The dentists who have found out how to conquer fear of the needle

Jacqui Bealing reports on the increasing popularity of treatments ranging from hypnotherapy to acupuncture

Elizabeth Luis was so scared of dentists she once had to be put under general anaesthetic for three and a half hours so that four crowns could be fitted and some root treatment done. As with many dental phobics, she had an anxiety that stemmed from childhood - she has memories of being strapped down to have decaying baby teeth pulled. The anxiety was exacerbated when she had her first filling at the age of nine: she created such a fuss at the sight of the injection needle that her dentist hit her.

"He was angry because the needle could have gone in my eye," she recalls. "My father told me he had been hit by his dentist so I grew up thinking this was normal behaviour. But over the years, I had totally lost faith in dentists." Mrs Luis, now 33, has recently learnt to overcome her fear. Her current dentist, Martin Wall, uses hypnosis to calm phobic patients. At his surgery in Tiverton, Devon, Mr Wall spends at least 20 minutes in an initial consultation with each new patient, finding out about their feelings towards visiting the dentist. If, like Mrs Luis, a problem is revealed, he will offer hypnosis to relax them and will then work on their phobias.

"The two hypnosis sessions I had were incredible," Mrs Luis says. "I was encouraged to imagine myself in a safe place - I chose a summer house in my grandparents' garden in Scotland - to which I could return in my mind every time I felt scared.

"I was also asked to visualise a mirror - by stepping through it I would leave behind the fears of the past and enter the future. Now there is no panic when I have treatment. I've just had two crowns fitted and I didn't worry even though I knew there would be discomfort. I've also got a lot more energy for other things."

Using hypnosis to conquer fear of pain is not new; but it is only one of several alternative therapies now being offered by a small but growing number of the UK's 28,000 registered dentists. Treatments being offered include homeopathy, acupuncture and cranial osteopathy, a form of massage which adherents believe corrects the rhythmic motions of the bones in the skull. Those rarely replace conventional methods of treatment - there is still no substitute for the dreaded drill - but, as with hypnosis, they can help to make both the dentist's and the patient's experience far less traumatic.

Those who practise holistic dentistry, as it is known, are mostly private dentists who say there is an increasing demand which is not being recognised or met by the rest of the profession. Peter Varley, a dentist who uses acupuncture, homeopathy and cranial osteopathy, and who also has a hypnotherapist working at his surgery in Soho, London, blames the apathy about complementary therapies on disillusionment among overworked NHS dentists.

"They just see a whole bunch of teeth with holes in them and they fill them," he says. "But a lot more people are more questioning about the dental treatment they are getting. They may not want antibiotics, for example. Yet they are not being given the choice."

Mr Varley, who has just written a book, Complementary Therapies in Dental Practice (due to be published next month by Butterworth Heineman), had been working for a dentist for six years when he first came across homeopathy in 1981. "I thought it was a load of hogwash at first," he says. "But after learning more about it, I began to see its potential."

In 1990, he set up the British Homeopathic Dental Association with Catherine Price, a dental practitioner who runs The Alternative Practice in Watford. Membership has grown from six to 150, with qualifications to either certificate or diploma level in dental homeopathy available at the Royal London Homeopathic Hospital.

"I use homeopathy on most of my patients," Mr Varley says. "Arnica is a great remedy for bruising to the gums caused by fillings. Propolis is a soothing mouthwash made from beeswax. All my patients get these free. They are very cheap - a phial of arnica tablets would only cost about 20p."

He will also prescribe homeopathic remedies for gum infections and abscesses if that is what his patients prefer. Most of them do, which means he has been able to reduce his use of antibiotics by 80 per cent.

He will also use cranial osteopathy to correct a patient's bite, or acupuncture, useful for relieving tension in the jaw for patients with temporo-mandibular joint (TMJ) pain.

"I took up acupuncture four years ago, but I've been a little disappointed with its broadness," he adds. "You can't use it for anaesthetising teeth, as I had hoped. But it's good for relaxing muscles. People are less frightened of acupuncture needles than the other needles dentists use. For a start, they don't go into your mouth, which is quite an invasive thing for patients."

He is currently one of only about 30 dentists in the UK to use acupuncture, compared with the 1,500 doctors who have studied the technique.

"The limiting factor for dentists is time," according to Dr Colin Lewis of the British Medical Acupuncture Society, which offers courses and training. "The needles can be used to relieve pain, but it takes a while to start working."

Dr Lewis says there is also a theory that acupuncture can help to improve resistance to dental decay by bringing the body's nervous system back into balance. "Unfortunately, there aren't any studies yet to prove this."

By far the most popular form of alternative therapy in dentistry, however, is hypnosis. Practitioners interested in learning techniques can now take certificate courses run by the British Society of Medical and Dental Hypnosis, or diploma and masters degree courses at the Centre for Psychotherapeutic Studies at Sheffield University and the psychology department of University College, London.

Dr Michael Heap, a psychologist who administers the courses for dentists at Sheffield University, says the main application for hypnosis is for calming phobic patients. Direct suggestion can be used to relieve pain.

"If a patient is frightened of the pain of the needle going into their gum, the dentist might get them to imagine a snowball in their hand which has made their hand go numb with cold. They could then press the imagined cold hand against their cheek to make the cheek feel cold."

Hypnosis can also be used to treat teeth grinding,TMJ pain, for tolerating dentures, and to help those with a severe gagging reflex who have been unable to have any instrument inserted into their mouth.

Martin Wall, who has been practising hypnosis for 20 years, prefers to use it as a way of building up an empathetic relationship with his patients. "I have always been more interested in people than in teeth," he says. Patients with the same fears and phobias as Elizabeth Luis are not uncommon.

"Many young women have vivid memories of large hairy hands being forced into their mouths when children. What dentists need to do is to ask permission to enter someone's mouth. It's all about empowering the patient."

A warning note about holistic dentistry, however, comes from the General Dental Council, the dentists' governing body. It has issued a statement saying that the GDC takes "a very serious view of any misleading claims made by dentists with regard to the efficacy of treatment". It advises that dentists "must take particular care when employing techniques and forms of therapy which are regarded by the profession as unproven or controversial"

To find out more about dentists who practise holistic treatments, contact the secretary of the British Society of Medical and Dental Hypnosis, 17 Keppel View Road, Kimberworth, Rotherham, South Yorks, S61 2AR. Tel 01709 554558.

The British Homeopathic Dental Association, 2b Franklin Road, Watford, Herts, WD1 1QD. Tel 01923 233336.