Practicing Pain Free Dentistry – Experiences of a Dentist who goes for a Dental Treatment to Another Dentist
“Please don’t move while I anesthetize you” or “You’re acting like a two year old” – are very common statements used by us dentists. How distracting and irritating is the whining patient to us who is scared of a little needle prick asking for that magical gel which reduces the pain from the prick? We see a many cases like these each day. They take up a lot of our “Precious” time which we could have utilized for treating other patients. The topical anesthesia is used for this situation; which is meant for children not fully grown mature otherwise healthy people. Alas! Many people have no sense and neither do they realize how important time is for the dentist. They never listen to the dentists, and off-course completely oblivious of the responsibilities of a dentist.
This is the general view of the dentists, but not mine since I have had a dental treatment which at least for me, developed respect for the patient. It was in the second year of my dental school, that I had a couple of cavities in my teeth. Well it was no big deal, I am after all a future dentist, was what I thought. I took an appointment for 10 am the next day (I could not stand food stuck in my teeth). So I was there in the restorative dentistry department at 10 am sharp, the next day. For fifteen minutes I searched for the doctor but in vain. I gave up and sat on the dental chair. After about half an hour the doctor was sighted. Apparently he was chatting with someone in the neighboring department.
The armamentarium was set for the treatment. The shining instruments that had felt so harmless in my hands seemed like dangerous weapons ready to inflict pain. “Be a man”, was what my mind told me and I gathered courage and let go of the thought. The chair was reclined and as it was the maxillary arch I needed treatment on, so it was nearly parallel to the floor. That felt very uneasy. Still! treatment had to be done. The cavity was examined and it was time to prepare it. The drill (highspeed airotor)! I cannot forget what horrible sound it made cutting into my tooth. The worst part of it was that I could not see what was going on despite being completely conscious and aware that something was going on.
It was all fine just some stupid, childish feelings, I thought, until that sharp lightning bolt like pain. I could not speak or exclaim but flinched. The drill stopped and I was asked did that hurt? “Yes it did! Can’t you see my eyes watering?” I thought. I replied in affirmative. “It will hurt a little, let us check it”. The first thing that came to my mind was to make a run for my life as I did not want to feel that lightning again but decided against it. The sharp probe was picking at my tooth again and again and every now and then I felt pain. And the dentist was humming something like “la la laaaa la la” which was quite disturbing at the time. I wanted to get over with it was soon as was possible and I was hating it to the maximum. I thanked when it was over after an hour of extreme anxiousness.
It was not long before one of the fillings broke off and I realized that they were not done properly (class II without matrix band). I felt quite angry that the protocol was not followed (of which I knew very little in 2nd year of my medical school). After that I have had multiple treatments done on my teeth because I have not cared particularly well for my teeth and partly because those improper fillings caused further decay. The worst experience was the palatal anesthetic injection which is quite painful (Interestingly not even half of the fresh dental graduated would know that sub periosteal injections are extremely painful).
Impression trays that pinched my gums, improperly fitting crowns, bad fillings, I have had quite a share of bad things in general dentistry. And I have always thought that when you can do improper fillings on a becoming dentist you can do them very easily on unsuspecting patients causing them a great deal of inconvenience both mentally and physically.
Dentists are believed to be Messiahs (healers) but the so called healers that are being produced in our part of the world are taught very little about their ethical responsibilities and more about focusing on the number of cases they do by hook or by crook. The quality of treatment really does not matter to the dentists rather the quantity of treatment. Pain is thought of as a feeling that is to be felt by the patient and nothing could be done about it. There is a serious communication gap between the patient and the dentist and trust has no place in the dentist-patient relationship. This attitude also foreshadows the students learning of mere basics of ethical dentistry and pain free dentistry.
Over the years I’ve met dentists, my teachers, and I consider myself extremely lucky to have known such people and learned from them, who have taught me how to practice pain free and ethical dentistry and give the patient, the first priority rather than anything or anyone else. A very respected teacher of mine gave me words of wisdom which I recall: “You’re a dentist, and in our country the patient usually comes to the dentist in pain. If you have not learned pain-control, during your undergraduate training you have learned nothing.”
Small things like reassuring the patient, use of topical anesthetic and other pain free injection techniques and confirming that the required area had indeed been anesthetized can greatly reduces the stress the dental patient feels and builds trust in the patient. Mal-practices which cause damage to the patient rather than benefit should be discouraged and practitioners using such should be shunned and discouraged.
I believe pain free dentistry should be knowingly and on purpose taught to dental students in every department and ethical treatment causing minimum harm to the patient should be promoted amongst students. A satisfied smile on the patients face is the best reward you can get. A relieved and relaxed patient is the best thing to hope for. After all life in our part of the world is already not very easy!
About the Author: Syed M. Abdullah Salman is a recent graduate of Dr. Ishrat ul Ebad Khan Institute of Oral Health Sciences, Dow University, Karachi, Pakistan. His field of interest includes oral surgery and restorative dentistry. He can be reached at: email@example.com
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