C
comfortdentist
Well-known member
Verified dentist
- Joined
- Jul 19, 2009
- Messages
- 2,734
- Location
- Miami, Fl
Two months ago a college age male was referred to me due to his incapacitating fear of dentistry. His dentist was a family friend and in general a nice guy however he wasn't able to adequately help him. Not only did he have a tremendous fear of dentistry but this was combined with a difficulty to become numb, rampant caries and general severe anxiety. He was also an exceptionally intelligent person.
My first appointment was a little over an hour long and I listened to all of his worries then we discussed how dentistry is like cooking or any other skill in that different people often will have different results. We discussed hygiene fluoride use and diet. I explained that the majority of his treatment will be just to do basic repairs for now as we work towards a healthy diet and habits and after some years he would need more crowns. I explained to him about IV sedation and finally he was willing to give me a little trust to try. The next week I did sedate him intravenously and on that day I started a molar root canal, perform crown legthening on that molar as the caries was too subgingival, and placed six restorations. Two weeks later he returned and I sedated him again and accomplished 13 more restorations but on that day I didn't sedate him as much and allowed him to become more "awake" so that I could interact with him in a totally comfortable manner as I start my second phase of desensitizing him to treatment. He did wonderful. After a few more weeks I brought him back with profound local anesthesia which by now I have mastered with him and finished the root canal with use of nitrous oxide also. I have a very large screen that shows the x-ray so I could explain the treatment and the goals for the day. He did great again and now is feeling much better about himself. Two more weeks pass and I see him to build-up the tooth and do a crown for him and yes I used nitrous oxide again. Another ten days goes by and he returns for the crown cementation with no local or nitrous. Another success but please remember he still has doubts in his mind and worries but all manageable.
Another few days he returns to see my hygienist. Under nitrous oxide he gets his first good cleaning in a long time. He was scared and almost didn't come because he was going to see her and not me. I called him later that day to review the appointment with him. He told me he was very worried and almost didn't come and that his mom had to convince him. I said it is alright to be worried and anxious but best to take that anxiety and concerns and turn them to questions to ask and since he did accomplish his goal for the day understand that those anxieties don't have to stop him from going forward.
He will be returning every 3 months for prophy, hygiene and diet review, and fluoride varnish.
It seems his dental success and helped him in general with his life.
a Happy -Dr. Kimsey
My first appointment was a little over an hour long and I listened to all of his worries then we discussed how dentistry is like cooking or any other skill in that different people often will have different results. We discussed hygiene fluoride use and diet. I explained that the majority of his treatment will be just to do basic repairs for now as we work towards a healthy diet and habits and after some years he would need more crowns. I explained to him about IV sedation and finally he was willing to give me a little trust to try. The next week I did sedate him intravenously and on that day I started a molar root canal, perform crown legthening on that molar as the caries was too subgingival, and placed six restorations. Two weeks later he returned and I sedated him again and accomplished 13 more restorations but on that day I didn't sedate him as much and allowed him to become more "awake" so that I could interact with him in a totally comfortable manner as I start my second phase of desensitizing him to treatment. He did wonderful. After a few more weeks I brought him back with profound local anesthesia which by now I have mastered with him and finished the root canal with use of nitrous oxide also. I have a very large screen that shows the x-ray so I could explain the treatment and the goals for the day. He did great again and now is feeling much better about himself. Two more weeks pass and I see him to build-up the tooth and do a crown for him and yes I used nitrous oxide again. Another ten days goes by and he returns for the crown cementation with no local or nitrous. Another success but please remember he still has doubts in his mind and worries but all manageable.
Another few days he returns to see my hygienist. Under nitrous oxide he gets his first good cleaning in a long time. He was scared and almost didn't come because he was going to see her and not me. I called him later that day to review the appointment with him. He told me he was very worried and almost didn't come and that his mom had to convince him. I said it is alright to be worried and anxious but best to take that anxiety and concerns and turn them to questions to ask and since he did accomplish his goal for the day understand that those anxieties don't have to stop him from going forward.
He will be returning every 3 months for prophy, hygiene and diet review, and fluoride varnish.
It seems his dental success and helped him in general with his life.
a Happy -Dr. Kimsey
