QUESTION

I hate going to the dentist because the dental cleanings are so painful. Any advice?

ANSWER

Many people enjoy dental cleanings, while others find them to be quite uncomfortable or downright painful. Don’t be shy about bringing up your concerns! You may be surprised at all the strategies your dentist and/or hygienist can use to significantly ease your discomfort.

The first step is to figure out what might be causing the pain. For example, cavities or gum inflammation (gingivitis) can make your teeth sensitive to the poking and scraping of a dental exam and cleaning. If you think you might have a cavity or have been told that you have gingivitis, it’s doubly important to ask your dental professional to be very gentle.

Before cleaning, you also can receive a numbing agent (such as benzocaine)—applied topically—that works within a matter of minutes. Be sure to ask for that if it’s not offered. If you want an even greater numbing effect, you can get an injection that will deliver a more powerful anesthetic. The topical agent will desensitize the delicate tissues in the mouth so that the needle stick will be much less noticeable.

There are also steps you can take before your dental appointment to cut down on tooth sensitivity. Your teeth become more sensitive when tooth enamel erodes and exposes the dentin, the hard tissue just beneath the enamel surface. So avoid acidic beverages, which weaken enamel—especially several days before your dental visit. This includes sodas, seltzer, and tomato and fruit juices.

Using certain over-the-counter (OTC) remineralizing toothpastes, rinses, gels and creams also can help ease sensitivity by rebuilding calcium and phosphate in your teeth. Ask your dentist which products will be most effective for you, and follow package directions when using them.

If your gums are very painful, your dentist may have a prescription oral rinse in stock, as well as topical creams and gels that are numbing for use during the appointment.

Taking an OTC pain reliever, such as ibuprofen (Motrin) or acetaminophen (Tylenol), about an hour before the appointment helps ease any discomfort, too. Some people also find that listening to relaxing music during the cleaning can make the procedure less stressful.

If these steps don’t give you adequate relief or the dental procedure you’re getting is extensive, you may want the comfort of sedation, such as laughing gas (nitrous oxide), which is inhaled through a face mask. Unlike IV anesthesia, there are no official guidelines for driving after nitrous oxide. Nitrous oxide has a reputation for being safe and for clearing the body quickly. However, in my practice I have noticed that the sedative effects may linger subtly for an hour or more, and I don’t recommend driving immediately afterward. Nitrous oxide can cause nausea and vomiting, so don’t eat immediately prior to your appointment. Check with your insurance carrier to see whether the cost of nitrous oxide for your procedure will be covered.

Some dentists are now offering a newer pain-management method that is delivered via electrical pulses. With this technique, known as transcutaneous electrical nerve stimulation (TENS), pads are placed on areas of the face where the numbing is needed, and the patient uses a handheld remote to control the level of electrical stimulation that is delivered.

Regular dental cleanings (every six to 12 months for most adults) are crucial not only for your oral health but also your overall well-being since gum disease has been linked to a number of serious conditions, including heart disease, diabetes and dementia.

So be sure to speak openly with your dental professional about your pain. By working together, the two of you will find solutions so that your dental cleanings will be much more tolerable!