The Elephant in the Room
If going to the dentist seems like you’re in a starring role in Nightmare on Elm Street… and Freddy Kruger is your dentist, you are not alone. The thought of sitting in a dental chair with a high pitched drill screaming inches from your brain can reduce a 300 pound NFL linebacker into a whimpering child. Fear, I think, probably prevents more people from getting their teeth fixed even more than the anticipated expense. Sure, going to the dentist costs money… everything costs money….. But here’s my thinking: you have a tooth. It has a cavity. It will not go away by itself and it WILL grow. So you either pay your dentist 150 bucks to fix it today and… YOU KEEP YOUR TOOTH. Or you put off treatment, and wait 12 months and the cavity grows into the nerve producing a toothache!! Now you go to your dentist, and you pay him 150 bucks to extract the tooth and…HE KEEPS YOUR TOOTH. Either way it costs us 150 bucks. The only question being … WHO gets to keep the tooth? So assuming most of us have this figured out by now….I figure that FEAR is the elephant in the room. We don’t necessarily acknowledge it, but that doesn’t make it go away…. It’s always lurking.
So let’s talk about eliminating FEAR. I’m not talking about eliminating PAIN, because that’s easily done today with some of the most potent aesthetics ever invented (but that’s another topic)… what I’m talking about is the EMOTION OF FEAR. Something that affects a great majority of us at the very core of our being. Being a devout coward myself… and being forced as a young child to endure dental treatment without anesthetic…” I feel your pain”…. I have seen the elephant.
So how do we remove fear from the equation?
With children it’s rather easy. An inhalation sedative called nitrous oxide can be administered through a latex nose piece. Commonly called laughing gas, it will remove anxiety from the young patient within minutes, get them grinning, and remove them from the scene of the crime. Sort of like the feeling you get after you’ve had a couple of beers. Once they’re happy and numbing gels have been applied, putting the tooth to sleep is a piece of cake. Of course it works on adults too… but for us. There are a couple of better ways.
I like the use of certain benzodiazepines as oral sedatives to reduce or eliminate fear. Depending on the patient’s general health of course, they can be taken at home or in the office prior to treatment. A couple of tablets taken an hour before the appointment (with someone to drive of course) … and most patients could care less that they’re sitting in the dental chair. I swear I could walk in wearing bikini underwear, and waving a chainsaw, and most would just grin at me and say,” Let’s get started Doc.” Certain drugs we commonly use in this class even produce amnesia, so the patient doesn’t even remember their treatment. Administering some of these drugs does require specialized training and licensing before a dentist can safely use them…. but they are invaluable in treating the truly fearful patient, (you definitely do not want to try this on your own, unsupervised.) This type of fear control is commonly known as conscious sedation… which allows many patients to complete all of their necessary dental treatment in one sitting.
I believe the most important thing a dentist can do is to put themselves in the patient’s place. I know first- hand that after I personally have had a dental treatment performed, have experienced the numbness, have heard the drill, felt the vibration, the fat lip, the weird tastes, am I opening wide enough?…and 1,000 other sensations, I can relate at a more visceral level to my patient, sitting in my chair, whom has placed their trust in me.
While I am writing this in a humorous manner, to the truly fearful patient, it’s not a laughing matter. My sincere intention here is to inform those of us that find a visit to the dentist terrifying that it doesn’t have to be that way any longer. There are safe, gentle ways to do the unthinkable. You can get your teeth fixed.
Each year as dentists, we are required to accumulate many hours of continuing education to retain our license to practice. We learn new skills, refine existing techniques and strive to keep up with the rapid advances in technology happening every day. This is a good thing. But I would go one step more. If I was King of the Dentists, every practicing dentist, every 6 months, would be required to go to the dentist themselves and undergo one hour of dental treatment, complete with numbing, drilling, pulling, stretching, gagging and listening to questions they are unable to respond to. Then and only then would we remember the elephant in the room.
Dr. Bill Ardito
855 W. Bell Road, Suite 600
Nogales, AZ 85621