Dr. Justin Moody discusses the gain of no pain
As dentists, I think we sometimes forget the fear that people feel when being treated at the dental office. Since we are so focused on presenting the case and what we can do for patients’ various dental conditions, often their comfort is just an afterthought. Dental implants and oral surgery are perhaps the most frightening procedures you could hear about, especially in today’s age, when we have YouTube® and all the other social media platforms adding to the overload of information and possible misinformation that instills even more apprehension. The power of social media reaches well beyond the promotion of our practices. Just this week, I had scheduled a bi-lateral sinus augmentation graft after meticulous patient education — only to have the patient call the next day to cancel. When asked why he was no longer coming in, the patient said he watched the procedure on YouTube and decided it was not for him.
Figure 1: Primary closure is so important for getting the case off to a good start
Figure 2: Pharmacology will make you look like a rock star in your patients’ eyes — minimal swelling and pain should be one of your goals
Figure 3: Drs. Justin Moody, Mike Freimuth, and Danny Domingue providing hands-on leadership at Implant Pathway Live Surgery Course
Figure 4: Adequate alveoloplasty to provide for adequate restorative space for the final restoration
Figure 5: Postoperative cone beam CT taken to check implant placement
Fear of the dentist is as real as the dental pain itself. Many of us think it’s just the anesthetic injection, but in all actuality, for most, it’s experiencing the pain of the procedure. As dentists really get a pass on the needle (our patients know it’s coming), it is uncomfortable for just a short time. There is no substitution for profound anesthesia during the case — get good at it, and use it. Even with this said, many still need some form of sedation to get over their initial fears. We can handle this at the office, but what about the postoperative pain?
Good sound surgical principles and tissue manipulation go a long way in minimizing postoperative pain. So many of my cases are more complex and require large tissue reflections, multiple osteotomies, and extensive suturing. I have found that the use of a proper pharmacology protocol prior to implant treatment makes an even bigger difference. Prophylactic antibiotics have been shown to reduce infections, and a short-term dose of a steroid such as Decadron will decrease swelling, which in turn will decrease pain. A NSAID will block alternate inflammation pathways that the steroid didn’t, and all of these will make you look like a rock star.
Since implementing this regimen in my practice, more of my patients have had a positive experience and ultimately have left more positive social media reviews. Better to be known as the painless dentist!
Justin Moody, DDS, DICOI, DABOI, is a Diplomate of the American Board of Oral Implantology and of the International Congress of Oral Implantologists, Fellow and Associate Fellow of the American Academy of Implant Dentistry, and Adjunct Professor at the University of Nebraska Medical College. He is an international speaker and is in private practice at The Dental Implant Center in Rapid City, South Dakota. He can be reached at justin@justinmoodydds.com or at www.justinmoodydds.com.
Disclosure: Dr. Moody is a paid speaker for BioHorizons®.
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