I want to take a moment and address a common problem that I have seen in just about every practice I have visited. Sensitivity and complaints following a dental restorative procedure is so common as to be consistently predictable. I would have to say that I can’t remember the last time a patient of mine said that a filling, root canal, or crown was sensitive from temperature or pressure, or that the patient felt sore. Allow me to give you a quick “standard of care” for doing any procedure where you “drill” on a tooth to insure that you will not have sensitivity. This week we will target the psychology of pain along with a couple of tips to mitigate that.
• Get in and Get Out: Taking too long to prep a tooth or complete a procedure guarantees muscle soreness, sensitivity to temperature and pressure. The longer it takes you, the more symptoms will appear.
• Get profound anesthesia the first time every time. Stabadent (www.stabident.com) , X-Tip, Septocaine (www.septodontusa.com ).
• Topical: www.stevensrx.com topical for a profound numbness before you inject.
• Always use a mouth prop: This will eliminate most muscle spasms and post op soreness.
• Premed with two extra strength Tylenol, and two ibuprofen. They have the same efficacy as two Vicodin.
• Use Dexamethasone 4mg/ml injections every time you do a filling, crown, extraction, or root canal: This will eliminate 90% of the post op discomfort. (Not to be used on insulin dependent patients).
• Write a pain prescription almost every time: The psychology of the patient knowing that have a few pain pills will eliminate their need.
• Extractions: Use Polysporin B (Polymyxin B Sulfate and Bacitracin zinc) and place it in the socket area following an extraction to eliminate dry sockets.
• Always give them your cell number if they need anything: The psychology of feeling in control and having a way to contact you will guarantee that you never get a call and they will feel great.
• Always call them yourself following any procedure you stick them with a needle. Same thing. Reality will exceed their expectations and they will refer everyone they know.
Next time we will talk about the clinical tips that make you look great. Until then, this is how you Summit.
Michael Abernathy, DDS