DentalBuzz: a jolt of current

trends, innovations, and quirks of dentistry

I wanna be sedated

By 3 Comments

 
By Amanda Kaestner

Sdated

Oh yeah, that’s all we need.

Back in 2006, a research psychiatrist at the National Center for Post-traumatic Stress Disorder, H. Stefan Bracha, M.D., suggested upsetting dental experiences could install PTSD in patients, which might then last their entire lives. Along with another couple of miscreants, Bracha advised that any caption including the word “phobia,” or “anxiety,” wasn’t humorless enough to describe the unfounded fear of our selfless, albeit remarkably remunerative, healing art.

What, then, is it exactly that sends our patients into states comparable with returning warriors who’ve experienced an imminent threat of death on the battlefield?

Thanks Again, Sir Larry

Well, patients who are edging onto the chair for an invasive procedure, obviously enough, are more fearful than those who’re scheduled for a cleaning (though we’ve all seen hygienists who seem determined to even out that particular playing field).

Assuming the dentist is warm and caring, rather than emulating Sir Larry, better known as Laurence Olivier’s character Christian Szell in 1976’s Marathon Man, the single most intimidating factor may well be unconsciousness. When you’re out, you’re unable to inhibit a negative event or experience. It’s not so much that patients expect us to slip ’em a roofie and wreak havoc with their innocence, it’s just that – in all fairness – being utterly helpless is an intimidating event for most animals. It’s lack of control… it’s…

Sedation and Anesthesia

Choose your poison. Of the several methods of dentistry sedation that ensure reciprocity on the recliner, each has its proponents, but most have problems, too.

Local Anesthesia. The injection of local anesthetic directly into the area where the work’s to be carried out; this blocks nerve impulses, thus moderating or eliminating pain signals. But it’s the jab, man. The. Jab. That needle heading inbound at their head is, for many patients, the very image which sets off their trip-hammering heart. Not nice.

Inhalation Sedation. Nitrous oxide/oxygen is a great deal of fun at frat parties, sure. It has its place in our surgeries, also, after the light-headedness and giggles give way to euphoria and sleepiness. Improperly administered, though, adverse effects can range from vertigo and nausea, through active vomiting to hallucinations and unexpected flash-backs (and couldn’t we expect that to bring on driver lawsuits, were the fact widely known).

Intravenous General Anesthesia. Voila! The Cadillac of the comatose. An intravenous (IV) catheter is inserted into a vein and from there, an infinitely-controllable amount of anesthetic happiness is introduced. Just a few good drips and the patient is in a safe state of unconsciousness, allowing the professionals to get to work without any major side effects after all procedures are said and done. To the patient’s benefit, there’s no sensation of pain at all, and no memory exists afterward of the entire time he or she was “under.” More and more practices are looking to this form of sedation as being their one and only form because it’s just that safe, comforting, and effective. For example, Advance Dentistry, a well-known practice in Cincinnati, has found that IV sedation helps the dentist because it reduces the risk of movement, and it provides maximum comfort (or minimal discomfort, I suppose) to the patient no matter how much work he or she may need done. It’s not uncommon to see IV sedation being their primary option for dental anesthesia. Furthermore, recovery from this form of anesthesia is typically swift and complete, with little or no “hangover” effect as one would see in the other forms listed earlier, so the patient’s free access to their credit card is seldom impacted.

We’ve come a long way since the early 19th century where anesthesia wasn’t even a thing in any surgical practices, much less dentistry. But thanks to Horace Wells first introducing nitrous oxide to his procedures back in 1845, we can honestly say that going to the dentist in today’s world really isn’t that scary of a thing. So look at your options when you go to the dentist and ask about other forms of sedation. It’s a far cry from “pass the liquor and bite down hard on this stick and let’s hope we don’t have to amputate anything from aftermath infection.”

How to talk to patients 101

By 4 Comments

dentistpatientcommunication
 
Have you ever wondered what kind of courses patients think you missed out on in college? They probably will never notice that you totally bombed the gold foil technique (neither will any dentist under 70, for that matter!). But they do wonder what you were taught about dealing with humans – the personal side, instead of the gushy clinical stuff.
Enter a bit of collegiate satire from a patient’s perspective. New DentalBuzz contributor Carolyn Roche has eight children and five grandchildren, a BA in Political Science from the University of Michigan, and is now studying English at Dixie State University in St. George, Utah where she lives with her husband, soon-to-be missionary for the Church of Jesus Christ of Latter-day Saints daughter, and two dogs. She occasionally begins her day with Special K, and would like to share this delightful suggestive nudge with all dentists and hygienists practicing now and into the future.

Lecture Notes on Dentist-Patient Communication

by Carolyn Roche
 

Professor Samuel Rose
Algonac Dental School
For Tuesday October 15, 2013

Today’s lecture is about communicating with your patient. No one wants to be the Frank Burns of the dental industry. You want your patient to have confidence in your wisdom and know that you will work on them with compassion and competence. We will discuss some guidelines about how and why you should maintain rapport and communication with your patient.

Acceptable Subjects of Conversation

Before you begin chewing out your patient for not flossing, break the ice by conversing about the following:

1. The weather. You can always jaw about the weather. Your patient has just come in from outside and can give you valuable updates. It will help them feel helpful to you.

2. The family:

a. You can drill him about his family. People always like to talk about their family.

b. You may talk about yours. You can forget about what Thumper said, “If you can’t say something nice, don’t say nothing at all.” It’s best to be honest with the patient or he won’t believe anything else you say. Tell him all the good and the bad about your family. Being open will encourage him to trust you as an honest person and like you as well. No one likes a goody-goody.

3. Recent acceptable news.

a. Crime. The patient will be happy to know which side of the law you are on. Always root for the good guy even though the bad guy is your brother. This could be another chance to talk about your family! Include all the crime details.

b. The economy. Let them know how much you earn and how much you have stashed away in safe investments. You will want to make an impression on them. Then make sure they pay the bill.

c. Medical news – if it throws a good light on professionals. If you have botched up anything recently, the patient will want to know the truth from the false rumors. Speak of your mistakes in detail. It’s okay to show off your knowledge. The patient will respect you more.

4. Remember to not get too personal with them. Forget the nonsense about building bridges to your patients. All patients should remain anonymous to you. You will be filling cavities for the rest of your life and to make YOU feel comfortable, think that they are just another cavity or tooth extraction. You will be less nervous and your patient will be less whiney. Once you get personal they will think they can complain about the pain. You don’t need that. It just wastes time.

How to Speak to Your Patient

However awkward, you must speak to the patient while you are working on them. Speaking to the patient with their mouth full is medically necessary. Make sure you have, at the least, the Hoover and a finger and a tool in their mouth.

1. Ask yes or no questions. A nod or a grunt means you haven’t frightened them enough to make them faint. Keep trying. Don’t mistake closed eyes for a faint; they are praying. There are no atheists in dentists’ chairs.

2. Ask questions that require a full sentence answer.

a. You can determine how frozen their mouth really is. If you can understand them, additional anesthetic may be required.

b. You can sue the patient for biting you. Dentistry can be an altruistic career, but remember your $1,500,000 in student loans need to be paid off before your children begin college.

After you have inflicted as much pain as possible, needle the patient about brushing and flossing. With the pain fresh in his mind he will be more likely to follow your recommendations. When you use these methods you will be filling your patients with tremendous motivation to have the healthiest teeth possible.

If You Need Help:

One of the great benefits of attending the Algonac Dental School is the support we offer to alumni opening their own practices. For a nominal fee of $500 –plus airfare, food, and accommodations- my staff and I will fly out and assess your new practice. We will help you streamline your operation. You won’t waste a moment in a day’s work after following our advice. For only $500 more, you can have the full, written report of our analysis and recommendations. NO OTHER dental school will offer this service! Call now for a FREE ESTIMATE 1-800-555-ROSE.

+++(Copy and hand out to students at end of class.)

Gold refining update

By Leave a Comment

by Morgan Kerrissey, VP of Business Development at Garfield Refining Company

Way back in 2010 DentalBuzz was in its groove, dishing on Garfield, spotting trends and staying ahead of the curve. Fast forward three years and some of those trends now seem a wee bit dated– look at Lady Gaga and her Twilight inspired grill! — while other trends have only surged in popularity. Since that first blog post the already popular Patient Bling Program** exploded with another 10,000 doctors enrolling. For those of you not already in the know, the program is offered by Garfield Refining Company and is known to them as their Patient Scrap Program (**Fun people still prefer the Dentalbuzz rebranded name!).

Garfield offers prepaid mailers that you can distribute to your patients so they can deal directly with a precious metals refinery. It doesn’t cost anything, Garfield handles all the paperwork, and best of all you earn a 10% rebate. It’s like free money. Plus this year they have added some new features, allowing doctors to customize their payment schedules, be paid in coins or bullion, and receive better email reporting. It’s a win/win: patients love the opportunity to sell their old crowns and doctors love the opportunity to give their patients a small perk.

So once again, if you haven’t already, click here to enroll.

 

What society thinks you do

By 1 Comment

missingtooth

Does the portrayal of dentists and dentistry in the media represent reality?

by Gideon, exclusively for DentalBuzz

Meeting new or existing patients with dental fear or phobia is growing more commonplace in a society that is led by the media. The portrayal of dentistry in the media is not always a positive, pain-free one and much like other medical practices, this has led to a generation of people who simply are not visiting their dentist. So is the regularly frightening or comedic portrayal of the industry a real representation of dental practices?

The media is not singularly at fault for dental phobias and this article is not setting out to prove otherwise. As we are all aware, early childhood experiences, other medical treatments that may have been unpleasant and learning fears from others all play their separate parts. From cosmetic dentists through to dental surgeons, none are immune from nervous and frightened patients – we are in fact trained to deal with patients’ worries in a compassionate and supportive manner.

Representation in the movies

Many of us will remember the dentist from Little Shop of Horrors first; Steve Martin did an excellent job as arguably the most terrifying and hilarious dentist in film history. With the use of oversized, out of date and unconventional equipment, it is clear to see how the notion of a narcissistic dentist fell into the public eye and into our hearts. It is quite obvious that dentists don’t use such techniques in practice but suggestion can be as damaging to reputations as reality. However, this film was far less damaging than the 1976 adaptation of Goldman’s The Marathon Man. The depiction of the Nazi dentist, who not only caused his patients extreme pain but also experimented inside their mouths, can be argued as the cause of the 70-80’s generation avoiding the dentist.

Throughout many movies and equally TV shows, dentists are often portrayed as either narcissists or as incompetent fools. There are very few noteworthy characters where this is not the case, at least in the US and the UK. In the early 2000’s the British TV show, ‘My Family’ had the leader of the home as a dentist who didn’t care for his family and cared even less about his patients. This is not the first role like this and it won’t be the last.


 

Even those movies where dentistry or even indirect dental references are used in a comedic way, such as The Hangover or Horrible Bosses, just the mention of this form of work is enough to remind a patient of a previous bad experience they may have had. It is this form of visual trigger that has caused a severe decline in dental health over the past few years. There is however a flip side to this notion. Dr Stu Price from the Hangover films does a fantastic job of portraying the dental health service in a positive, funny and upbeat manner. This may serve to lessen patient’s fears rather than increase them.
 

Cartoons

We all know that the age we need to start the education program about personal health is when patients are very young. It is why we hand out badges or stickers to our younger guests, but this work is then counteracted by the portrayal of dentists within children’s cartoons. Whatever age you are, it can be assumed that at some point you will have watched a cartoon where a dentist created all manner of horrific contraptions. Psychologically, although these contraptions and potions may be viewed as funny by your child, they can leave negative mental scars that are far harder to eradicate in later life.
drilltooth

It is at this tender age that dentistry, along with other medical procedures and practices need to be portrayed in a positive fashion. To eradicate dental phobia, the representation of the profession to younger people must become more educational and realistic.


  
Gideon is a 3rd year student at Brandeis University well on his way to becoming a dentist, and who appreciates films, family, TV, the dentists who are currently mentoring him and all the people in the world who may one day be his patients.
 

WWII dentistry video

By 3 Comments

What was ideal dentistry like seventy years ago?

Thanks to dentist Dr. Mac Lee of Edna, Texas for bringing this Navy training video to our attention for this edition of TimeWarp Tuesday. You will be both impressed by the way things were done back then and relieved that dentistry has progressed so much since. Even though it’s a bit longer than you’d usually sit through, remember PEARLS! There are pearls here, even in the way, way back times.

Like Smears! They were doing bacterial profiles in 1944! And Check Out That Piece of Autoclave Artwork. That is definitely something that would look good in your practice, and you would have to drive it, like you would a classic auto, not daily, but just BECAUSE. Sure, the new one is faster, but the old is a CLASSIC and you would use it because it’s too cool just to keep it locked up in a museum somewhere.

Be sure to look out for these bitty tids of juice as well:

• Procaine. That looks like some scary stuff to be injecting into people.
• The long exposure time on the radiograph.
• 10 minute sterilization in a water bath? Really?
• The surgery cart and tongs are creepy awesome.
• What the heck kind of toothbrushing technique is that?

With an emphasis of keeping everything super clean, this is probably the most memorable line in the video:

“Never should there be a sign of the last patient.”

 

We should all hope there’d be no bits of him anywhere afterwards.

Article Archives

Contact Us

Guest columnists are welcome to submit edgy stories that cover new ground (no regurgitations, please!) , or if there's a topic that you'd like to see explored please punch in your best stuff here and see if it ends up sticking to the website.

Follow DentalBuzz on Social Media