What Sixty Years in Dentistry has taught us about Dental Fear Part One: Pain

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It is safe to say that we as humans are driven to seek pleasure and avoid pain, and in the past Dentistry undoubtedly was considered to be in the latter category.

While Dentistry has moved forward in leaps and bounds, it seems that some people are still avoiding regular dental care. In fact, in 2018 the Australian Dental Association (ADA) reported that only 60.7% of Australian adults attended a Dentist in the twelve months prior, and only 55.5% completed a dental examination and professional cleaning*, or ‘active maintenance’ as we know it at Medland Dental. The importance of regular active maintenance is far more apparent now than it has ever been. Not only have advancements in knowledge and technology allowed oral health practitioners to practise pain-free dentistry, but we now know there is a direct correlation between oral health and overall health.

So why are people still avoiding the dentist? As Medland Dental approaches our sixtieth year of caring for patients in Brisbane, and throughout Australia, we have found there is still ‘fear’ of the dentist.

We have come to understand this ‘fear’ can take many forms and generally fall within one of ten ‘fear factors’. Most importantly, we have worked hard to find solutions for our patients, enabling them better care for their oral, and indeed, overall health.

This two-part series will unravel these ‘fear factors’ and the ways we have helped our Medland Dental patients to overcome them. In this article, we are focusing on the ‘clinical’ based fear. It was very common in the days when Dr Medland founded Medland Dental in 1959 that dentistry was considered to be painful. This was an era where people mostly sought out dental care when they were in pain, and extractions were the norm, rather than the exception. Dr Medland was at the forefront of dentistry at the time, believing the focus should be on prevention and conservation when others were still practising more reactively. Dr Medland sought to create gentle, positive and genuine relationships with his patients whilst educating them on the importance of preventing issues occurring. Through prevention, more teeth could be saved from extensive treatment or extraction, and so the experience, and the perception, of Dentistry and Dentists, began to shift with Dr Medland.

1. Generalised pain

Memories of pain or discomfort can have long-lasting effects, and fear of generalised pain before, during and after dental treatment is a significant concern for many patients

How do we help:

• Our focus on prevention and offering proactive treatment options helps our patients to reduce the risk of painful dental emergencies like decay related toothaches, broken teeth and infections, which traditionally resulted in more painful and complicated procedures.
• Before commencing treatment, we carry out a ‘cold test’ to ensure the nerve of the tooth undergoing treatment is completely anesthetised and unresponsive. Our dentists do this so that they can provide more anaesthetic or use different anaesthetic techniques pre-emptively rather than finding out during treatment that the nerve of the tooth is still responsive. This means that our patients can rest assured before the treatment starts that their tooth is completely anaesthetised and do not have to fear pain or the anticipation of pain.
• For the times where postoperative pain may occur, we offer our patients pain relief before the local anaesthetic wears off and advise what is appropriate pain relief at home.

2. Injections

Dental injections are one of the most feared aspects of dental treatment.

How do we help:

• Our clinicians are very conscious of and understanding to this common concern and can offer relief with nitrous oxide (happy gas), or, in more severe cases, with the prescription of anti-anxiety medication.
• Many people are unaware that the discomfort an injection may cause is the result of the anaesthetic moving into the tissue, rather than the actual injection itself. Our dentists take the time to place high strength topical anaesthetic (also called “numbing cream”) first and then administer the anaesthetic slowly, which helps to reduce any discomfort.
• We have found that guiding our nervous patients through a series of breathing techniques is a fantastic way to reduce anxiety naturally.
• Our kind and understanding Dental Assistants are always there to support our patients with a reassuring, gentle hand on their shoulder, or even to hold the patient’s hand if needed.

3. Triggering of Sensitivity

The experience of professional cleaning triggering a sensitive response can deter patients from having regular active maintenance appointments.

How do we help:

• While an ultrasonic scaler is an essential instrument to remove calculus quickly and effectively, we understand it may cause sensitivity for some patients. Our hygienists routinely ask patients whether sensitivity to cleans has been an issue previously and will apply desensitising pastes, numbing gel or local anaesthetics if required.
• For patients who experience post-treatment sensitivity, our clinicians will administer a desensitising fluoride varnish following a professional clean.
• Patients may also experience generalised tooth sensitivity in their day to day lives. At Medland Dental, we stock a range of products that help to alleviate this problem. Our clinicians will always take the time to educate our patients on these products can help, and how they should be used.

4. Infection

We understand that our patients put great trust in us to care for not only their dental needs but for their overall safety as well. Being unaware of the quality of a practice’s sterilising procedures can cause concerns for patients about infection control and whether they are in safe hands.

How do we help:

• To remain an Independently Accredited Private Dental Practice with Quality Innovation Performance (QIP), we are required to adhere to the strictest of sterilising guidelines. At Medland Dental we choose to maintain our sterilising procedures at a level above the requirements.
• Patients can rest assured all instruments used for their appointment remain unopened and sterile until our clinicians are ready to commence treatment.
• We have one dedicated Dental Assistant who completes all sterilising procedure operations, minimising the risk of mistakes occurring as a result of miscommunication.
• We are very proud of our infection control procedures and are happy to show our patients the processes that we take to ensure their safety.

5. A repeat of past experiences

Past negative dental or medical experiences can create a fear of the dentist. Patients may not even have experienced this fear personally, as it is indeed possible for a loved one who had a bad experience to pass the fear on.

How do we help:

• At Medland Dental our patient’s wellbeing is always our highest priority. We take the time to understand our patient’s concerns and to explain how dentistry has progressed positively over the years and the options available.
• Through seeking to understand the cause of a negative experience, we can work towards creating positive experiences for our patients. For example, if a patient is alarmed by the sound of the drill, we offer our patients the opportunity to listen to their favourite music through headphones which serves as an enjoyable distraction from the noise of the Dentist and Dental Assistant at work.

It is a fact of our profession that some patients may never truly enjoy dental treatment; however, the clinicians and staff at Medland Dental will always take the time to listen to your concerns and treat you gently, with kindness and respect to help you to overcome your fear, in whichever form it may take.

If you have any questions about how we can better help you enjoy your dental appointment, please don’t hesitate to contact one of our lovely Front Office Coordinators on 3426 5777 or email info@medlanddental.com.au.

Follow us on Facebook for Part Two of this series, where we discuss all ‘non-clinical’ fears, including the big one…cost!

*Source: Australia’s Oral Health Tracker Technical Paper