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.

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​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.
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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.
 

​Rebecca remembers it like it was yesterday. She recalls being in a meeting with colleagues going over the yearly marketing plan, when she lost control of her emotions. Her peers were suggesting some changes in tactics and she felt like a complete failure. Tears welling in her eyes, she says she abruptly removed herself from the meeting.
 
“I’m still ashamed when I think about that day,” she says.” Whenever I feel my chin start to wobble at the first sign of feedback from my boss, it’s like I’m a toddler and not the professional I need to be.”
 
Now in her 40’s, she is starting to reflect on her challenges in group settings and questioning her self-perception as emotionally damaged and lacking in character.
 
After a recent ADHD assessment, Rebecca is starting to understand that her responses to situations are an aspect of undiagnosed ADHD, not a personal failing.
 
The intensity is real
 
For Rebecca and millions of others living with ADHD, it’s difficult to regulate emotion, leading to frustration, impatience, and outbursts.
 
In an effort to meet new people, she recently joined an online dating site.  She says if she doesn’t get a response or a conversation goes cold (which is common in online dating), Rebecca sees it as a flaw on her part and spends two days in bed, scrolling social media and eating junk food.
 
This is partly due to the diminished working memory of folks with ADHD. When someone like Rebecca isn’t able to access other thoughts or memories, her thoughts may become hyper fixated on a negative memory or experience and before she can adapt, her emotions hijack her attention and flood her brain with one intense and unwanted emotion such as anger or sadness.
 
Now that she is beginning to understand herself more through a treatment plan that includes therapy and coaching, Rebecca is implementing a toolkit to help her navigate intense emotions.
 
She uses a meditation app and listens to soothing music when she feels agitated by the news of the day. For Rebecca, social media can be especially challenging. Seeing highly curated photos of her peers and celebrities causes intense feelings of inadequacy.
 
Awareness is powerful
 
With her newfound awareness of how her emotions can easily become overwhelming, she limits her time using an app that pauses her social media accounts during working hours. She says it helps.
 
“I used to feel so awful while scrolling social media but now I take intentional breaks and I’ve unfollowed hashtags that are distressing or make me feel insignificant.”
 
Rebecca is also working with a therapist to help her navigate work dynamics and the related stress. She’s already noticing a difference in how her colleagues respond to her in meetings and in correspondence.
 
“By taking more time to respond in highly charged situations, I’m able to organize my thoughts better and offer solutions to thorny problems instead of reacting from a place of fear or anger.”
 
Regulating emotions for people living with ADHD can seem like an impossible feat, but there are ways to help reduce the intensity.

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Tips for managing intense emotions
 
Get it on paper. Often, seeing your thoughts on the page diminishes their power. If you don’t have a journal handy, using the voice notes on your smartphone can also help.
 
Breathe from your belly in through the nose counting to 4 then out through the mouth, counting to 4. Repeat 4 times.
 
Mindfulness, while popular in the general population can be stressful for ADHD folks, so start with mini-meditations of 1-5 minutes.
 
Resist the urge to binge on unhealthy foods and eat plenty of vegetables and fresh fruit.
 
When feelings become intense, stop and drink a glass of water.
 
Reach out to your community and don’t self-isolate
 
Count to five or even 10 before speaking. It will give your mind the chance to slow down and provide a calmer response.
 
If your emotions feel out of control, seek help immediately through a crisis line, listed below. 
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BC Crisis Line (includes links to other services)
Crisis Services Canada