False Emergency

October 2004

By: Dr. Scott R. Harden

On the verge of tears, pacing the floor in writhing pain, Tammy could not postpone making a decision any longer. She was feeling desperate, acting irrational, but knew she had to make the pain stop. The toothache that Tammy Jones was experiencing escalated to an unbearable level and was throbbing so badly she could feel her heartbeat in the tooth. I shouldn’t have waited this long to get something done, she thought.

She felt very despondent about picking up the phone to call yet another dentist regarding her bad teeth. As she dialed the phone number to the dentist, she felt a familiar confinement from anxiety overwhelm her. The phone rang and she pondered, why am I so apprehensive about going to the dentist?

Tammy possesses a classic example of dental phobia, an ailment clearly shared by many Cherokee County residents. Dental phobia can manifest from a mild deterrent to a paralyzing fear of seeking dental care. It is related to many causes ranging from psychological issues to physical issues such as macroglossia, an enlarged tongue that partially blocks the airway and gives the patient a sense of choking.

It has been reliably reported that 50% of the American population does not seek regular dental care. An estimated 9-15% of all Americans fully avoid dental care altogether. This translates to some 30 – 40 million people nationwide including 20,000 people in Cherokee County, that are so afraid of dental care that they avoid it altogether.

In terms of your dental health and overall wellness, this can have serious implications. In addition to chronically infected gums and teeth with abscesses, which can affect your overall medical health, your ability to chew and digest can be seriously compromised. Without healthy gums and teeth, your speech can be affected as well. Your confidence and self-esteem can be compromised if you are insecure about your breath and smile. This can ultimately lead to serious limitations in both your social and business environments.

After delaying treatment for four years, Tammy’s visit to a dentist one month ago left her bewildered and distraught. She reflected how direct the dentist was about “having those bad teeth extracted on the lower left”, and how little explanation he had offered as to why. The dentist referred her to an oral surgeon for the extractions and put forth no effort to reappoint her for follow-up care. She had not formed a good relationship with that dentist or the office staff, and was not confident about their advice. Despite her desire to be free of her pain-ridden teeth, she did not feel strongly compelled about having her teeth extracted.

Tammy read various articles regarding dental restorative treatment and implants written by Dr. Scott R. Harden, a restorative and cosmetic dentist located in the Woodstock area. I want to have options, she thought.

“Fountain View Family Dentistry, this is Leanne, how may I help you?” Tammy was nearly speechless as she held the phone to her ear. She responded after an awkwardly long pause, “I have a very bad toothache and would like to make an appointment”. As Tammy drove into the parking lot, she contemplated not keeping her appointment. Embarrassed about the terrible condition of her teeth and gums, and worried about the financial expense of treatment, her apprehension grew exponentially as she approached the door to the dental office.

The initial visit at Fountain View Family Dentistry, proved to be an entirely different experience from her previous visit one month ago. Tammy felt very at ease and more comfortable than she has ever felt in a dental office. The front office staff provided her a warm welcome and created a very positive dental experience, long awaited by Tammy. The practice manager further discussed the expenses of dental care at the end of her visit and made treatment affordable to her. “I feel so comfortable in your office”, she exclaimed to our practice manager before leaving.

The doctor provided Tammy with several treatment options, and discussed them while images of her teeth were projected onto the overhead monitor utilizing an intra-oral camera. Tammy told an assistant, “the camera allowed me to easily understand my diagnosis and treatment plan.” Option one included extracting three teeth in the lower left and replacing them with a removable partial denture, an option unappealing to her. Another option included extracting the same teeth and placing implants to restore her missing teeth. Option three was the most attractive to Tammy; it was very unique and customized for her specific needs. This option included extracting two teeth that were non-restorable, performing a root canal in one salvageable root of a molar while extracting the other bad root of the same tooth, a procedure referred to as a “hemi-section”. This allowed her to acquire a fixed bridge spanning from the retained root forward to a healthy tooth, which would be permanently attached.

The doctor further explained this treatment plan to Tammy utilizing a patient communication tool he calls the “BBOT or building blocks of treatment”. Stages of treatment are simply broken down to basic steps or building blocks that allows the patient to attain a clear understanding of their overall treatment.

At Tammy’s visit to begin treatment, she felt one last imminent desire to abandon her treatment procedure. Knowing that immediate treatment for pain relief was necessary and that Tammy’s concerns were psychologically founded, Dr. Harden added his tender reassurance and gentle words to help calm Tammy’s mental anguish.

“Tammy, you have been a false emergency long enough in your life, and its time to take positive steps to fix your teeth”, the doctor stated to Tammy as she squirmed nervously in the dental chair. “What is a false emergency”, she inquired? “A false emergency”, he explained, “is a patient that has had a significant problem existing for a long time, often years, and decides by some measure that today is the day they must be seen.

In order to help Tammy refocus her attention, the dental assistant provided her with headphones to play either a CD or DVD movie from their library. These added touches along with the Comfort Control Anesthesia device, a computer controlled device that allows anesthesia to be delivered without any discomfort, helped Tammy move forward with her dental care. “The entire procedure was painless despite a root canal and extractions, and I did not even feel any discomfort the following day”. Tammy achieved a major milestone, and is well on her way to achieving complete dental health … a dream come true. Congratulations Tammy!!!

This is a true human-interest story about a recent patient experience at Fountain View Family Dentistry. The patient’s name has been changed to maintain professional discretion.