As a dentist in practice for over 30 years, I have frozen a lot of people, given thousands of injections, and I have practically perfected my injection technique to make it almost painless. There are a few tricks that I have learned over the years: 1. use topical anesthetic and leave it on the gums for at least 1 minute 2. Pull the soft tissue so that it’s “tight” – this decreases the sensitivity a lot! 3. Before actually inserting the needle into the soft tissue, leave a drop of the local anesthetic for a few seconds on the gums 4. Insert the tiniest tip of the needle very very slowly before inserting the needle a little deeper 5. Inject very slowly. If all these steps are followed, the patient will either not feel anything at all, or just feel a little bit of discomfort, but it is by no means painful.
Yesterday I had a patient who needed to have some fillings done, and she asked me to do it without any freezing. She said that she didn’t like the feeling of being frozen and waiting to “unfreeze”. I was very surprised, as even though I do many procedures without freezing – when I am sure there will be absolutely no discomfort, in this case I could not be sure that this would be the case. I told her that I’ll try, and as soon as she would want me to stop she should just raise up her left hand. I started to drill a little bit in her tooth and was sure that she would stop me immediately. She didn’t even budge, didn’t raise her hand, assured me she was ok, and I continued. I was able to clean out the decay in 2 teeth, and she was totally fine and comfortable with it. I restored the teeth with composite resins, and she was absolutely relaxed and ok with the entire procedure. At the end she said that she was so happy that she wasn’t frozen, and she found the whole experience great.
Would I choose to have any dental fillings done on my own teeth without freezing? Absolutely not! I am amazed and in awe of the way some people can tolerate and control their response to pain.
I participated in a Mindfulness Meditation workshop a few day ago. I took an 8 week course about a year ago, and have found it quite difficult to commit to a daily meditation practice on a regular basis. I always find some excuse for why I can’t find 15 minutes in a day to sit still, quiet my mind, and just focus on my breath. What are some of my excuses? I’m too rushed in the morning, I’m too busy when I get to the office, I don’t take a break during the day, eat lunch at my desk in between patients, and by the time I get home I am too tired, and just want to watch tv, or read. At night I lie in bed thinking that I’ll just focus on my breath for a few minutes, but soon enough, I fall asleep.
Studies have shown that there are actual physical changes in your brain when you meditate regularly. Depression can be reduced or eliminated, sleep is improved, and
At this workshop, one of the instructors talked about how your meditation practice can be compared to flossing. She said that sure it is annoying to floss ever day, but once she started doing it on a regular basis, her teeth and gums felt much better, and now she flosses every day, and she also is committed to meditating every day as well.
Our teacher, Dr. Joe Flanders, then asked me how do I get my patients to floss, what do I tell them? At first I just wanted to say, “FLOSS OR DIE!”. I thought better of it, and didn’t want to sound too alarmist, so I just explained the link between your oral health – i.e., the health of your gums, and how this is so closely connected to your overall health. Gum disease is linked to diabetes, heart disease, premature labour, and other illnesses.
What’s my point in all this? I have been flossing my teeth daily all my life and have been encouraging my patients to do so as well, but with very little compliance. Now I want to incorporate a new habit into my own daily routine- mindful meditation. No excuses! If I can expect my patients to floss, and don’t accept their excuses, then I can surely find time in my day to meditate.
I will be visiting 2 daycares on Wednesday, April 27, (tomorrow) to talk to young children about healthy eating for strong teeth. My dental assistant and my daughter (a McGill Dietician student) will be accompanying me. For the last 30 years, even with all the new advances in dental care, the prevalence of toothpastes containing fluoride, fluoride supplements, mouth rinses and topical gels, I have not actually seen a deterioration in the dental health of the children in my community, but there has definitely NOT been any improvement. I would have to say that the situation has remained pretty stable, which means there is NO PROGRESS! I do not have 17 year-olds coming to my office for full mouth extractions like I did in the 80′s, but I still see 2 year old children with bottle caries, 4 year olds with decay in practically every tooth in their mouths, and 7 year olds who can’t eat because they have abcesses (infections) in several teeth. My goal is to change this, even if we get through to just 1 child per daycare. We have planned some interactive games, some discussions, and time for questions and answers. And of course, each child will receive a loot bag filled with lots of dental goodies!
I have examined the mouths of thousands of children. Some of the kids plop themselves down on my (dental) chair, open their mouths wide, let me “count their teeth”, and look at the experience as fun and relaxing. Other children start screaming as soon as they get into the operatory ( my room), refuse to sit down, squirm and are totally impossible to examine. Sure it’s nice to have cooperative children all the time, but what I have found most rewarding in my practice has been to see a child for the first time who is so scared he or she refuses to open his mouth, and to transform this child in a matter of a few visits to a happy, relaxed patient. Some kids are afraid because they have heard horror stories from their parents, siblings, or friends. Other kids are scared for no reason – just the “fear of the unknown”. My approach has always been: “Tell, Show, and Do” (in that order). The child has to trust me, and therefore honesty is VERY IMPORTANT. The language that I use is also very well chosen – tooth cleaning is “tickling your teeth”, the suction is referred to as my vacuum, and numbing the tooth is “putting your tooth to sleep”. I love my job and when a child that I’ve just treated gives me a hug, it makes it all worthwhile!
I have been practicing dentistry for 30 years. I have treated babies from 12 months old up to elderly patients in their 90’s who, luckily, still have teeth. I see patients who were little kids when they first started seeing me, and are now bringing me their own children to be treated. I feel very proud and gratified when a patient starts off being terrified and nervous, but after a few visits, will practically fall asleep in my chair (while having treatment, such as a filling!).
A few truths I have come to realize:
1. Absolutely everyone needs a dentist, whether they have teeth or not.
2. Nobody likes coming to the dentist, (well maybe just a few).
3. People who smoke not only have many more general health problems than non-smokers, but also have a MUCH greater chance of losing their teeth (besides the fact that smokers have a much greater risk of oral cancer).
4. If my patients would just listen to my advice, (which I repeat ad nauseum at every check -up) I could ensure that they keep their teeth and gums in a healthy state pretty much for life.
5. Key words are brush, floss, use fluoride, eat healthy, avoid sweets, and get check ups every 6 months.