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You can find the current article at its original source at http://www.theguardian.com/commentisfree/2016/apr/28/dentist-horror-jacobus-van-nierop-dentistry-pain
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| Trust me, I’m a dentist. You have nothing to fear | |
| (35 minutes later) | |
| I take this as a great compliment. Half a dozen or so times a year, patients will spontaneously fall asleep in my dental chair during treatment. | I take this as a great compliment. Half a dozen or so times a year, patients will spontaneously fall asleep in my dental chair during treatment. |
| I don’t slip Valium in the mouthwash or use subliminal hypnotic techniques to induce compliancy, I promise. The patients just drift into the arms of Morpheus until I’ve finished the restorative procedure I’m performing. Nowadays, dentistry is more like grouting than surgery, so drilling is kept to a minimum and sleep is therefore, relatively undisturbed. The patients usually wake up embarrassed and profusely apologetic for having nodded off, while simultaneously wiping the local anaesthetic dribble and sleep drool from their chins. | I don’t slip Valium in the mouthwash or use subliminal hypnotic techniques to induce compliancy, I promise. The patients just drift into the arms of Morpheus until I’ve finished the restorative procedure I’m performing. Nowadays, dentistry is more like grouting than surgery, so drilling is kept to a minimum and sleep is therefore, relatively undisturbed. The patients usually wake up embarrassed and profusely apologetic for having nodded off, while simultaneously wiping the local anaesthetic dribble and sleep drool from their chins. |
| If only it were always like that. Some patients (particularly the middle-aged still haunted by the dreaded “school dentist”) still have to be coaxed into the surgery by prising their fingers off the door jamb with a reinforced spatula. | If only it were always like that. Some patients (particularly the middle-aged still haunted by the dreaded “school dentist”) still have to be coaxed into the surgery by prising their fingers off the door jamb with a reinforced spatula. |
| Earlier this week a Dutch dentist, Jacobus van Nierop, was jailed in France for inflicting “horrific injuries” on “drugged” patients in the town of Château-Chinon. He had been found guilty of carrying out “useless and painful procedures” on patients. He apparently used to take “pleasure at causing pain”, according to prosecutor Lucille Jaillon-Bru. | Earlier this week a Dutch dentist, Jacobus van Nierop, was jailed in France for inflicting “horrific injuries” on “drugged” patients in the town of Château-Chinon. He had been found guilty of carrying out “useless and painful procedures” on patients. He apparently used to take “pleasure at causing pain”, according to prosecutor Lucille Jaillon-Bru. |
| It’s redundant to point out that Dr van Nierop’s case will do little to allay the fears of the average dental phobic, but the fact is, modern dentistry is a world away from the boiling cauldron of biting on a stick and leather restraints some older patients conjure up in their minds before coming for a check-up. The reasons why patients are afraid to visit the dentist are manifold, but are usually based in myth – it is physically impossible to take a tooth out with a knee in the chest! | It’s redundant to point out that Dr van Nierop’s case will do little to allay the fears of the average dental phobic, but the fact is, modern dentistry is a world away from the boiling cauldron of biting on a stick and leather restraints some older patients conjure up in their minds before coming for a check-up. The reasons why patients are afraid to visit the dentist are manifold, but are usually based in myth – it is physically impossible to take a tooth out with a knee in the chest! |
| I freely admit that I am a former dental phobic. I entered dental school late, as a mature student, after an inspirational dentist cured me of my fear with a gentle, almost cossetting approach. My personal worry was of choking on the instruments in my mouth, which resulted in an embarrassing tendency to retch, and many patients suffer from a fear of suffocating, or are frightened of “drowning” on the water sprays we use to cool our instruments down. | I freely admit that I am a former dental phobic. I entered dental school late, as a mature student, after an inspirational dentist cured me of my fear with a gentle, almost cossetting approach. My personal worry was of choking on the instruments in my mouth, which resulted in an embarrassing tendency to retch, and many patients suffer from a fear of suffocating, or are frightened of “drowning” on the water sprays we use to cool our instruments down. |
| Most dentists are kittens deep down and if patients just explain to their clinician about their fears, we will keep the instruments at the front of the mouth so that the tongue and palate aren’t stimulated and the airway doesn’t feel like it has been violated. By explaining your fear of impressions, we can warm up the impression so that it sets much more quickly. Chairside breathing techniques can also reduce problems with a fear associated with a compromised airway. | Most dentists are kittens deep down and if patients just explain to their clinician about their fears, we will keep the instruments at the front of the mouth so that the tongue and palate aren’t stimulated and the airway doesn’t feel like it has been violated. By explaining your fear of impressions, we can warm up the impression so that it sets much more quickly. Chairside breathing techniques can also reduce problems with a fear associated with a compromised airway. |
| The dreaded needle is also a big barrier to a patient seeking treatment, but can be easily overcome. Many dentists (like me) routinely use surface (topical) anaesthetic in the form of a gel before we begin the numbing procedure with the hypodermic. Together with delivering the anaesthetic very slowly, we can often introduce the needle with the patient not feeling entry at all. Some dentists now even use a method of delivering local anaesthetic electronically, maximising comfort. | The dreaded needle is also a big barrier to a patient seeking treatment, but can be easily overcome. Many dentists (like me) routinely use surface (topical) anaesthetic in the form of a gel before we begin the numbing procedure with the hypodermic. Together with delivering the anaesthetic very slowly, we can often introduce the needle with the patient not feeling entry at all. Some dentists now even use a method of delivering local anaesthetic electronically, maximising comfort. |
| The fear of being hurt during treatment is also a barrier to a patient seeking help. Modern local anaesthetics are so good these days that providing a tooth is not very inflamed or infected, comfortable dentistry is guaranteed. Many new patients I see as emergencies in pain have usually not attended for treatment for years. They have almost always had a “bad experience” with a dentist many years previously. | The fear of being hurt during treatment is also a barrier to a patient seeking help. Modern local anaesthetics are so good these days that providing a tooth is not very inflamed or infected, comfortable dentistry is guaranteed. Many new patients I see as emergencies in pain have usually not attended for treatment for years. They have almost always had a “bad experience” with a dentist many years previously. |
| Some patients fear the loss of control in the chair, not surprising since the mouth feels a very vulnerable and sensitive part of the body. Most dentists will establish the use of hand signals with the patient at the start of treatment. If not, a lightning quick jab up the dentist’s nose usually halts procedures. | Some patients fear the loss of control in the chair, not surprising since the mouth feels a very vulnerable and sensitive part of the body. Most dentists will establish the use of hand signals with the patient at the start of treatment. If not, a lightning quick jab up the dentist’s nose usually halts procedures. |
| For the very anxious, simple oral sedation can be provided in practice via Temazepam tablets prescribed by your dentist. If you are really lucky, some dentists can provide inhalation sedation (gas and air) or can refer you to specialist centres for intravenous sedation or in exceptional cases, for general anaesthetic. There really is nothing to be scared of. | For the very anxious, simple oral sedation can be provided in practice via Temazepam tablets prescribed by your dentist. If you are really lucky, some dentists can provide inhalation sedation (gas and air) or can refer you to specialist centres for intravenous sedation or in exceptional cases, for general anaesthetic. There really is nothing to be scared of. |