Cincinnati Smiles.com | General Dentistry for Adults and Children

In our office, we do everything we can to minimize patient discomfort. We are never in a hurry to move on to the next patient and our primary concern is you and your comfort. Oral surgeons often work with general anesthesia or deep sedation where the patient is essentially put to sleep. They accomplish excellent results in this situation. However, there is always a risk involved when you are put to sleep. In general dentistry, it is more difficult to accomplish excellent results when the patient is asleep. Factors such as patient position (lying supine) and registration of certain jaw positions make detailed dental treatment very difficult.

We offer nitrous oxide sedation, oral, and will be offering IV medications in the future to relax you. These are reviewed on the Sedation Dentistry page. If you have substantial dental fears, please read this entire page, which explains many dental fears.

Most importantly, we take the time to listen to your fears and to do whatever you require to allow you to have the necessary dental treatment successfully completed. Everybody has different needs. We don't have to rush you through a procedure. If you have pain during a treatment, we take the time to stop and make sure that the tooth becomes numb before we proceed. This gives you much more control over the situation. However, it still takes a lot of courage for the phobic patient to pick up that phone. Many fearful patients ask a friend, spouse, or relative to accompany them for moral support. This is a great strategy. You owe it to yourself to maintain oral health. Give us a call at 771-2230.

In 1990, Dr. Timothy Smith, a professor of psychology at the University of Kentucky, and Dr. Kroeger, the previous owner of the practice, published a scientific research study in the Journal of the American Dental Association that described the effectiveness of the dental fear control program. For over two years they trained ten dental offices in Ohio, Kentucky, West Virginia, and Indiana to use this method. The results were very positive. In our office, over more than 30 years, more than 1,000 patients have gone through this program and most have been helped significantly.

Can affect your self-image.
Can allow dental disease to destroy teeth, gums, and bone support in the jaw.
Can allow oral cancer to go undetected. Leukemia can be seen in the mouth in the form of bleeding gums and squamous cell carcinoma, if not treated early, can be deadly.
Can allow gum disease to cause teeth to spread and your bite might change. Bad breath can develop from gum disease.
Can affect your overall health: dental infections can spread through the blood stream or towards the neck. Inability to chew well can affect digestion of food.
Can affect your career: a good smile = powerful persuasion.
Can affect relationships.
Can lead to expensive dental bills. Dental neglect is more expensive than prevention.
Certain types of heart disease can worsen with dental infections.

The program consists of two sessions, although most patients only need the first one. You begin with some paperwork.

You'll complete three forms designed to find out what you're afraid of and what may have caused the fears. We will discuss these fears with you and get your feedback. Often just hearing someone listen to your concerns helps to make you feel better. You'll write about any bad experiences you may have had in dentistry. Share these with us. We'll be happy to listen.

You will then watch a videotape showing a fearful patient, just like yourself, receiving dental treatment. This tape was professionally produced by the University of Kentucky audiovisual department. It shows the patient getting a gentle injection, the use of nitrous oxide, and the patient raising his hand to stop the procedure. Control is a major concern for most dental phobics. Some have trouble watching this video ... but it helps to reduce fear.

We'll then give you an audiotape that will offer instruction in two relaxation exercises, methods proven to help you reach a deeply relaxed state. The first, guided imagery, takes you through four imaginary scenes, tranquil and happy places where you can go, in your mind's eye, to forget about the dental visit. By focusing your attention on these pleasant ideas, you'll be able to relax.

The second exercise is progressive muscle relaxation. Here you will learn to alternately tense and loosen every major muscle group in the body. After 15 minutes of this, you will become deeply relaxed. Psychologists like to use this method to induce hypnosis. Again, it requires practice.

At the end of this first session, we encourage you to listen to the tape at least once a day. That way your relaxation skills will increase daily. We also give you a copy of Dr. Kroeger's book, How to Overcome Fear of Dentistry. Reading this book will help you to understand your fears and how to deal with them.

If you feel you need more help, we have a second session available. In this visit, we'll first review your progress. Then, while relaxed, you'll watch the videotape again. Watching the video for a second time should increase your confidence. Next, we'll use a fear desensitization ladder, a technique where we'll give you a fearful scene to imagine and then you'll relax. The scenes gradually increase in intensity. Most patients don't need this second session. But, it's OK if you do.

At the end of the dental fear control program, you can schedule an appointment for an initial exam.

Lots of people are afraid of getting stuck. It can become a terrific phobia. Sometimes nitrous oxide, coupled with medication and natural relaxation, must be used. We pride ourselves in giving gentle injections. These take extra time and patience. We always use a topical gel to numb the gum ahead of time. Most patients don't even realize what has happened.

Pain from drilling is the most feared procedure in dentistry. With profound numbness, this pain is rare. In preparing small cavities, air abrasion (a small, concentrated stream of abrasive particles) can be used instead of the conventional drill. However, air abrasion is not effective for most dental restorations.
We allow our patients to stop the procedure if pain occurs during drilling. At this point, we can use a number of methods to make the tooth more numb. It is extremely rare in or office for anyone to have discomfort during drilling. In a worst case scenario, we can always stop, place a temporary, and continue treatment some other day.
Afraid the drill will slip? Some folks are. Dentistry demands precise, exacting concentration. During drilling, the chance of slipping is minimal. In fact, the use of rubber gloves increases the grip adhesion of the fingers to the drill.
Afraid of the sound? Use headphones and listen to music or to a relaxation tape. Crank up the volume if you want it louder. Some patients pack cotton in their ear to block the sound.

The gag reflex is a beneficial protection to avoid swallowing something too large. However, if exaggerated, it can make certain dental procedures very difficult. Several things can reduce gagging. Nitrous oxide sedation can help, as can local anesthesia. Raise your foot off the chair during an impression. Breathe deeply and very slowly through your nose.

Many young children have this fear. We reassure the patient that high-speed suction is used to evacuate particles and debris so that they won't be swallowed.

Most phobics who have avoided the dentist for a long time are embarrassed about the condition of their mouth. They don't want anyone to look in there. Everyone one in our office has been trained to work with fearful patients and they have empathy with you.

As a result of prior bad experiences, a lot of people fear that the dentist or staff will criticize them or give them a lecture for neglecting their mouth. That may have happened to you. In our office, we don't criticize, rather we congratulate you for having had the courage to take a risk and visit the dental office.

Have you had a painful extraction, painful gum surgery, or a bad experience with a root canal or crown? Let us review with you what happened to you and then explain how perhaps we can make the procedure easier for you, in case you need it done.

Yes, excellent dentistry costs money. So do cars, computers, and vacations. Cars wear out soon and break down often. Computers are outdated the week following purchase. Vacations are fun but are usually forgotten soon. But, a properly restored mouth will give you chewing function, smiling power, and good oral health the rest of your life. Patients must decide on their priorities. In our office, we can help you finance your treatment.

True, dentists use tiny, sharp tools ... and for good reasons. But these are not designed to inflict pain. If you have been 'stabbed' by a dental instrument, you will be justifiably wary. If you have this fear, let us know up front. We will take extra care to avoid sensitive places during our exam, especially root surfaces that are not covered with protective enamel.

In dentistry, we have a type of local anesthetic that wears off rather quickly. We also can use a technique that numbs only one tooth at a time. If needed a new product called OraVerse is available to reverse the numbness.

We have a local anesthetic that will last much longer than the average and provide hours of pain relief. This might be indicated in surgical procedures or those involving significant post-operative pain.

Some have had rough, painful experiences during a routine dental cleaning. Hence, their fears are real. However, a dental hygienist, if she or he has enough time allotted, can be gentle. In case this fear is extreme, nitrous oxide, a numbing solution, or even a local anesthetic can be used during teeth cleaning. Deep scalings or root planing, advanced periodontal treatments, should be done with profound numbness.

In these times, this fear can be real, especially in large cities where the AIDS virus is prevalent. In our office we use universal precautions on all patients - for all procedures - and we sterilize our instruments in a steam autoclave. A local hospital monitors the sterility of our autoclave every week. Except for a single incident in Florida, there have been no documented instances of patients getting AIDS in a dental office.

Yes, if you have avoided the dentist, you may need a lot of treatment. But, then again, you might not. Often it's not as bad as you might think. Many of our phobic patients are pleasantly surprised to learn their treatment will cost less than they imagined. If finances are tight for you, then treatment can be split into phases and completed as you can afford it.

There are several other fears that are related to dental treatment. They are not common and many are based on individual experiences. If these fears turn into phobias, it is often a good idea to get psychological help.

What else can you do? Talk to a friend or relative and explain your fears. Just chatting often helps. Give us a call. We'd love to see you.

Frustrated by treating fearful patients? You aren't alone. Many dentists rate the fearful patient as something they'd rather avoid. We all know what happens when a patient has uncontrolled fear:

By allowing your patients to assume responsibility for their dental fear, you will empower them to be able to be more relaxed in your chair. They will be more at ease and so will you and your staff. You can order the book, How to Overcome Fear of Dentistry ($17.95) and the audiotape, Learning the Relaxation Response ($16.95) by calling (513) 771-2230. Discounts are given for multiple copies ordered.

The book, Managing the Apprehensive Dental Patient, is also available ($44.95). Dr. Omer Reed called this book, "a remarkable aid" and Dr. Gordon Christensen labeled it "highly pragmatic and yet scientifically sound."

Here are some ideas that might help you build your practice by treating fearful patients: