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Patient didn’t know!

C

comfortdentist

Well-known member
Verified dentist
Joined
Jul 19, 2009
Messages
2,734
Location
Miami, Fl
Today I saw a long term patient of record that needed a crown on a cracked top molar. About 15 seconds into the preparation he quickly stopped me. I stopped and asked if he was okay. He said nothing hurt but he was concerned and scared as I hadn’t given him an injection to anesthetize him. I had to explain to him and show him the used anesthetic syringe to convince him that he already had been injected.
He was happy then
 
That sounds like a good anesthetic technique. What are some of your secrets to good technique for us to know?
 
Or, if the patient is older, they may have short-term memory issues.
 
I have focused on making injections as comfortable as possible for many years. Like anything you take to a fine art it isn't easy nor just like a good meal is it a single step.
Of interest another patient in the afternoon thought the same thing so I had a good day.
 
That is definitely a good injection! I wish my dentists could do that! Although my endodontist just gave me a painless palatal shot for the first time ever, for an apicoectomy on my front upper tooth. She numbed the front, then said she was going to numb the palate through the front, then inject into the palate from behind the tooth. I never felt a thing! It was amazing!
 
I will say that my endodontist does an excellent job but I'd rather inject myself as it hurts less.
 
I will say that my endodontist does an excellent job but I'd rather inject myself as it hurts less.
Do you actually do that?? I'm amazed if so, seriously impressive
 
Do you actually do that?? I'm amazed if so, seriously impressive
I have done it several times. why? First to learn how to better give an injection and second because it hurts less.
 
I have done it several times. why? First to learn how to better give an injection and second because it hurts less.
I just think it's impressively dexterous, do you use a mirror?
 
Wondering if you use this method or anyone has had it as well as me.. it is such a brain trick but really works.. my new dentist does it this way and I always close my eyes at injection, I will be waiting for the injection and he is already done.. it is crazy I don't feel a thing.. even on bottom block injections.

"Many dentists, including me, will often use this a distraction during the injection. (shaking the cheek and lip area) While it definitely helps the patient take their mind off of the process, it is also rooted in neuroscience through a phenomenon called the gate control theory. This theory proclaims that non-painful stimulation of a site can help to “close the gate” on painful stimulation. The nerve fibers that carry touch, pressure and vibration sensation are thicker than those that transmit pain, and when they are stimulated their cells may actually inhibit transmission through the thinner, pain-carrying nerve fibers." Why does my dentist shake my teeth, Vincent Badali, reference .
 
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Wondering if you use this method or anyone has had it as well as me.. it is such a brain trick but really works.. my new dentist does it this way and I always close my eyes at injection, I will be waiting for the injection and he is already done.. it is crazy I don't feel a thing.. even on bottom block injections.

"Many dentists, including me, will often use this a distraction during the injection. (shaking the cheek and lip area) While it definitely helps the patient take their mind off of the process, it is also rooted in neuroscience through a phenomenon called the gate control theory. This theory proclaims that non-painful stimulation of a site can help to “close the gate” on painful stimulation. The nerve fibers that carry touch, pressure and vibration sensation are thicker than those that transmit pain, and when they are stimulated their cells may actually inhibit transmission through the thinner, pain-carrying nerve fibers." Why does my dentist shake my teeth, Vincent Badali, reference .
My endodontist does this. My dentist did not. It doesn't work for me, though, but probably because I am so tense and waiting for the shot.
The oral surgeon would push a dental instrument against the roof of my mouth when giving a palatal shot as a distraction and it did help.
 
"Many dentists, including me, will often use this a distraction during the injection. (shaking the cheek and lip area) While it definitely helps the patient take their mind off of the process, it is also rooted in neuroscience through a phenomenon called the gate control theory. This theory proclaims that non-painful stimulation of a site can help to “close the gate” on painful stimulation. The nerve fibers that carry touch, pressure and vibration sensation are thicker than those that transmit pain, and when they are stimulated their cells may actually inhibit transmission through the thinner, pain-carrying nerve fibers." Why does my dentist shake my teeth, Vincent Badali, reference .

My Endo tried this method with me and it did not do a thing for me...I actually hated it. I don’t even have a fear of injections but for some reason that one was super painful and made my eyes tear. He also tried putting some sort of cold stimulus near the injection site as a distraction AND used topical...that also did NOTHING! I don’t know if RCT injections are different somehow or if he just wasn’t very good at painless injections but it really hurt a lot...especially because I wasn’t expecting pain with the injections as my regular dentist is very good at them. He did get me completely numb and completed the RCT with no pain so I forgave him. My dentist is no frills or distractions...sometimes she uses topical but not usually. Sometimes she asks if I want topical but I always turn it down (I don’t really care for it-it somehow ends up numbing my throat and freaks me out more). She just goes really slow and injects in small increments. Sometimes she will give me a first dose and then add one or two more doses after that once the local has started to work a little on the surface layers. She has only given me one painful injection in 15 years and that was early on with her (like my second filling with her). I wasn’t comfortable stopping her back then but she noticed right away that I was in pain and stopped. It took a little persuasion to let her inject me again after that.
 
".sometimes she uses topical but not usually. Sometimes she asks if I want topical but I always turn it down (I don’t really care for it-it somehow ends up numbing my throat and freaks me out more). She just goes really slow and injects in small increments. Sometimes she will give me a first dose and then add one or two more doses after that once the local has started to work a little on the surface layers. "

1. aghh I hate that, the feeling of numbness in your throat and I remember one dental assistant I had gotten toknow at the last place explained it is when too much topical mixes with saliva and you swallow it can produce that , ThankGod she was so careful about this. and I tell every assistant from then and they've let me take the suction after the topical is applied or the anesthetic given so I don't swallow any saliva mixed with a little anesthetic. I HATE this too!
2. Also this is how my last dentist did it .. very slowly and he said something about the being room temperature making it less painful. so I guess he was thoughtful of that. and just really understanding how to make it less stress ful
3. At first.. this shaking of the cheek/lips. kind of was like "what is this?".. I almost didn't want to be distracted and caught off guard but then I noticed I never felt it, it was like ok. You are good and I"m ok with your way even if its different than my last dentist..(I even said , Wow... thank you! lol) they sure have different ways. both were great though at painfree shots. hey as long as they are painfree or less pain I'm good. :).
 
When I had my first injections with my regular dentist she told me that I may "feel a small pinch or maybe even nothing at all." I remember it really catching me by surprise because no dentist had ever suggested that an injection could be painless before (what a concept?!). That injection was done without topical and was in fact, painless. After the unexpected painful injection I had with her she used topical more to get me back on her side until I built back up some trust with her but it really was just a fluke thing and never happened again. She explained that the painful injection was in a bad area because there was not a lot of tissue around the tooth she was trying to numb (upper side closer to the front).
 
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