[Local Medical]Help patients relax, reduce pain, hypnotherapy and get rid of dental anxiety | Good doctor

Therefore, for her, every patient who walks into the clinic will be carefully examined. If the patient has mental anxiety, she will take some measures to help him relieve his anxiety. On the contrary, the patient seemed very happy, and she would think that the other person had “zero anxiety.”

But research shows that nearly every patient who walks into a dental office carries some form of anxiety, so she believes it’s most important for dentists to understand that every patient has some unwanted symptoms, so at least Take steps to reduce their anxiety.

Why do patients feel anxious? The main reason is tooth pain. A patient once told Anna Bouni that tooth pain is more unbearable than labor pain. It is conceivable that toothache is extremely painful, and the patient may have had a bad experience when visiting the dentist. For example, the dentist did not give them a chance to report, or the dentist forcibly removed the tooth even though he knew the patient was in pain and was not ready, etc.

So, for patients who have had various problems, they have more severe anxiety. She points out that sitting in the dental chair can make people feel helpless because their mouth is open and they cannot control it, so this feeling of helplessness also leads to the accumulation of more anxiety.

After making an appointment, he got cold feet and ran away.

She pointed out that dental anxiety is a vicious cycle, and we can clearly see that anxious people often have avoidance behaviors, so when they make an appointment, they will call at the last minute to say something else, or to say that they feel better. Children, on the other hand, simply cry or don’t want to come to the dental office at all.

“When patients choose to continue to avoid it, their dental problems will become more serious, the required treatment procedures and costs will become more complex and expensive, and the process may be more painful. It can be seen that this is indeed a malignancy that dentists need to break Cycle.”

She said that the solution to dental anxiety can be divided into two parts: pharmacological and non-pharmacological. As a pediatric dentist, behavioral management is actually the core task of the pediatric dentist. In fact, she has done a lot and learned a lot.

“Non-pharmacological aspects include explanation-demonstration-operation

(Tell Show Do, TSD),

Distraction, imitation object, positive reinforcement

(Positive Reinforcement), rewards, etc.

Pharmacology is oral sedatives, intravenous sedatives,

Nitrous oxide and oxygen sedation, general anesthesia, etc. “

The COVID-19 epidemic was a big blow to dentists because in those three years, they did not have the opportunity to be exposed to general anesthesia. Since most hospitals were focused on fighting the epidemic or making way for vaccinations, many patients had to Access to treatment was futile because general anesthesia was not possible, so the dentist had very few resources to use. Therefore, Annabuni turned to many non-pharmacological methods, including hypnosis.

Hypnosis can also reduce the gag reflex

Anna Boone regards hypnosis as “verbal sedation” or ordinary sedation.

“This can actually achieve results similar to sedation and oral sedation used internationally. I think hypnosis definitely has its benefits, because there are no side effects, and it doesn’t require any tools, just your voice, and it can also instill Positive behavior because multiple doses are not required but the effects are longer lasting.”

In addition to hypnosis reducing pain for patients, especially those who are very anxious about dentistry, hypnosis allows dentists to actually deliver the treatment. She also uses hypnosis to change personal habits (Habit Breakers), such as thumb sucking, nail biting, bruxism, etc., because these habits can lead to more dental problems.

She said that hypnosis can also reduce the gag reflex, because patients with severe gag reflexes or excessive salivation during treatment will make it difficult for dentists to operate, forcing them to use inhaled sedatives or general anesthesia. “One study shows that hypnosis can also reduce bleeding from minor oral surgeries.”

She pointed out that many patients with dental problems require some form of treatment, and the cost is quite expensive. This can be very difficult for patients, especially children, such as primary school students and teenagers. Some of these children need to wear dental braces, which can be very difficult for patients. With either removable or fixed braces, they must comply with treatment to get the desired results, which can be a challenge for children.

“We can design the best equipment, but if the child is unwilling to wear it, we will not be able to get the expected effect. So I think this method can be implemented by combining hypnosis and motivation, and can improve the child’s motivation to cooperate. “

Children open their eyes and enter a trance state

She often comes into contact with children in her work. Generally, the hypnotist will close their eyes during hypnosis, but the situation of some children is different. She realized that they can enter a trance state with their eyes open. When the treatment is over, you think this time When hypnosis fails, they suddenly ask, “Can I walk out of this door and jump onto the clouds now?” (trance state). So, when she gave her children hypnotherapy, they became more alert and looked for other clues.

Her clinic at the university has two treatment areas, a chair side and a therapy room. Therapy rooms are more suitable for adults because they provide privacy so patients are more willing to disclose more details to the therapist and feel less anxious. Younger children can solve problems directly in the chair area.

Some teenagers may also need to be treated in a therapy room because some teenagers come with a lot of underlying but non-dental related problems, so from her experience working with teenagers she actually found that they actually had bigger problems, e.g. Bullying, abuse, etc.

Drug and expensive It’s best not to use nitrous oxide

In order to help patients relieve anxiety, Annabuni also uses various techniques such as dissociation, parts therapy, pseudo-orientation in time, anchoring, and desensitization. )wait.

Anna Buni pointed out that nitrous oxide (N2O) is a tool commonly used together with oxygen as a dental sedative. It is indeed very effective pharmacologically. However, dentists should avoid or reduce its use as much as possible, except for one reason. Another reason why nitrous oxide is a drug (chemical) is that it is actually very expensive.

The patient gradually relaxes through hypnosis

In the case of a child, she tried using nitrous oxide as the beginning of dental treatment, while talking to the patient to gradually induce a hypnotic state.

During this process, she actually did not inject nitrous oxide until the end of the treatment. She only delivered oxygen throughout the process, but the patient had entered a calm and very relaxed state under hypnosis.

Her students said it was incredible, but they understood that it was actually hypnosis affecting the patient.

Later, she used nitrous oxide as a placebo, only delivering it at the beginning of the treatment, and told the patient’s parents about the entire treatment process. If the patient could relax and accept such treatment, she would not initiate nitrous oxide. To continue sedation through hypnosis, of course, this must obtain parental consent.

Parental consent required

There will be some difficulties at the beginning, after all, parents have not heard of hypnotherapy, but parents whose children have experienced hypnotherapy all give positive reviews and will ask for treatment again the next time they need it.