Mike Gow, clinical director of the dental anxiety management unit at The Berkeley Clinic in Glasgow, explains how he manages patient anxiety while delivering excellent results.
Dentistry can be a stressful healthcare setting for practitioners.
Surveys carried out by Dental Phobia reveal that up to 53% of the UK population are scared of visiting their dentist.
Additionally, dentists have long faced the burden of regulatory demands and, in the case of those delivering NHS dentistry, overwhelming patient targets. But rising costs and long hours following the pandemic brought new layers of stress and burnout.
Add compliancy demands into the mix amid a period of change and uncertainty and workplace wellbeing continues to be at risk.
Mike Gow is clinical director of the dental anxiety management unit at The Berkeley Clinic in Glasgow. He is considered one of the most prominent dental anxiety experts. But he is also aware of the stresses his colleagues face daily.
At the end of last year, Mike organised and spoke at the Dentistry Wellbeing Symposium & Dinner in Glasgow.
He notes: ‘The past three years have been nothing short of extraordinary for the profession of dentistry and their teams. The challenges that we face ahead are huge.’
Rising expectations
According to a recent Dental Defence Union (DDU) survey, 86% of dental professionals say that workplace pressures have increased in the past two to three years.
John Makin, head of the DDU, notes: ‘Pressures are intensifying, caused by a number of issues outside of dental professionals’ control. These include an increase in treatment needs caused by the pandemic, rising patient expectations and treatment and referral delays.’
As a result, the DDU survey reveals that many dental professionals are turning to coping mechanisms such as mindfulness, breathing exercises and breaks in the fresh air to cope.
Mike acknowledges that emerging technologies have been largely responsible for an accelerating pace of change within the profession, which has had implications for patients and clinicians alike.
He says: ‘As clinicians, we are always looking for slicker, more effective ways to deliver dentistry. Digitalisation has solved problems, but the expectations grow as patients demand more.’
As a result, this puts a lot of pressure on a practising clinician. It may even threaten their physical wellbeing in terms of the working positions they adopt to deliver more complex treatment in a shorter space of time.
Back, neck and shoulder pain are commonplace in the dental sector. Repetitive tasks also bring concerns for hand health.
Investment
Challenging interactions in surgery can also impact mental wellness. Reassuring nervous or phobic patients may well be an accepted part of everyday practice. But this can often cause stress in an environment often beset by time constraints.
Yet much of these challenges can largely be offset by changing the way a clinician works, a commitment to taking breaks, employing relaxation exercises between patients, and the investment in the education and protective tools that help to reduce fatigue.
Mike says: ‘Whilst it’s amazing that we can, for example, turn around crowns in a short period of time and often in a single visit, it can be an uncomfortable patient experience if the anaesthetic has started to wear off by the time it’s ready to be fitted. This might also create anxiety for the practitioner.
‘So, using The Wand, which I have done for 15 years, can reduce the risk, as it is especially simple to deliver more anaesthesia.’
The Wand is a computerised anaesthesia system that gives clinicians control of administration. A small pen-like device that is easy to hold, Mike uses it with every patient – whether or not they have dental fear – because ‘every patient wants comfortable dental treatment’.
‘I rarely pick up a handheld now,’ he says. ‘The Wand is more effective, more comfortable and precise. It allows for different styles of techniques, which is a huge advantage.
‘The grip is comfortable and doesn’t risk the tendons. Historically, I would feel pain in my wrists and hands from delivering multiple injections, but that is no longer a problem.’
Delivering excellent care
So, while The Wand complements Mike’s approach to delivering excellent dental care to patients and aids predictability with its targeted delivery of LA without collateral numbness, it is also a game changer for his health and wellbeing.
He says: ‘The Wand is phenomenal for my patients – it is much easier for them to tolerate. But it is great for me, too. I no longer have to do slow injections with a technique that will eventually strain the tendons in the back of my hand and the whole experience is less stressful for everyone involved.
‘Using an ID block means waiting for 10 minutes, but The Wand works almost immediately. I can also work bilaterally on molars either side of the mandible. This is phenomenal when carrying out restorative work in sedation cases.
‘It’s great for veneer and crown preps, too. So although the patient is fully anaesthetised, there is no numbness to the lip when doing a smile evaluation. The Wand has been revolutionary in my dental practice.’
Comfortable environment
Professional interactions are not solely reliant on positive relationships. Technology inevitably plays a part in earning patient trust, especially if it means pain-free procedures.
But the digitalisation of dentistry helps practitioners, too. It gives them the confidence to deliver safer, faster and more effective treatments. It also creates a more comfortable environment without the challenges of patient anxiety.
And if that means the mental and physical health of those delivering dentistry is protected, then it is more than a mission accomplished.
Relaxation tips for the dental team
In a presentation at the Dentistry Wellbeing Symposium entitled Reduce Stress and Relax, Mike shared the relaxation exercises he uses with patients to help clinicians reduce their stress, too.
- The ‘4:4:8 breathing technique’ – a fast and effective life hack that switches the body from operating in the sympathetic to the parasympathetic nervous system. This technique can alleviate a ‘fight or flight’ response within a few minutes. Breathe in for the count of four, hold your breath for the count of four, and then breathe out for the count of eight www.youtu.be/MzASINsAP6w
- The ‘clenched fist technique’ – squeeze one fist as hard as possible when feeling stressed or anxious. Count to 10 and then release, allowing the hand to relax and let go of any tension. Doing this raises awareness of relaxation and can help release tension when stress or anxiety arises
- The ‘space exercise’ – find a moment to reframe any stress. It works as a relaxation exercise for the dental professional and a distraction technique for patients. It’s ideal between appointments because it is fast. Close your eyes and repeat three times silently to yourself: ‘I imagine the space between my eyes.’ This can be space, a colour, a shape, a sound, a feeling and so on. It does not necessarily require us to visualise anything – we can interpret how we wish. We start with the eyes and work our way down the body, repeating the statement for the ears, teeth, shoulders, arms, hands, fingers, knees, feet, ankles and toes. It takes 60 seconds and is a great way to recharge before the next patient. Repeating the cycle at night in bed can help get us to sleep
- Anchoring – this is one of the best life hacks that enables you to counter and neutralise negative emotions using your own personal bank account of positive feelings. Learn how to do it here: www.youtu.be/hQkIzogpKZ4.
Follow @drmikegow on Instagram and Facebook for more tips and to find out about future training courses. You can also stay up to date with the Dentistry Wellbeing Symposium via www.facebook.com/dentistrywellbeing.
