Look at me, breathe deeply, fabric to the needle, and slowly, slowly, slowly. What are we talking about? Painless injections.
Are your injections completely painless? (“Oh, yes, I do totally painless injections.”) Be brave enough to ask your staff and, more importantly, your patients. Looking at your patient’s eyes will tell the whole story. You think you’re doing painless injections. You use a topical, the Wand, VibraJect and maybe other devices. But you really don’t need any of those things. We are going to talk about a method that I innovated out of a personal need to make totally painless injections. I call it the number one cabinet builder.
As a child, I was phobic about teeth. When I was 5 years old, I had a terrible experience. Some of your patients have had negative dental experiences, so how can we expect them to be relaxed and comfortable in our practice?
Also by Jeffrey Hoos:
What does patient comfort mean?
Why it’s not just patients who have to say “yes” to treatment
One of the most painful things in the world happened to me on that date when I was 5 years old. I had a tooth removed with novocaine, but it didn’t work because the tooth was infected. I was subjected to a horrible and unnecessary dental experience that affected me deeply.
When I met Dr. Irving Paul in Bangor, Maine, he changed my life. He helped me overcome my dental phobia by creating the confidence and environment that made me want to be a dentist when I was 6 years old. He showed me compassion and converted me from a dental phobic to someone who told everyone, “I want to be a dentist. dentist.”
Years later I realized my dream and walked into Tufts. I decided that I wanted to learn how to inject painlessly. The university offered a course in hypnosis, and I thought that might be the answer. I learned a lot about relaxation, and to this day I hypnotize myself to sleep at night. Hypnosis teaches you the important tool of overcoming someone else’s will. The reason for learning hypnosis is to create a situation where patients will be totally relaxed and therefore completely at ease. There are many ways to put our patients at ease, for example using nitrous oxide or oral sedation; some patients may even be so phobic that they require intravenous sedation.
Think about the complexity of the nervous system. It is made up of two parts: the sympathetic and parasympathetic nervous systems. The parasympathetic system allows you to relax, which is necessary to experience a painless injection, and the sympathetic system prepares you for combat. Your body is pouring epinephrine into your system and a lot is happening to prepare you for this battle.
But what if you are not relaxed, but rather coiled up and ready to fight the enemy? Imagine being asked to give a speech that you are not prepared for. You are nervous, your mouth is dry and you feel shaky. Think about your patients who are nervous. When they ask to go to the bathroom, it’s because their sympathetic nervous system has taken over. They want to leave the dental office.
How many times have you been unable to numb a nervous patient? Their acid-base balance has changed because the sympathetic system has taken over. We need patients to be relaxed, but they cannot be in an uncomfortable environment. We need the parasympathetic nervous system to be in charge.
We also have to use very sharp instruments or needles. It may seem intuitive, but if you use a needle once, it’s not so sharp. When you enter a different site that is not numb (like when you numb many teeth), the patient will feel it.
How does it all fit together? Are you infiltrating or blocking? It doesn’t matter with this “painless injection” method. When you combine distraction, hypnosis, rapid movement of tissue toward the needle, slow injection, and the right instrumentation, you can inject painlessly.
Building 101 practice is all about putting the parts together, and painless injection is an important part of that.
Editor’s note: This article appeared in the July 2022 print edition of Dental economy magazine. Dentists in North America can take advantage of a free print subscription. Register here.