My patients always tell me that I have soft hands. I don’t think so. They usually make that judgement based on the way I give an injection. And let’s face it once the injection is given the game is over. The fear dissolves, except for those few who hate the sound of the drill.
Most people hate the needle.
I know I do. Because I have always feared the needle I became very empathetic about giving shots.
I can tell you that giving a painless injection is less about skill and more about empathising with the patient. I don’t really know whether I have soft or light hands…but I do know that I am really sensitive to my patient’s feelings and fears.
We cater to cowards because I too am a coward.
They don’t teach great injection technique in dental school. I had to learn it on my own…as a patient who has had extensive and sophisticated dentistry through the years. My first recollection of a painless injection came when I was in the Army. The dentist grabbed my cheek and pinched it with significant force. I certainly knew he was there but I wasn’t concerned about his pinch…it was that needle I feared. Then out came his concealed weapon…but I never felt it. My mind couldn’t leave the thought of his pinch which he was now shaking.
That was my first exposure to the Gate Control Theory.
The trick to giving a painless injection. You see the brain can only feel one source of pain at a time. The pain receptors can only accept stimuli from one gate. The dentist was fooling my brain.
It works…every time.
Of course there are some other factors that contribute to the painless injection, like:
1. The location
Usually the easiest place to take an injection is the upper back areas. The more difficult places are the upper front areas. Of course, the dentist has some control by using the Gate Control Theory, and,
2. Using a topical anesthetic, rubbed on the area for thirty seconds. Our practice uses a very potent topical anesthetic called Tac Gel, and
3. Injecting very slowly, because ballooning the tissue is probably the greatest source of pain, especially in areas where the tissue is thin like those upper front teeth.
4. Having a caring empathetic dental assistant who can provide support, reassurance and a hand to hold.
5. Most procedures do not require adrenaline. That’s the stuff that makes your heart go boom, boom, boom. Doctors call that tachycardia, and most people hate that feeling. For simple fillings the use of adrenaline is unnecessary…so ask your dentist for the safer and more comfortable anesthetic. At my Cherry Hill Office we go without adrenaline most of the time, and patients really appreciate it when the numbness goes away within 90 minutes.
6. Finally the dentist takes his time and builds a trusting relationship long before that needle comes out.
Patients have a right to expect this kind of treatment.
I recently had a urologic surgical procedure that carries a significant amount of discomfort. My doctor wanted to perform it in his office under local anesthesia. Let me tell you…that location is much more sensitive than anywhere in the mouth. As a dentist, I told him that I would prefer he didn’t work on a squirming patient…
“Put me to sleep,” I said.
He did…and I was one happy camper.
You have rights…express them, see who is listening…that is the real key to empathy.