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Complacency would be easy. After all, most of us think we are doing<br />
a pretty good job in the comfort area. It would be so hard to change our<br />
reputation when we could just keep laughing about it in good-hearted, selfdeprecating<br />
humor. However, we could learn from the Japanese. After<br />
World War II, the words “Made in Japan” were branded to mean poor quality.<br />
Today, the Japanese have turned quality into a science and everyone<br />
knows that Japanese products set the standard for reliability. Dentists can<br />
similarly change reputations by proving ourselves anew.<br />
I have been treated by many dentists in my life, all of them conscientious<br />
and some of them famous. I am certain that they all thought they were<br />
comfortable and painless, but only two of them really were. Some of the<br />
experiences were downright unpleasant. I have had blocks that hurt like a<br />
tetanus shot. I have been gagged by impressions. I have had anesthetic<br />
wear off then reassured that “we’re almost done.” I have weathered a twohour<br />
crown prep. I have had a root canal without being completely numb.<br />
I have had repairs done with no anesthetic at all. I have had my tongue<br />
nicked, my lips bruised, and my throat jabbed! The interesting thing is that<br />
I am not a dental phobic and I do not hate the dentist. I just want to have<br />
the pleasant, comfortable experience that I know is possible. After all, I<br />
have experienced comfortable dentistry in the past. My wife, Allison, wisely<br />
says that it does not matter how great the dentistry is if we hurt the patient,<br />
the pain is the only thing they will remember. She is absolutely right.<br />
Each of us owes it to our patients to do everything we can to make each<br />
visit completely comfortable. If a patient is genuinely phobic or simply<br />
prefers to be sedated, we should be trained in oral conscious sedation.<br />
But for the vast majority of procedures, we should carefully begin earning<br />
the reputation of being painless and comfortable. There is so much<br />
we can do. It starts with genuine compassion. We can be on time. We can<br />
use a great topical and allow time to let it work. We can revisit our “painless”<br />
injection technique and do it every time with The Wand. We can be<br />
gentle in our manner. We can be comforting in our communication. We<br />
can provide our patients with pillows, blankets and video glasses. We can<br />
teach our team to be friendly in interactions, comfortable in assisting,<br />
and gentle in hygiene techniques. We can buy equipment and materials<br />
that make the experience comfortable. Microultrasonics and lasers reduce<br />
the need for scaling and for perio surgery that patients despise. Digital<br />
x-ray sensors are now rounded for comfort. New implant techniques<br />
eliminate flap surgery. Rubber dams and Isolites provide comfort and relaxation,<br />
while reducing gagging and drowning. Intraosseous anesthetic<br />
guarantees profound numbness in difficult situations. Rotary endo techniques<br />
are quick and painless. New bonding protocols reduce sensitivity.<br />
And so do new whitening products. Proper medication eliminates post<br />
op pain. The list is endless.<br />
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70 <strong>LVI</strong> VISIONS • JANUARY • FEBRUARY • MARCH • APRIL 2008<br />
To help you get started,<br />
here are some essentials:<br />
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Topicals<br />
EMLA (AstraZeneca)<br />
before injections<br />
Oraquix (Dentsply)<br />
for localized scaling<br />
Anesthetics<br />
Use a little Citanest plain first, then<br />
Septocaine for local infiltration.<br />
For blocks, after a little Citanest plain,<br />
use Carbocaine followed by lidocaine.<br />
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Syringe<br />
Do not use one except for intraosseous<br />
injections!<br />
Get The Wand (www.milesci.com)<br />
for every operatory. In fact, get a<br />
spare! A slow injection is a comfortable<br />
injection.<br />
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Intraosseous Anesthesia<br />
When you can not get them numb,<br />
use the X-Tip (www.x-tip.com), invented<br />
by Dr. Kit Weathers. (Stands<br />
for Total Instant Profound Anesthesia—and<br />
they are not kidding.)<br />
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Video glasses<br />
www.i-vue.net. Patients will laugh<br />
while you work—if you show them<br />
the right DVDs. Office favorites are:<br />
Jerry Seinfeld Live on Broadway,<br />
Robin Williams Live on Broadway,<br />
Kings and Queens of Comedy, Blue<br />
Collar Comedy Tour.<br />
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Hygiene<br />
80% of your hygiene procedures<br />
should be done with microultrasonic<br />
scalers. We use a Pro-Dentech piezo
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