Nobody loves going to the dentist. But ignoring or even skimping on one’s oral care can result in far worse complications than cavities or bad breath.
Multiple studies have linked gum disease to heart disease—oral bacteria may enter the bloodstream and travel to the arteries, causing inflammation and setting the stage for a heart attack. The inflammatory effects of gum disease also may increase risk for diabetes, stroke and certain types of cancer.
The problem: Even many health-conscious individuals let their oral care slide because they just do not like going to the dentist. (Everyone should get a cleaning and checkup twice a year…if you have gum disease, it’s four times a year.) And for more than 40 million Americans who suffer from what’s known as “dental anxiety,” seeing the dentist is more than just uncomfortable—it can be downright terrorizing.
The solution: Cutting-edge advancements and a few simple tricks can make a trip to the dentist much less unpleasant…
PROBLEM #1: Needles. Topical gels that numb the area to be injected have improved. Buffering the injected numbing medicine with bicarbonate makes it less painful and helps it to work faster. Small vibrating devices that attach to the syringe also reduce pain from the injection. Some people find that simply averting their eyes allows them to receive an injection of anesthetic. However, this does not work for everyone—in fact, research suggests that needle phobia may be genetic for certain individuals.
The Fix: “The Wand.” This is a slender device—it looks much like a pen—that uses a computer to control how quickly an anesthetic is administered through an extremely fine needle.
Since the pain associated with most needle-injected anesthetics usually is due to the practitioner injecting the drug too quickly, The Wand can eliminate (or nearly eliminate) injection pain—in fact, assuming that you are looking in the other direction, you may not even realize that you’ve been injected. To find a dentist in your area who uses The Wand, consult the manufacturer’s Web site, MilestoneScientific.com and click on “Find a Dentist.”
PROBLEM #2: Drilling. The dreaded whir of the drill is one of the most common complaints about dental care.
The Fix: A laser drill or electric motor handpiece—both are quieter than the traditional drill. If the drill is particularly disturbing to you, ask when making your appointment if the dentist uses one of these devices. Sedation is also helpful (see next page for details).
PROBLEM #3: Blinding overhead lights. Modern lights used for dental procedures have a narrow focus and very defined light pattern, so the bright beam should be focused only on your mouth. Still, some people are bothered by these lights.
The Fix: Sheer gauze. To dim the bright lights to a soft haze, your dentist can place a strip of sheer gauze gently across the bridge of your nose, covering your eyes. You can peek through the gauze if you like, but it serves as a gentle reminder to close your eyes. Many patients also find the gauze to be calming—it’s not restrictive or uncomfortable, as sunglasses or heavier eye shields can be.
PROBLEM #4: Postprocedure jaw pain. Holding your jaw open for an extended period of time can irritate and inflame the joints on either side, sometimes resulting in severe jaw pain that can make it difficult to even eat. If you are numbed during the procedure, you probably won’t notice the pain until the medication wears off.
The Fix: A rubber mouth holder, often referred to as a “bite block.” If you know that your jaw usually aches after dental work, ask your dentist to use this small rubber “pillow.” It is placed between your upper and lower back teeth, allowing your jaw to rest more comfortably in the open position.
If you are concerned that you might suffer jaw pain even after using a bite block, ask your dentist about taking two 200-mg capsules of naproxen (Aleve) and two 500-mg capsules of acetaminophen (Extra-Strength Tylenol) as soon as you get up from the dental chair. Naproxen stops inflammation and pain, while acetaminophen changes the way your body responds to pain.
If you received your dentist’s OK, you can take a second dose of acetaminophen alone about five to six hours later (for example, at dinnertime if your appointment was around noon)…and a third dose of both drugs eight to 12 hours later (for example, the following morning).
If your jaw still aches after 24 hours, your dentist can prescribe the narcotic painkiller hydrocodone (Vicodin), but start with half a pill to see whether that’s sufficient.
Important: Be sure to tell your dentist about any medical conditions you have and all the medications you take—people with gastrointestinal disorders, such as ulcerative colitis, or those taking blood-thinning drugs, such as warfarin (Coumadin) or aspirin for heart conditions, should generally avoid nonsteroidal anti-inflammatory drugs, such as naproxen—they can increase bleeding risk. Selective serotonin reuptake inhibitors and other antidepressants also can interact with naproxen.
WHEN IT’S A PHOBIA
No matter how hard they try, some people just can’t make themselves go to the dentist regularly.
In fact, studies show that 25% of dental appointments are canceled because the patient is made so uncomfortable by dental care and/or treatments. Of course, canceled appointments add to the problem. As time passes, the person’s dental condition worsens, making him/her feel embarrassed and even less likely to see the dentist. What helps…
• Psychotherapy. Dental fear is often linked to a history of childhood or adult abuse. The sometimes invasive nature of a dental visit can reawaken disturbing memories, which are stored in the “fight-or- flight” area of the brain.
As soon as people with this type of dental phobia hear the drill—or even step foot in a dentist’s office—their adrenaline pumps and they feel compelled to run away, bite or even kick in response to the perceived threat. Fortunately, traumatic memories often can be overcome through psychotherapy, such as cognitive behavioral therapy.
• Sedation dentistry. For some people who fear dental visits, “sedation dentistry”—oral or intravenous (IV) antianxiety medication that allows the patient to relax or even fall asleep while under a dentist’s care—is a good solution.
Examples include oral sedatives such as triazolam (Halcion) and alprazolam (Xanax). A small dose can last for a two-and-a-half-hour procedure such as a root canal. IV medication is generally preferred for more severe anxiety. Inhaled medication (such as nitrous oxide) is best for relieving pain, not anxiety.
Caution: Anyone with a chronic condition should tell the dentist about it before being sedated. For example, certain patients, such as those with sleep apnea, require monitoring to avoid excessive relaxation that can obstruct the airway.
Smart idea: If you are particularly fearful of dental visits, ask your dentist if you can first meet in his office either a few minutes before your appointment or on a different day to discuss your concerns—this way, you’ll feel less pressure than you would if you were lying in the chair while voicing your fears.
Also: When calling to make an appointment, ask the receptionist how the dentist handles apprehensive patients. Based on the receptionist’s response, you often can get a good sense of the dentist’s and staff’s understanding of these issues.
Finally, be sure to choose a dentist whom you trust and with whom you have an open, easy rapport. A professional who listens and validates your feelings is key to relieving anxiety.