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Drill Baby, Drill!  Dentists Work To Overcome Patient Fear

Tuesday, September 28, 2010 at 5:00 AM

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What are you looking forward to this week? Seeing a movie? Trying out a new restaurant? Visiting a good friend? How about going to the dentist? (pause) I didn't think so. Most of us, don't find our visits to the dentist pleasurable, and some will go to great lengths to avoid it as ideastream® health reporter Gretchen Cuda tells us in today's installment of Watch Your Mouth

CUDA: Before the advent of anesthesia in the mid 1800’s the practice of dentistry was brutal.  Stories of teeth being yanked out with a pair of pliers and a shot of whisky are enough to make one cringe.  Thankfully, dentistry is much more civilized today.  Dental offices are clean and bright.  Soothing music plays in the background, and patients are given plenty of pain numbing Novocain. And yet…despite all these advances ….most of us have things we’d rather do.

MAN: I don’t like going to the dentist
WOMAN:  I don’t like going.  I like my dentist, the hygienist is fine - I just don’t like going.
WOMAN:  Just somebody’s hand in your mouth, and rooting around in your teeth - it’s just an uncomfortable feeling. The whole invasive process - it’s just gross.  I never liked it.
MAN: The worst part is you have your mouth open and people working in your mouth and asking you questions and drool is coming down there…

CUDA: Yes there’s occasional drool, there’s the talking with your mouth full, the stretching of your face; and the needles - it’s not pretty.  Still, most of us go. Not so for Denise Dygutowicz who recounts negative experiences as a young child that kept her from the dentist’s office for most of her life.

DYGUTOWICZ: That led me to not go to the dentist from the age of 10 or 12 to my late 20’s early 30’s , and I’m 36 now.

CUDA: Dr. Jeffrey Gross, a dentist in Eastlake, Ohio says fear of the dentist is something he encounters regularly.

GROSS:  We encounter fear on a daily basis, in fact that’s the biggest obstacle we have to real good dental care and getting work done.

CUDA:  In Dr. Gross’ office, there is soft music, soothing colors and an open row of dental chairs without walls between them that he says reduces anxiety because patients can see all around them.  Gross also offers various services that calm nervous patients - like headphones to drown out the noise, varying degrees of anesthesia - from topical anesthetic gels for deep cleanings, to novacain, to nitrous oxide. And when drilling is required, he uses quiet , low-vibration drills, and in some cases even replaces the drill with a silent and painless laser.  But he also says a big part of changing patient attitude is language…

GROSS: When we talk about procedures, just the way I talk to you, I could yank a tooth or I could remove a tooth.  Most patients would like their teeth removed as opposed to yanked. We could prepare your tooth or we could drill your tooth. All these terms, they create an environment and a situation where the patient has more or less anxiety.

CUDA: Gross says many patients who fear the dentist are like Dygutowicz - who had bad experiences as children

GROSS:  Once a patient is afraid, that emotion stays with them for the rest of their lives. That’s why it’s so important to work with kids, and make their first experiences really be positive experiences. When I treat a child, we don’t use the word ‘drill’. We’re gonna wash your tooth, we’re gonna clean out your tooth with Mr. Whistle.  And Mr. Whistle now is just something whistling on their tooth. If you don’t give that child a negative experience, he will never associate the drill with something uncomfortable.

CUDA: And for most kids - it works.  Removing the negative associations that generate fear plus adding a few positive incentives like movies, flavored fluoride, and a toy at the end of every visit instills the idea that going to the dentist is fun.  Just ask 11-year old Patrick Ryan of Lakewood.

PATRICK RYAN: I actually do have a fun time at the dentist …I like the flavors that they have - I just like it, I don’t know it’s just really fun.

CUDA: Of course, no matter how great your dentist, not all dental work is fun or completely painless.  Occasionally cavities need to be drilled, gums bleed, and teeth must be pulled - and that can cause some real discomfort - either during the procedure or later during healing process. But Gross says it’s about communicating with the patient and being honest about what’s going to happen.

GROSS: The biggest thing is not delivering what you promised.  If you promised you’re not going to hurt them, you can’t hurt the patient.  And if for some reason it’s going to be an uncomfortable experience, because let’s face it, we are working on the human body, you have to take those steps to make sure that you don’t cause them any discomfort.
Gretchen: But no one really likes to have someone poke around in their mouth or prod at their…
Gross: We don’t poke or prod (laughs) We touch (laughs)! It’s vocabulary.

CUDA:  Two decades without a professional dentist “touch’ her teeth is something Denise Dygutowicz now regrets - when she finally did go it was when she was in a lot of pain and needed a root canal and other serious dental work.  Dygutowicz says that was the wake-up call - she now sees her dentist on a regular basis - but although she says he’s very nice --she still doesn’t really like it.

Gretchen Cuda, 90.3

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Health, Shale, Watch Your Mouth!

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