Dentist Nigel Braine-Hartnell explains how modern anaesthetic materials and techniques have helped his patients feel reassured.
Treating the fear of dental care in childhood predicts more regular dental examinations later in life.
This is according to a recent study that suggests ‘if not addressed, can persist and complicate life over the years’.
The study concludes that an individual approach chair-side to dental fear ‘can be effective in bringing patients to regular, examination-based oral care’.
Approximately one in two adults say that they are at least somewhat afraid of dental care, and one in ten says they are very afraid.
Sadly, the pandemic has not been kind to these patients, exacerbating their trepidation and compounding procedural anxiety by the fear of infection, specifically Covid-19.
According to the case report, Dental Anxiety and PTSD During the COVID-19 Pandemic: A Dentist’s Nightmare, patients with high dental anxiety can be difficult to treat, often requiring more time, and might have complex behavioural needs, leading to unpleasant experiences for both the patient and the treating facility staff. Treatment of this patient population is a high source of stress for dentists.’
All of this confirms that patient health needs are not only manifold but also unique to each person who presents in the chair and that open communication and empathy serves to create a less stressful environment for everyone involved.
Opportunities to enhance
Patient-centred care is a key component of safe, effective and appropriate dentistry, with patients now considered ‘active members of the dental care treatment cascade’.
And whilst good communication may well be the cornerstone of a tailored and inclusive approach, technology offers dentists opportunities to enhance the patient experience, simplifying processes and ultimately making time in the chair more comfortable and less invasive.
Amsel & Wilkins is a family dental clinic based in Banbury, Oxfordshire. Nigel Braine-Hartnell is one of its dentists who, with the rest of the team, has built a reputation over the last few decades as a ‘caring, friendly practice where patients can feel relaxed and comfortable in a modern environment equipped with state-of-the-art technology’.
Promising words indeed, but just how does the team at Amsel & Wilkins ensure this is the case for even the most nervous of patients?
Nigel qualified from University College Hospital London in 1988. He trained alongside colleague John Adams at Sheffield Dental School during 2004-5 on its dental implant course. Nigel also has an interest in endodontics, winning the 2002 British Endodontic Society General Practitioner Prize.
With this comes a wealth of experience, which means he well understands the patient psyche – in particular those who arrive with fear and trepidation. Implementing the soft skills from the start is key to putting them at ease, he believes.
Avoiding mistakes
‘Our website is designed to allow for an online report to be collated and sent to prospective patients without them having to visit the practice first. From this, we can set a Zoom-type consultation to discuss their thoughts and concerns. For nervous patients especially, this enables them to “meet us” before deciding if they would like to book a face-to-face examination.’
‘Once booked in to see us, we greet patients by name as they enter reception. We take great care to ensure each one feels as safe and as comfortable as possible. This starts before any treatment begins.
‘We then take time to listen to their concerns and agree a plan together that suits their budget and expectations,’ he says.
‘These discussions are mindfully arranged away from the surgery setting to build trust and rapport. It ensures the patient can make an informed decision about their care’.
Nigel adds: ‘It also lets the patient open up about previous negative dental experiences, allowing us as a team to avoid any repetition.’
Once inside the surgery, the clinician’s open approach with nervous patients offers a continuum of positivity.
‘During treatment, we ask patients to indicate if they ever feel less than comfortable or out of control so we can address this and avoid any negative experience. We tell patients to raise their hand if they ever feel pain during a procedure, and always stop and deal with this before restarting.’
The practice is proud of its investment in leading technology, and The Wand is a key part of this. A computerised local anaesthetic delivery system, it can significantly reduce, and even eliminate, pain from an injection. By removing the pain, you can remove a significant amount of the patient’s fear.
Confident in reassuring
Nigel explains: ’Fear of pain often features in patients’ concerns and we reassure patients that modern anaesthetic materials and techniques such as The Wand allow us to be confident in reassuring patients that their visit will be pain free.
‘I have been using The Wand for more than 10 years and have found it a game changer. I used to use topical gel before giving any local anaesthetic but that became scarce at some point, so I tried The Wand without and haven’t looked back since. It is so gentle that there really is no discomfort when using it.’
The computer in The Wand cleverly controls both the flow and pressure of the anaesthetic’s delivery, ensuring it is delivered at a rate below the patient’s pain threshold. It’s administered by an easy-to-use pen-like grasp, meaning intimidating-looking needles are a thing of the past. But it is also possible to administer with more precision to exactly the right spot.
This helps Nigel achieve the results he wants whatever the procedure.
‘I routinely use The Wand in all applications, including mandibular molar implant surgery. This was a leap of faith at the time for me. It is far better at palatal infiltrations than conventional syringes in my hands.
‘If I have a patient with lower molar toothache I do resort to an inferior dental block and then add a buccal infiltration with The Wand. I do not want to have to stop mid procedure with rubber dam in place to give more local anaesthetic. All of this can have several advantages for the nervous and/or young patient, beyond simply removing the fear and the pain.’
Positive dental experiences
Nigel adds: ‘I like the fact that The Wand delivers predictable deep anaesthesia and patients often comment as they leave how much less swollen their lip or cheek feels compared to previous dental experiences.
‘Having experienced The Wand once, patients return more relaxed and confident for further visits with less anxiety and often ask if I will be using the “beeping machine” again.’
And aware of the need to ensure a positive dental experience in the early years, paediatric patients also benefit from its use.
‘I now use The Wand with child patients and they tolerate it very well. It is much easier to explain and less scary to look at than a long needle syringe, as children tend to look at what you are up to and notice every detail.’
Evidently it is providing Nigel and his team with a useful tool in their goal to build on early positive dental experiences to create long-lasting patient loyalties.
For more information on The Wand, visit dentalsky.com/wand-dental.
