We know the drill: Dentists incorporating new tools, techniques to calm patients’ nerves

Wednesday, Feb. 6, 2002 | 8:22 a.m.

A dusty cloud plumes above your face. The screeching drill burrows deeper.

Jaws stretching, eyes tearing, the dentist whittles away. Motionless, you can still recall the awkward needle that pierced your tender gums.

Hours of numbness, half-smiles and awkward eating habits lie ahead.

You pray that you'll never have another cavity. Maybe you just won't go back.

You wouldn't be alone.

According to the American Dental Association, an estimated 35 million adults have such anxieties about an impending dental appointment that they either worry about the appointment, postpone it or avoid going altogether.

Even a simple teeth-cleaning procedure involves the awkward rummaging of your mouth by another person's fingers and pointy metal tools.

Local dentists say that some patients arrive at appointments with such high anxiety that the patients have broken into a sweat or suffer heart palpitations.

"We've had people, the first time we meet them, they're shaking," Dr. Bruce Crowley said. "You just feel so bad for them."

Crowley, along with other area dentists, has been finding ways to help calm nervous patients. One of Crowley's approaches: cable television.

While undergoing dental work, patients can watch anything from documentaries on cable's History Channel to the game show "The Price Is Right" on televisions mounted on a nearby wall.

Ninety percent of patients take advantage of it, Crowley said. "It helps the time go by quicker. Little kids watch cartoons"

At other dental offices, spa-like atmospheres are being created.

Dimmed lighting, vibrating massage chairs, DVD movies, serenity fountains and beverage bars are replacing some dentists' clinical-looking office of yore.

Howard Wardle, equipment specialist for JB Dental Supply on West Oakey Boulevard, said he's seeing more dentists incorporating televisions, sound systems and cushioned dental chairs into their office designs.

The idea, some dentists say, is not only to help sooth nervous patients, but to have them equate their dental experience with that of a more calming and refreshing trip to the hair salon.

"It's not just about the procedure or process anymore," said Dr. Dwyte Brooks, local dentist and vice president of the Nevada Dental Association. "It's how do we take care of the whole person?'

"Dentistry has fought harder than you can imagine to find a better way to do things."

New dental technology also includes the use of less-invasive electronic needles and digital X-rays.

Laser technology and air-abrasion tools can be used to remove plaque and work on shallow cavities, eliminating the dreaded sound of a high-speed drill.

Oral cameras placed in a patient's mouth produce an image on a computer or television screen so the patient can see exactly what's happening in his or her mouth.

The dental spa

At Brooks' office a chandelier hangs from the dome-ceilinged reception area, where coffee and tea are served. Bread is baked twice daily to overcome the clinical dental-office smell with a more pleasing aroma.

Patients who undergo lengthy treatments can watch DVD movies by wearing eye goggles with television screens in them. Afghans and throws are available to patients who have a chill.

To further relax a nervous patient, Brooks uses voice modulation and voice-pacing techniques.

Twenty years ago such procedures, he said, would have been considered unusual. "Most of us were taught in dental school how to remove teeth, drill holes and how to fill them."

But catering to the emotional comfort of patients who harbor dental fear, whether from a prior bad experience or discomfort from the personal-space invasion, is becoming more common, Brooks said.

At the office of Dr. James White in Summerlin, Victorian-style furniture and a beverage bar greet patients. Oxygen mixed with aromatherapy oils -- lavender, lemon grass and "nirvana" -- is delivered through tubes to the nose to those who are interested.

Rachelle Fraser, treatment coordinator and assistant at White's office, said, "It's to make you feel better, feel good."

But for some patients, feeling good is not enough.

Henderson resident Steve Custer said he's "white knuckled" at every dental appointment.

The 6-foot-3-inch, 260-pound sergeant with Metro contends that he'd "rather go into a bar with bad guys and guns, than go to a dentist."

Just thinking about going to the dentist, Custer said, causes him to sweat and his heart to race.

"It's not because it's painful," Custer said. "It's the expected pain."

He's been given everything from nitrous oxide (laughing gas) to musical headphones to reduce his dental anxiety. But nothing works.

Six weeks ago Custer needed a broken, abscessed tooth to be capped, a wisdom tooth to be pulled and loosened teeth repaired. His dentist of several years, Dr. Earl Lord, administered the sleeping agent Triazolam.

For the first time, Custer said, he was able to sleep the night before his appointment. He said he had little fear going into the appointment and absolutely no memory of the procedure.

Had he not taken the drug, the appointment would have been one of the worst experiences of his life, he said.

Lord, of Smile Designers of Las Vegas, began offering "relaxation dentistry" about a year ago.

The pill is usually taken the night before an appointment, and again just prior to the appointment. Patients are relaxed to a sleep-like state. Afterward, there is little, if any, memory of the procedure.

Lord said he no longer offers nitrous oxide because it didn't successfully calm patients who were nervous. There are some patients who use no anesthetic at all.

Lord's office's reception area looks similar to a cozy a living room, with soft colors, overstuffed furniture and a 90-gallon fish tank.

Sometimes, Lord said, just talking to the patient and helping them to understand what is happening takes the fear out of procedures.

Smart fillings

Lord uses the latest in dentist technology, including lasers and micro-abrasion tools. But regardless of technology, facing the drill is inevitable.

Micro-abrasion machines, which use air pressure to emit aluminum oxide (similar to a sandblaster) create a mess and take longer to cut through the tooth. Nor can the tools be used on silver fillings.

At the American Dental Association Health Foundation's Paffenbarger Research Center in Gaithersburg, Md., researchers are looking at ways to reverse tooth decay by developing "smart" fillings that could eliminate the need for much-feared root canals.

The fillings contain calcium phosphates. Attaching the filling to a decaying tooth would help to remineralize the decay and enable the tooth to heal itself, said Dr. Frederick C. Eichmiller, dentist and director of the Paffenbarger Research Center.

Researchers are also developing remineralizing toothpastes, chewing gums and mouth rinses that would help retard tooth decay, as well as a fluoride-releasing device that would administer small doses of flouride on a concentrated area, he said.

Today when dentists see the beginnings of cavities, they can't do anything about them other than to tell a patient to brush well, Eichmiller said.

Then, when the dentist examines the mouth three to six months later, there is usually a large cavity. These techniques, Eichmiller said, will give the dentist extra tools.

"There's always going to be a need for restorative dentistry," Eichmiller said. "But it will be selective."

archive