Whenever a patient, particularly one who is afraid of dentists or dental treatment, is in severe discomfort with his / her teeth and / or gums, the first thought that comes to their minds is to remove the tooth. I often hear from women that their "tooth discomfort is worse than childbirth." They say, "at least there is a beginning and an end to that discomfort." That strategy may indeed give the patient immediate relief and therefore can be a short term solution.
Even if they have dental insurance, they also complain about the high cost of dental treatment. They believe that removing some or all of their teeth and replacing them with a partial or a full denture is the answer to their financial strain and oral cavity problems, and that the result can be as functional and look as good as their natural teeth.
To remove some or all of your teeth and replacing with a partial or full denture is not a good long-term solution. Although I empathize with their situation, especially the high cost of proper dental care, the common fears of dental treatment and the potential discomfort during and after treatment, I definitely would ask them to explore other solutions with their dentists.
In situations where nothing can be done to save the teeth, extraction and the fitting of full dentures is an option. However, these full dentures can never be as attractive or as functional as natural teeth.
I would like to address these concerns so that patients may have the information necessary to make an informed decision on their future dental health.
Even with previously planned orthodontic or wisdom tooth extraction, the decision to remove teeth should never be taken lightly. The loss of a single tooth can potentially affect the entire mouth. Almost immediately, the adjacent and opposing teeth will drift into the space created, allowing food to get caught. This can damage the gums and, eventually, the bone. The change in the way that the teeth bite may cause muscle and jaw pain.
The cost of proper dental treatment can be a deterrent for some patients. Many dentists will accept your dental insurance as partial or full payment, or be willing to work out an affordable monthly payment plan. Because of the importance of maintaining your teeth, it would be advantageous for you and your dentist to work this out together.
Although dentures do not usually cost as much as dental treatment to save your teeth, they can result in problems. These can be costly, and can compromise your health. Following is a list of problems associated with wearing full dentures.
1. Food cannot be chewed as efficiently, which can lead to digestive problems. Certain foods, such as corn and apples, may not be able to be eaten at all. Even well made dentures fall short of looking or acting like natural tissue and teeth.
2. Dentures are made of plastic that can wear or break, and need to be repaired or replaced periodically.
3. The plastic will absorb mouth fluids, causing discoloration and odor.
4. The tissue beneath the denture can shrink, causing rubbing and sore spots. This also may cause the denture to loosen, necessitating the use of messy denture adhesive creams, or relining, to tighten the fit.
5. A full denture is an artificial device that needs to be removed for a period of time each day.
6. Implants may be used to stabilize a full denture. However, even then, it cannot equal the form and function of natural teeth.
Getting full dentures may be less costly and, in some cases, a less painful procedure for a patient, but when saving your own teeth is possible, it is unquestionably the best option.
Odontophobia is defined as the "fear of all things dental". A mild dread is called dental anxiety; a severe case is termed dental phobia.
Avoiding dentists and proper dental treatment is a problem, given that ongoing neglect can lead to tooth decay, periodontal (gum and bone) disease, tooth abscesses, and moderate to severe pain. This can spiral until the only visits are for dental emergencies.
It can also affect one socially. Many patients will be too embarrassed to smile. Some men may even grow mustaches or beards in order to hide their poor oral condition.
Studies show fear of dentists can often be traced to a personal bad childhood experiences or dental horror stories that they hear from family and friends or even movies that they have seen that depict dentistry in a negative context.
During the course of my career, I have listened to many patients expressing their fear of dentists and dental treatment. Some the reasons given are:
1) not being fully numb during treatment
2) being held down or restrained in a papoose
3) Being yelled at by the dentist.
4) fear of needles
5) fear of pain during and after treatment
6) fear of not being in control
7) gagging during X-Rays or treatment
8) excessive cost of dental treatment
9) worry that they'll be derided and made to feel bad by the dentist for the condition of their mouth.
Any of the above may deter many patients from seeking proper dental care in the future. The profession is very sensitive to this issue. There are many methods that can be used to reduce discomfort and also reduce a patient's fears about dental treatment.
When looking for a dentist who is sensitive to these issues, I always recommend word of mouth from family and friends as the first and best referral. There are dentist locater services like 1800dentist or local dental associations that one can contact. However, note that these services cannot guarantee the quality of care or the possibility that the dentist will be sensitive to your individual needs. And just because he / she advertises that they specialize in treating fearful patients, remember that anyone can make that claim.
In this age of computers, you can also check out their website. Then, call the office. Speak to the receptionist to get an initial feel of the practice. You can even ask to speak to the dentist. If he / she takes the time out of a busy schedule and is willing to answer your questions, it should give you an even better feel if it's the right place for you.
Then, schedule a no-treatment, consultation-only appointment. This is an an excellent opportunity for you to interview the office. Don't be afraid to ask any questions and be sure you get the answers you need. Don't be intimidated. Be sure that you understand the explanations and that the dentist breaks it down to language that you understand. Notice key words that are used. A dentist who is sensitive to fearful patients will use words like discomfort instead of pain, or numb / freeze instead of needle or injection. Approach the visit with the idea that you are hiring them to take care of you and your special needs. It must be an environment that you trust and that makes you as comfortable as possible. Knowledge can help to diminish fear of the unknown.
Besides the simple agreement between the dentist and the patient to put the patient in control to use a hand signal to stop treatment, the following is a list of techniques that dentists may use to reduce or eliminate pain and fear:
1) EFT (Emotional Freedom Technique) is a form of energy psychology. It is a simple technique of tapping on specific acupuncture points while thinking about the issue. The results can be a dramatic decrease in the emotional charge surrounding previous dental experiences or traumas. EFT can help dentists and patients reduce or eliminate the emotional stresses related to dental treatment and the dental offices and staff to reduce the stress inherent in the dental environment.
2) Some dental offices can teach you some other simple relaxation methods and / or deep diaphragmatic breathing and / or yoga techniques and / or behavior modification therapy and / or desensitization. These can help to lessen the fear response to being in the dental office.
3) Hypnosis can be used by trained practitioners to reduce a patient's anxieties about dentistry.
4) Acupressure or acupuncture can be used by trained practitioners to reduce dental anxieties and discomfort.
5) By clipping an electrode to a patient's ear lobes, through a technique called painless cranial electro-stimulation, the patient can control the amount of stimulation to relax them.
6) Television, audiotapes, videotapes and the use of a virtual reality-like set of goggles are forms of distraction. By placing the patient in a more pleasant visual and / or auditory setting, focus on the dental treatment can be reduced.
7) Inhalation anesthetics such as Nitrous Oxide analgesia (laughing gas) is breathed in through a mask placed over your nose during treatment. It will create conscious sedation and will reduce anxiety and discomfort for the patient.
8) Topical anesthetics (numbing gels or patches) are placed onto the tissue site minutes prior to the injection in order to reduce the feeling of the tip of the needle entering tissue.
9) Local anesthetics, such as Novocaine (used little in dentistry today), Lidocaine or Carbocaine (the latter does not contain epinephrine, which can raise blood pressure). In all cases, warming the cartridge, injecting slowly, using a topical anesthetic and shaking the lip will decrease the discomfort of the injection.
10) Other than the commonly known syringe and needle that delivers a local anesthetic to numb a tooth or a section of the mouth, there are other methods, including computer-assisted injection systems such as "The Wand", that can be used in many circumstances that can cause the patient less pain than the conventional syringe.
11) Pain, anti-anxiety and sedation medication can be taken orally before treatment to produce oral conscious sedation and parenterally (IV or injection, infusion and implantation) prior to during or after treatment to reduce anxiety and pain. IV sedation involves being conscious but having no memory of the procedure and is only offered by specially trained practitioners.
12) General anesthesia (being totally asleep) has the greatest risks and is usually reserved for extreme cases. It can be used with patients who are very apprehensive and extremely phobic. Because the patient is rendered unconscious, this procedure should only be done by a dentist who is properly trained, and in circumstances where either the severity of treatment or the patient's fear of the treatment precludes any other possibility.
13) To decrease the heat and vibration (the main source of physical pain during dental treatment), and the whining sound (the main source of the auditory and emotional pain) that accompanies a Hi-Speed Air-Driven Turbine Handpiece (Dental Drill) . Today, there are three systems can be used as alternatives to the dental handpiece in certain situations. Each has its uses and its limitations. All of these procedures can virtually eliminate the need for local anesthetic in some cases.
- The Kinetic Cavity Preparation system (KCP- "Drill-less" Air abrasion) can be used for small cavities and early tooth decay. The process uses a special handpiece to spray or propel a stream of clean dry air mixed with tiny abrasive particles of alpha alumina (a substance used in toothpaste) onto the surface of the tooth and remove the tooth decay. It is most effectively used for placing fissure sealants, removal of small discoloration and stains, and repair or replacement of small fillings. It can be used to expose early tooth decay (hidden cavities), which can then be removed and restored with a filling material.
- In addition to soft tissue (gum) procedures, root canal therapy, and bonding of tooth colored materials and tooth bleaching, some Dental Laser Systems use a combination of laser energy and water (hydro-kinetic energy) to precisely remove tooth decay and hard tooth structure. It is then restored with a filling material.
- Ozone Therapy is a more controversial procedure, whose efficacy for dental procedures is not yet accepted by the ADA at this time. It is my belief, that although more research is necessary, the concept of Ozone Therapy, either alone as explained below or in conjunction with conventional procedure will someday be used to replace the conventional air-driven turbine hand-piece in some cases.
Some combination of the above methods will make most patients comfortable. It should be noted that many procedures can be done on some individuals without using any of the above methods.
The treatment rendered and the pain threshold of the patient will determine discomfort after treatment. Patients should not eat until the numb feeling is completely gone. If they do, it is possible that because they don't have feeling, they may chew on their tongue or lip causing damage. It is particularly important for parents to watch their children. Freshly squeezed vegetable and fruit juices, soft food such as yogurt, blended salads, cooked grains are a good nutritional source of food if the patient is having a difficult time eating more solid foods.
A short fast also may help in the healing process and limit stress on the sore area. Even though it is not ideal to suppress symptoms, if the pain more than the patient can tolerate, consult with the dentist who did the procedure about options for pain reduction.
Despite your best efforts, if you're not making progress in alleviating your fear and it's severe enough to keep you from getting care, you may need to seek professional assistance or find a self-help group.
Source by Dr.