The idea of lying mouth-open, listening to the grinding of metal on enamel, was enough to keep Sylvia Poff away from the dentist.

For 30 years.

“My fear level was so high, I would rather deal with the pain than deal with sitting in that chair,” said the 67-year-old Illahee resident, who popped over-the-counter pain relievers like candy to stave off the agony caused by her decaying teeth.

But a University of Washington study on whether a computer program can help ease patients like Poff of their fears and anxiety is underway. Dr. Peter Ruff, an East Bremerton dentist practicing here since 1977, was one of a handful of dentists contributing to the study to be completed in June.

The familiar request of “open wide” has become an overwhelming demand for many patients, he said.

“The mouth is a very, very vulnerable place,” he said, adding that the dentist’s hands poking and prodding easily “creates an environment of distrust.”

It’s an ironic twist. Dentists say patients like Poff, who fear the drill most, end up needing the greatest amount of work.

“The people that stay away from the dentist because they are afraid, they’re the ones that end up with the real costly and involved procedures,” said Dr. Keith Redd, a Bremerton dentist not involved in the study.

Redd said he sees patients, one he recalled as not having seen a dentist in more than 50 years, who require multiple visits to deal with unbearable amounts of pain for something that could have been prevented with a routine check-up.

According to the website dentalfear.net, between 30 to 40 million Americans are estimated to have enough fear or anxiety that they will avoid the dentist.

The fears have roots in each patient’s history but many stem from negative childhood experiences at the dentist office.

Such was the case for Poff, who credits her anxiety to her first visit to the dentist.

“It stayed with me forever,” she said. “It was traumatizing.”

Eventually the drugs and the determination to avoid the drill weren’t enough and Poff needed relief. At the suggestion of a friend, she reluctantly met with Ruff.

Now Poff, who said she has never visited the same dentist twice, won’t even think about seeing anyone else.

“I would fly across the United states to have him work on my mouth,” she said.

The program Ruff shows his patients as part of the study is called CARL, or Computer Assisted Relaxation Learning. Through a series of videos, a viewer is taken through the steps of an oral injection. It intends to make patients more comfortable with the process. Should the program prove successful, the videos could be available online in the next few years.

Redd said despite being one himself, he hated childhood visits to the dentist.

“Several kind of beat me up a little bit,” he said.

The key, Redd said, is creating a positive first-time visit.

“It goes a long ways toward not creating another generation of dental phobics.”

Dr. Lisa Heaton, a clinical psychologist and the study’s project director, said it’s not uncommon for adults to stop seeing a dentist once they’re out on their own. She said women tend to report more fear than men and children comprise the greatest percentage of fearful patients.

She also said there is a range of fear where some are affected more than others.

“There are goers-but-haters, but where it crosses that line into a phobia is when it starts impacting their life,” she said.

One of the biggest concerns fearful patients have, Heaton said, is feeling dominated.

“Control is a huge issue,” she said. “Some feel they have to sit down in the chair and hold on for dear life.”

Fearful patients are invited to meet with Ruff in his private office, away from the sound of drills. There they can discuss their anxieties before beginning any type of procedure.

Once a patient makes it to the chair, Ruff said he is constantly narrating the procedure from beginning to end.

“They need to be in control of the whole thing,” he said.

Some dentists, like Redd, use humor to put patients at ease or give the patients the option of using headphones to listen to music.

Poff said it was Ruff’s concern and consideration that made a world of difference.

“It was his ‘do it little by little’ comment that made me think, ‘this is somebody that is going to work with me.’” she said.