The anticipation of pain, that array of bizarre metal instruments prodding around inside one's head and the alien-abduction style light beaming down.
All are possible causes of the pervasive fear of the dentist.
Now imagine heaping an eating disorder trigger on top of all those discomforts. This was the exact experience for one patient.
Reddit user "yayaheeyayahee" recently shared the lengthy account of their recent nightmarish dentist experience, along with some further explanation of their pragmatic response to the mishap.
For this narrator the real issue at play was not a general discomfort of the dentist. Rather, a significant history of emotional and bodily distress was the X-factor.
"This is really hard for me to share. I have purging disorder. It's like bulimia but no binge. I'm 25 and started getting help which was hard because everyone associates throwing up with bulimia."
"I've been purge free for the first time since I was 10. I hadn't been to a dentist since I was 12."
"Well obviously, my teeth are f*cked. Now when I made the appointment I was clear that it's been a long time since I'd been to a dentist and have an eating disorder, and asked if I could schedule with a kind dentist because it was already scary for me."
Though according to yayaheeyayahee, kindness was an elusive commodity when push came to shove.
"When I had the appointment...that's not what happened. The person who started the cleaning and exam was very rough and as soon as she got into it she made this long deep sigh and said 'Let me guess, you're bulimic?'"
The appointment had now literally fulfilled their largest fear. One would think a further nosedive wasn't possible.
But the conversation continued southward.
"I started to say 'No, I have purging disorder' and she cut me off as soon as I said no and said something like 'Please don't lie to me. It's not going to help you or me. We're going to have to (bunch of stuff I don't remember/understand'."
"I said 'No, you don't understand. I don't have bulimia, I have--' she cut me off and said 'It doesn't matter. You have severe enamel erosion, several of your teeth have X and Y'."
This hygienist's listening skills make it very clear that most days are spent with patients being physically barred from speaking.
At that point, yayaheeyayahee was forced to put their foot down.
"I said "IT'S PURGING DISORDER" because I thought if I said 'no' again she would catapult me."
"She said 'Okay, sure, 'purging disorder'' with air quotes and rolled her eyes."
But the narrator's firmness was a short-lived event.
They shut down completely after the air quote trivializing of the eating disorder.
"I'm not proud of it but I started to cry because it was already so anxiety-inducing for me. She got annoyed and took off her gloves, threw them away, and said she would be back when I calmed down."
"Instead of calming down, I just got my things and left without paying anything. I cried in my car but shook it off and ended up going home."
The saga did not end there.
In the age of internet reviews and accountability, yayaheeyayahee had the resources to take action.
"When I got home I was still really upset and so I started writing reviews left and right about the situation. I think I left one on like seven sites."
The allure of anonymity on the internet, however, is not always what it's cracked up to be.
The office caught up with the narrator and demanded some answers.
"About two weeks later, I got a call. It was someone from that dental practice who had matched my name with my appointment and wanted to discuss my reviews and how I was obviously very upset, but was leaving those reviews really necessary."
When the victimized Redditor refused to back down, they ran into some flack while seeking advice from friends and others in their life.
"A bunch of people are telling me I'm wrong because 1-star reviews can really hurt small businesses and how it's not their fault they aren't trained better, but I shouldn't take it out on them."
"I don't know. Is it really that bad?"
Most responses to the shared post were from folks in yayaheeyayahee's camp.
"This kind of thing is exactly what the review system is for." hapcloud77
"You know what does affect small businesses? Incompetent and rude staff who don't treat people with respect or decency when they're in a medical profession." nje004
"Regardless of whether or not the procedure was more difficult because of your disorder, she has a duty to look after her patients as best she can."
"Nobody with so little empathy, patience or simple professionalism should be working in any sort of medical field." otterstones
"It took their office two weeks to follow up with you, and only because of bad reviews."
"If this dentist was as compassionate and understanding as OP was led to believe, there'd be a red flag when they unexpectedly left mid-appointment, with a follow up call." Melcistima
A hefty few responses came from other empathizing voices who also overcame or continue to struggle with an eating disorder.
"I'm guessing, as someone who also dealt with a lot of eating disorders, that you feel the need to clarify that it's purging disorder and not bulimia because you don't want people to think you binge."
"Not wanting people to think you binge is likely from considering bingeing as something that out of control people do, or that overweight people do. So I think a lot of those feelings come from your eating disordered mentality."
"But none of that is important because you were treated badly." comeththearcher
"I struggled with bulimia for 5+ years, and it messed up most of my molars. I had the same fear of dentists, and when I went recently I had the same request - someone understanding and kind, and willing to treat free of judgement."
"This is not a hard thing to do nor an unreasonable request." LittleRossa
There was a smattering of people who felt yayaheeyayahee was in the wrong for being way too nit picky.
"You got irrationally upset at the semantics regarding a disorder. This is a perfect example of first world problems." starrship
"You're arguing semantics over what you had as a kid. To a dentist, whether or not you ate before throwing up is irrelevant. She was trying to do her job, and you had a breakdown over whether or not you binged before puking." vivere_aut_mori
"Well to be honest it sounds as if you're taking out your own negative feelings towards yourself on the dentist's office." weepscreed
"Purging vs. Bulimia. Semantics? Is that really what triggered you?" dontwontcarequeend65
His comment throws some contradiction on the previous, unsupportive comments.
"I've worked in the medical field for about as long as you've been alive and the number of people I've had to sit down and give a good talking to about understanding the distinction between certain illnesses is astronomical."
"Throwing up with a ton of food in your stomach has a MUCH. DIFFERENT. IMPACT. on your teeth and on your esophagus than throwing up small amounts." VeerlesPearls
The vast spread of responses here sheds some light on an aspect of internet behavior: people are evidently not full steam ahead when it comes to bad reviews.
A lot of people claim to be very judicious before pulling the Yelp trigger. But would their own online reviews prove that or show just the opposite?
Or are their judgmental responses on Reddit a window on what they're really like on Yelp?