C
comfortdentist
Well-known member
Verified dentist
- Joined
- Jul 19, 2009
- Messages
- 2,734
- Location
- Miami, Fl
This week I had a true and severe needle phobic referred to me from another dentist four hour drive away. He had previously been referred to a OMS for sedation and extraction. The OMS consult wasn't calming for him as the OMS couldn't avoid going straight to the IV.
So I consulted first with the referring dentist then with the patient on Tuesday afternoon. I listened to his history and the basis of his needle "trigger". We agreed to a reasonable approach to take effect the next day.
SO he and his partner returned the next day. I mixed up an drug for him to swallow then after about 25 minutes he walked with help to the treatment room. After he settled in I gave him nitrous oxide at a high dose. His partner was there for emotional support. I then most gently placed 1 drop of local anesthesia under his skin in his forearm. While tense he wasn't panicked. I then placed the IV catheter and followed with an adequate dose of sedatives. This allowed me to give him local anesthesia without troubling him. I removed the tooth without incidence. He thanked me afterwards and said he would let the referring dentist know how well it went.
Interestingly enough that even my own staff was unsure of the day's outcome. Afterwards I explained to them why I did certain steps or procedures to allow him to be first comfortable with me then with the procedure.
A couple of examples......
Treatment room has a view of a well planted tropical outdoor area
I wore a nice custom tailored dress shirt. Why? This gentleman worked in the arts and I knew my attire would be important to him. I needed to get him to accept me FIRST before he could possibly accept treatment.
I will also admit that at the conclusion I was almost as happy as the patient was because this was a challenging case to treat and I had complete success.
So I consulted first with the referring dentist then with the patient on Tuesday afternoon. I listened to his history and the basis of his needle "trigger". We agreed to a reasonable approach to take effect the next day.
SO he and his partner returned the next day. I mixed up an drug for him to swallow then after about 25 minutes he walked with help to the treatment room. After he settled in I gave him nitrous oxide at a high dose. His partner was there for emotional support. I then most gently placed 1 drop of local anesthesia under his skin in his forearm. While tense he wasn't panicked. I then placed the IV catheter and followed with an adequate dose of sedatives. This allowed me to give him local anesthesia without troubling him. I removed the tooth without incidence. He thanked me afterwards and said he would let the referring dentist know how well it went.
Interestingly enough that even my own staff was unsure of the day's outcome. Afterwards I explained to them why I did certain steps or procedures to allow him to be first comfortable with me then with the procedure.
A couple of examples......
Treatment room has a view of a well planted tropical outdoor area
I wore a nice custom tailored dress shirt. Why? This gentleman worked in the arts and I knew my attire would be important to him. I needed to get him to accept me FIRST before he could possibly accept treatment.
I will also admit that at the conclusion I was almost as happy as the patient was because this was a challenging case to treat and I had complete success.
