Forewarned is Forearmed!

For patients, dentistry is scary! Its full of drills, needles, radiation, pulling and pushing, blood, and plenty of unknowns! An every day procedure for us, such as an occlusal filling, may be something they’ve never experienced. When you couple all of this with a young looking dentist, its easy for your patients to jump at every move.

While many of the “scary things” are necessary, we can always try to disarm the unknowns by simply giving a little explanation to the patient. Etch, the curing light and the feeling of being numb are just some of things we can easily give some explanation about. As mentioned previously, here at DentalHeadStart we LOVE metaphors and similes! So lets go through a few which we can use during our procedures, forewarning our patients of whats to come, so they can mentally forearm themselves for it!

Etch

If you haven’t tasted etch before, then you really should! Its sour and stings the tongue, kind of like those super sour warhead lollies. If you’re not using rubber dam, warn about a sour taste coming as part of the glue for the filling. Thats all you need to say to “disarm” the shock your patient might get from using the etch.

Prime and Bond

Not always noticeable to the patient but worth a mention. Warn about a chemical smell and taste, similar to acetone or nail polish. 

Alvogyl and RCT sealer

Many of our older patients will recall the dental surgery smelling strongly of oil of cloves when they attended as children. While not used as much as it used to be, its an ingredient in alvogyl and root canal sealers. Very noticeable with alvogyl is the taste and the smell. RCT sealer is usually just smelt by the patient when its heated up with the heat-out instrument. Both worth a mention, warn about a smell or taste of oil of cloves.

Anaesthetic

Another item used so frequently that you really should experience yourself. If you’ve never tasted it before, then squirt some into your mouth and see how you like it! It really is horrible. Warn about a bad, salty taste, and always offer a rinse of water to get rid of it.

Palatal Injections

Its common to warn about the sting of an injection, but not so much about the effect it will have. When a patient is at the stage just before panicking, the feeling (or lack thereof) that a palatal infil/block can give may push them over the edge. It can feel like the throat is closing up, and as if they’re unable to swallow. Warn about a “fat” feeling in the throat, and that it might feel like its hard to swallow, followed by reassurance. 

Sof-lex discs and finishing strips

Few patients seem to get worried by these things, but for some people there is no such thing as too much warning. Warn about a polishing strip or disc, similar to using some sandpaper on the tooth.

Matrices

Often seen as fandangled contraptions of years past by the patients. If you step back and really look at a tofflemire, it really looks pretty archaic! Warn of some pressure, as you place the scaffolding on the tooth which will shape the filling.

Slow speed

When the patient isn’t numb this is usually less likely to cause pain in comparison to the high speed. When anaesthetised however, the vibrations from the slow speed are a lot more intense than anything the high speed can create. Some people are very sensitive to this and feel as though it vibrates through their entire skull. Warn about a “bumpy” feeling as we do the final cleaning of the cavity.

Final words…

Describing these small procedural steps to patients has gained me far more compliments than a perfectly sculpted composite ever has. I think it makes the patient feel more comfortable with the innately uncomfortable sensations, while also letting them know that you know what you’re doing enough to be able to explain it. Some may want to doze off as you work or just don’t care in the slightest – and usually they’ll let you know. No harm no foul, but for some it might be the difference that makes their experience good enough to come back to you!

James is a recent graduate dentist working in private practice in regional NSW Australia. Read more at www.dentalheadstart.com/meet-james/

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