Overcoming nerves to restore self-confidence with 3M oral care

Preet Bhogal presents a case where he treated a class II division I incisor relationship on a severe, low angle skeletal II base with labial ceramic fixed braces.

The patient

A very nervous, dentally phobic, 19-year-old female patient presented at the practice. She had concerns about the appearance of what she described as her ‘goofy front teeth’.

She enquired about whether orthodontic braces could move her teeth and help her smile with confidence when in public.

The patient was medically fit and well, although she had not attended the dentist in several years due to a previous bad experience and breakdown of communication. She had a history of failed functional appliance treatment at the age of 12 years.

In summary, she presented with a class II division I incisor relationship on a severe, low angle skeletal II base. An increased overjet of 14mm and an increased and complete/traumatic overbite to her palate. As well as poor oral hygiene and active caries.

Dental phobia

As the patient was extremely phobic, it took many visits to stabilise her oral status. She was very reluctant to undergo any invasive dental procedures. At this initial visit, we allocated additional time so that the patient did not feel rushed in any way. I find this is extremely important to obtain trust and make the patient feel at ease. We explained what we would do before each part of the consultation and a full set of intraoral photographs were taken.

Following a full orthodontic assessment, we uploaded the photos to a large screen to demonstrate all notable features. The importance of stabilising her dentition and oral health was made clearer to the patient. She could see in detail the caries and poor hygiene. This motivated her to visit a sensitive general dentist to…

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