INDIAN RIVER COUNTY — The approximately 50 percent of Americans who do not seek routine dental care offer a wide variety of excuses. Cost is often cited as a factor, but in fact the number one reason is fear.
Despite improvements in technology designed to minimize pain, some patients still have a dread of dentistry.
Some qualms come from real or perceived experiences, but more often the terror stems from exaggerated tales of dental mishaps. Whatever the reason, delays in dental care only compound the problem.
“They let things go for so long that they end up in the emergency room,” says Dr. Bruce McDonald, a partner at Ocean Oaks Dental Group in Vero Beach. “And the bigger the problem is, the more afraid they are of taking care of it. The problem never gets solved.”
Oral surgeons and pediatric dentists, who receive anesthetic training in their residency programs, are certified to offer IV sedation or general anesthesia in their offices.
However, because of Florida Board of Dentistry restrictions, most general dentists are not.
“Nor can we hire an anesthetist to work in our office,” says McDonald.
Oral sedatives are an allowable option, but leave the patient groggy and can be risky.
For that reason, when a friend whose daughter falls into the category of being “very, very frightened of dental treatment” asked for help, McDonald was determined to seek an alternate solution.
He reached out to the well-known dental supply firm Henry Schein Dental, which donated a mobile dental hand-piece and delivery system that is now available for use by any dentist in the county at the Indian River Surgery Center.
Worth approximately $5,000, the control unit includes the drill and basic instrumentation; dentists bring their own filling materials and portable instruments.
“There aren’t enough patients for one practice to purchase the equipment and leave it there,” McDonald says. “What I’m hoping is that some of the other dentists will see the need for this, and then it’s a worthwhile endeavor for everyone.”
With this new equipment, patients can receive dental care from their regular dentist in a safe, comfortable environment, with sedation administered by a physician anesthesiologist subcontracted by the Surgery Center.
“The Indian River Surgery Center has been very accommodating with us in getting this whole thing set up,” says McDonald. “It’s really the type of thing that’s good for everybody – patients, dentists, and Surgery Center. This is something that I would like the general population to know about and I would also like all of the dentists to know that it is there as an option.”
Because of the additional charges for use of the surgical suite and anesthesiologist, it is not generally cost effective to utilize IV sedation for cleanings and minor dental procedures, but is rather meant to be an option for processes such as extractions, crowns, bridges and implants.
“This is for people who end up needing major dental treatment that just cannot tolerate it. I have a patient that has vertigo and can’t lie back in the chair. It is for people with medical issues, or who just have an unmanageable fear of dental treatment.”
A 21-year-old patient of his who says she is “absolutely terrified of going to the dentist” was thrilled with the option.
Her anxiety stems from an experience as a 3-year-old, being taken to the dentist for her first cleaning. Unbeknownst to her parents sitting in the waiting room, the dentist instilled terror by strapping her down in the chair.
When they learned what he had done, her parents were furious, but the damage was done.
“Even now, at 21, I’m still scared of the dentist,” she says. “I didn’t go for two years, which of course is insanity.”
She also had an eating disorder and despite regular brushings, acid had severely damaged her teeth and removed the enamel.
“I was scheduled to have 10 appointments; there was no way I could do 10 appointments. He said if he could put me out he could do it all at once. I was under for 5½ hours. I had 17 fillings; he put enamel back on as well.”
Of the experience she says, “It was perfect. I could be out and didn’t know what was going on. I woke up and it was perfect. It was 10 appointments in one.”
“It’s a good area for us to get into,” said Surgery Center administrator Barbara Narenkivicius. “It’s a great service to be able to provide care to people who want to be asleep when they’re having their dental work done. Anesthesia sedation is very safe when you have an anesthesiologist doing it. For people who have been afraid to go to the dentist for years and who have a lot of dental work to take care of, it’s a good solution.”