why children are often frightened of the dentist, even when they have never been before, is because parents, grandparents and other adults transfer their own fears based on out-of-date experiences. "In the past they had good reason to be frightened because 30 or 40 years ago going to the dentist could hurt like crazy. At one time, for example, lots of dentists didn't think children needed anaesthesia because they thought they had no nerves and didn't feel pain in baby teeth.

"And in some places although tooth extractions were free, you had to pay for anaesthesia sopoor people went without pain relief. It's therefore not surprising that older people have a painful imageof dentists.''

Dr Yeo says it is important for the dental health of children that the painful experiences of the past are not passed on: "The message is not to let your child get nobbled by granny on the way to the dentist."

More developments are on the horizon too, including a compound that coats the teeth and prevents bacteria from sticking. One coat of the compound gives protection for up to four months.

A new generation of plastic fillings are on the way, and scientists now reckon they will soon be able to get the body to grow third, fourth and even fifth sets of natural teeth rather than the regulation two. Researchers at Texas University have already grown test-tube mice teeth, and say they will eventually be able to use new technology to regenerate teeth in the mouth itself so that humans will no longer be limited to two sets of real teeth.

"The goal is to generate teeth at the site where they are lost so we can make, third, fourth, fifth sets of teeth," says Professor Mary MacDougall, professor of paediatric dentistry and associate dean of research at the University of Texas. "Tissue would be planted in the socket and would grow in the oral cavity just like the first and second teeth grow now.''

For most people, and for dentists, that will be good news, but for dental phobics it could of course be the ultimate nightmare. No longer would they be able to look forward to dentures and a final escape from the dentist. Instead, every time they pluck up courage to have a tooth taken out, another one will just start growing again, year after year after year...