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Four Questions Your Dentist Wishes You Would Ask

The technology and treatment options for consumers of dental care have greatly improved over the last 20 years. The new dentistry now provides you with the opportunity of maintaining your natural teeth throughout your life. One of the ways this is accomplished is by referral to a dental specialist to treat specific dental problems.

When dentists refer you to a specialist, your understanding of the problem and decision for treatment is vital in determining a specialized dental plan. The plan for your dental health and your general dentist's overall goals often depend on these specialized resources.

When you are referred to a dental specialist, he or she becomes a part of your dental team. Although your specialist will give you information about the reasons for the referral and the treatment, there are also some active steps you can take to increase your participation in the dentistry treatment and healing process.

A query of dental specialists indicates that there are some questions that they would like you to ask to enhance the treatment outcomes they seek as a result of your dental plan. Answers to the following questions will often augment the information provided by your general dentist and enable you to clarify any further questions you may have about the specialized treatment you are receiving.

• What is the cause of the condition that you are treating?
• What treatment gives you the best overall outcome and how will it help you?
• What can you do after treatment to help the healing process?
• What can you do to control the condition in the future or make sure it doesn't happen again?

These four questions will help you gain insight into the disease process that led to the need for dental care treatment and the prevention and self-care measures you can incorporate into your life to avoid future problems. With this information, you can also work with your general dentist and the dental team to maintain your dental health plan.

Specialized dental care for your dental needs is one of the ways the new dentistry has brought innovations in diagnosis and treatment to benefit consumers.

By Brian DesRoches, PhD

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Will I Be Comfortable During My Root Canal Treatment?

The answer should be an emphatic "YES!" Fortunately, dentistry has developed new techniques for delivering local anesthetics painlessly. These techniques also assure that the anesthetics act more rapidly and produce a more "profound" level of anesthesia. Additionally, modern dental procedures utilize better technologies that are generally much less traumatic and invasive than those of the past. The result of these advancements is that patients should have minimal or no discomfort during the tooth numbing and/or treatment procedures. Root canal treatment should not cause pain, but rather relieve it when present and keep it from reoccurring. Unfortunately, dental pain may also have a psychological component, possibly stemming from a negative past experience, a story in the media, or even the fear of the unknown. Sometimes these situations can prove challenging for the patient and the dentist to control. Examples include:

• Some patients associate tooth pain with past root canal treatment when, in fact, the pain they remember was experienced prior to their emergency visit. Oftentimes, this pain develops over a period of several hours to a few days and is allowed to build and worsen before seeking treatment. Once the patient seeks emergency care, endodontic treatment should not be uncomfortable and should provide quick and certain relief from any painful symptoms stemming from root canal disease.
• Patients may become very anxious when being examined or treated dentally because the mouth is such an important part of the body and psyche. Some patients may feel anxious and vulnerable because of their positioning in the dental chair with members of the dental team working above them in such close and intimate proximity.

These and other distresses are real to the patient. Much of the time, however, the distress can be reduced or eliminated if the patient discusses it with the dentist and gets understanding and reassurance. The doctor and the patient must work together in these situations to make certain that the patient feels as comfortable, trusting, and informed as possible in the dental environment. Most individuals can do this satisfactorily. If patients continue to feel significant distress, even after having these discussions with the dentists, they should be aware that there are supplementary modalities for which they might be candidates. These modalities include:

• Oral sedation involves ingesting a sedative pill or liquid before the appointment. This can help anxious patients a great deal and make the treatment experience much less psychologically stressful.
• Nitrous oxide analgesia, known as "laughing gas," can be inhaled along with oxygen to make patients feel less anxious and more comfortable.
• Intravenous sedation can be administered in a dental facility by a specially trained and certified dental team or by a specially trained dental anesthesiologist. With intravenous sedation, patients are not asleep and they can still respond, but they will not feel or remember anything. This technique works very well in creating a pleasant experience for many anxious patients and is a good anesthetic modality for more lengthy dental procedures.
• Hospital dentistry is conducted in an environment where a variety of anesthetic modalities are available and can be used under the safest medical conditions. General anesthetic and intravenous sedation can both be utilized in the hospital setting.

These sedative techniques and medicines may also be helpful if particularly lengthy treatment procedures are necessary in specific situations.

With all of the advancements in pharmaceuticals and in their delivery, there should be no need for any patient to delay root canal treatment because of fear that the treatment will be painful.

By Clifford J. Ruddle, DDS, in collaboration with Philip M. Smith, DDS