Tuesday, November 20, 2007

Technology has extracted much of the pain from dental work.

I saw this article in my local newspaper. I use the newer version of the wand called the STA (Single Tooth Anesthesia) and like it very much.

Posted by the Asbury Park Press on 11/20/07

BY MICHAEL RILEY
STAFF WRITER


Zaire Riley of Long Branch was about to get a tooth pulled last week. And the 10-year-old in the dentist's chair had a big smile on his face.

Someone asked him if he was scared.

"No," he said.

His mother, Mirta Colbert, was right by his side at the Monmouth Medical Center Dental Clinic in Long Branch. She's not afraid of a trip to the dentist either, she says.

And that's a good thing. Anxious parents have a way of passing along that anxiety to their kids, says Dr. Michelle Ziegler, program director for the Dental Residency at Monmouth Medical Center.

The way to overcome a fear of the dentist is never to have that fear in the first place, she says.

"If those first and second trips to the dentist are pleasant experiences," she says, "then fear doesn't have to be a part of it."

Nevertheless, some people still get scared.

Dr. Robert McTaggart, attending and faculty dentist at Monmouth Medical Center, says that studies say the number of people afraid of a visit to the dentist has come down, but . . .

"Somewhere between 12 to 17 percent of people describe themselves as "very anxious' when facing the prospect of sitting in that chair. I've had to talk patients in from the parking lot," he says.

Ziegler understands where that fear comes from.

There's the pain factor, she says.

And then the procrastination factor — "people sometimes keep putting off the trip to the dentist," she says.

You put those together long enough, Ziegler says, and then people are afraid to go the dentist because they are worried that the dentist is going to scold them for not having come in sooner.

At that point, she says, "there's definitely an embarrassment factor." But a lot of that fear is misplaced, dentists say.

"Things have come a long way," Ziegler says. "For one thing, our hand pieces are a lot faster now."

"Hand pieces" is dentist talk for drills.

The faster those instruments spin, she explains, the less likely patients in the chair are to feel pain.

And if it is the very sound of the drills that sets patients' nerves askew, well, the drills are getting quieter.

"The electric drills are almost silent," says McTaggart, who is in private practice at General Dentistry and Advanced Dental Sedation, both of Toms River. Even given the more efficient drills, some of them moving at up to 300,000 rpm, the numbing medicines have improved, he says, providing more efficient ways to block pain signals from getting to the brain.

And so have the instruments used to inject the medicine.

"We have what's called "The Wand' — it doesn't even look like a syringe," Ziegler says. "It's a way to provide a slow, consistent injection that is less painful. Dentists use them especially, but not always, for children."

Zaire got what the dentists called his "tooth sleep juice" with just such a wand.

All of that, though, is not enough to calm some people down. This is why the phenomenon of sedation dentistry is gaining in popularity.

It's not quite accurate to say that sedation dentistry "knocks patients out" says Sally-Jo Placa, chairman of the Department of Dentistry at Jersey Shore University Medical Center in Neptune and in private practice in Woodbridge.

"It is not general anesthesia," says Placa.

Dentists need special training and special permits to administer either type of sedation — a pill or an IV drip."

Patients can still respond to commands, she says, and generally have little or no memory of the event.

Sedation is used on apprehensive patients, the disabled and those facing complex procedures, such as having all four wisdom teeth out at once.

McTaggart says that about 15 percent of his patients request sedation dentistry, which mirrors the percentage of Americans nationwide who are very nervous about a dentist poking around their mouths.

"Dentists really invade your personal space," Placa says. "But as a dentist, it is never my intention to cause you pain. It's easier for me to work on you if you're not in pain."

As for scolding patients who have neglected their dental health, she doesn't do it, she says.

"Some dentists feel that with some patients with whom they've developed a relationship, scolding might be a way of motivating them," she says. "But we know who's not flossing."

Fear of the dentist might not be a thing of the past, but it's getting there, says McTaggart.

"Teeth are getting better," he says. "With fluoride, better education and more diligent parents, people have less reason to be anxious now."

EDITOR'S NOTE: Zaire Riley is not related to the author of this article, Michael Riley.

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