How on earth did I not remember this type of Anti-Patient? I guess it is all coming slowly (but surely) back to me after returning to work.
Before you read any further, it might be good idea to read my post Anti-Patient so you know what I am on about.
Anti-Local Anesthesia
Now, this type of patient is not so uncommon in the dental chair. Let me tell you about the two of the most typical situations I face.
Patient Case I
I am about to start the scaling and root planing and I can tell from the looks of the gum that it is going to be painful. I offer local anesthesia (LA) but the patient declines by saying:
“I once had such a bad experience with LA that I have not taken any since..”
Or
“Oh, I never take any LA, not even when I have a filling done.”
I explain that it will most likely hurt but the patient does not change his mind. Not even when I explain we could use topical LA (I use Oraqix) which would not require needles.
So I begin the treatment. The sonic scaler goes relatively well but when I begin to scale those deep pockets the patient is jumpy (as if somebody was poking his limbs with a needle), turns his head suddenly (exaggeratingly) and is kinda slowly sliding towards my lap as he’s pushing from the handles of the chair.
After I have nearly injured my own finger and patient’s lips for the third time because of the unpredictable motions and after I have three times asked patient not to move his head, I stop the scaling and tell the patient that I won’t be able to carry on unless he keeps the head absolutely still. Because it’s not safe. I offer the LA again and usually at this point they agree.
Patient Case II
The patient (who also just declined LA) keeps still throughout the treatment (scaling) and says she’s fine when I ask her if she’s ok (multiple times). So naturally I carry on to finish the treatment.
Once the patient gets up from the chair she does not look happy and says
“It hurt a lot.”
Or
“Oh I hate having this done.”
Or
“It’s never hurt before.”
Soooo annoying! Did I or did I not offer you LA? Of course it hurts if you decline LA when it is recommended. And why would you say you are fine when you are not?
What is the most annoying in all this is that she will go and tell ten of her mates how horrible experience it is to have the teeth cleaned. Simple marketing rule – bad experiences you tell to ten people, good experiences to one. So unfair!
Dental Revelations 