Since the beginning of the profession of dentistry, we have had to deal with the unfortunate association with pain. Rarely a day goes by where my assistants and I don't hear a story about a patient's “old time” dentist. One of the most common things we hear from female patients is that they would rather have a baby than go to the dentist.
I would like to examine where this came from and also discuss why in this day and age, except for rare instances, dentistry does not need to be painful anymore.
The early dentists in our country weren't even called dentists.
Rather, they were called tooth draw'ers. These were people who would travel the countryside, usually with a carnival and set up a tent so people could come and have teeth taken out.
Now as you can imagine in those days there was no such thing as anesthetic, either local or general. I shouldn't say that, often times patients would supply their own anesthetic in the form of a whiskey bottle.
The tooth draw'er would simply reach in with whatever crude instrument he had fabricated and yank away. Whatever came out was it. If any pieces were left behind, then they healed over, fell out later or got infected. There was no such thing as disinfection or sterility in those days. So before the inception of dentistry, the association with pain has been established.
The early days of dentistry were filled with attempts at making patients comfortable. These attempts were usually through the use of an anesthetic gas. Our medical colleagues had been making the same attempts to be able to anesthetize patients and these attempts spilled over into dentistry. Early attempts using either nitrous oxide (laughing gas) or ether ended in tragedy. At least one patient died. Another attempt to complete a dental procedure in front of medical colleagues with nitrous oxide ended up with the patient not being anesthetized enough and the dentist being chased out of the operating theater as a sham. This once again reinforced dental procedures as being painful.
Early in the 20th century, dentists were beginning to do more and more restorative procedures. It was becoming common knowledge the huge benefit of saving teeth rather than extracting them. As I would walk the halls of my dental school, I enjoyed looking at the photographs of the colleagues who came before me in the old school clinic with foot pedal driven handpieces. I then could see the advancement to the belt driven handpiece.
Even with these innovations the procedures were still quite painful.
Let's move to today and look at why I can make the statement that dentistry doesn't have to be painful. The advent of Novocain was one of the biggest innovations ever brought out for making dentistry pain free. Although the brand name Novocain is long gone, its descendants live on. You can get the chemistry lesson from your own dentist so I won't bore those not interested, but suffice it to say that the modern day local anesthetics are quite different from the original Novocain and therefore much more comfortable to administer.
Recent statistics show that close to 50 percent of the American public doesn't see a dentist regularly. Many of these 50 percent don't seek dental services due to fear. This is due to a previous painful experience or some other association with pain and dental procedures.
For these people, more is needed than just local anesthetics. There are a number of levels of anxiety reducing measures that your dentist can provide. These can be as simple as providing headphones to block out the noise of the handpiece all the way up to providing an IV for sedation.
One of the most exciting steps that have come out is the ability to provide sedation dentistry in pill form. Oral conscious sedation, or OCS, has opened the door for many patients to be able to overcome their fears of dental procedures and get their dentistry done in a manner that they won't remember being at the office. The use of nitrous oxide is also an effective mild sedative. This has evolved greatly from the days of the doctor getting laughed out of the operatory theater to a point where it is easy to use on an everyday basis for helping patients with their fears.
We have evolved quite a long way in dentistry. From the days of the tooth draw'er to modern techniques of relieving anxiety and pain. What a leap. It sure makes dentistry a lot more fun to practice and a lot easier for the patient.
Dr. Michael K. Keating, DDS, is a dentist in Auburn and can be reached at 252-7278 or e-mail him at DrMike@FingerLakesSmiles.com
The early dentists in our country weren't even called dentists.
Rather, they were called tooth draw'ers. These were people who would travel the countryside, usually with a carnival and set up a tent so people could come and have teeth taken out.
Now as you can imagine in those days there was no such thing as anesthetic, either local or general. I shouldn't say that, often times patients would supply their own anesthetic in the form of a whiskey bottle.
The tooth draw'er would simply reach in with whatever crude instrument he had fabricated and yank away. Whatever came out was it. If any pieces were left behind, then they healed over, fell out later or got infected. There was no such thing as disinfection or sterility in those days. So before the inception of dentistry, the association with pain has been established.
The early days of dentistry were filled with attempts at making patients comfortable. These attempts were usually through the use of an anesthetic gas. Our medical colleagues had been making the same attempts to be able to anesthetize patients and these attempts spilled over into dentistry. Early attempts using either nitrous oxide (laughing gas) or ether ended in tragedy. At least one patient died. Another attempt to complete a dental procedure in front of medical colleagues with nitrous oxide ended up with the patient not being anesthetized enough and the dentist being chased out of the operating theater as a sham. This once again reinforced dental procedures as being painful.
Early in the 20th century, dentists were beginning to do more and more restorative procedures. It was becoming common knowledge the huge benefit of saving teeth rather than extracting them. As I would walk the halls of my dental school, I enjoyed looking at the photographs of the colleagues who came before me in the old school clinic with foot pedal driven handpieces. I then could see the advancement to the belt driven handpiece.
Even with these innovations the procedures were still quite painful.
Let's move to today and look at why I can make the statement that dentistry doesn't have to be painful. The advent of Novocain was one of the biggest innovations ever brought out for making dentistry pain free. Although the brand name Novocain is long gone, its descendants live on. You can get the chemistry lesson from your own dentist so I won't bore those not interested, but suffice it to say that the modern day local anesthetics are quite different from the original Novocain and therefore much more comfortable to administer.
Recent statistics show that close to 50 percent of the American public doesn't see a dentist regularly. Many of these 50 percent don't seek dental services due to fear. This is due to a previous painful experience or some other association with pain and dental procedures.
For these people, more is needed than just local anesthetics. There are a number of levels of anxiety reducing measures that your dentist can provide. These can be as simple as providing headphones to block out the noise of the handpiece all the way up to providing an IV for sedation.
One of the most exciting steps that have come out is the ability to provide sedation dentistry in pill form. Oral conscious sedation, or OCS, has opened the door for many patients to be able to overcome their fears of dental procedures and get their dentistry done in a manner that they won't remember being at the office. The use of nitrous oxide is also an effective mild sedative. This has evolved greatly from the days of the doctor getting laughed out of the operatory theater to a point where it is easy to use on an everyday basis for helping patients with their fears.
We have evolved quite a long way in dentistry. From the days of the tooth draw'er to modern techniques of relieving anxiety and pain. What a leap. It sure makes dentistry a lot more fun to practice and a lot easier for the patient.
Dr. Michael K. Keating, DDS, is a dentist in Auburn and can be reached at 252-7278 or e-mail him at DrMike@FingerLakesSmiles.com
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puzzled1 wrote on Jul 31, 2007 1:02 PM: