We all can relate to the panicky feeling when watching a movie or tv programme where the damsel is about to drown in a submerged car. The water level is rising as she tries to find a way out without succeeding. She bangs the windows with her fists, pulls the door handle only to realise there is no way out. She breaths rapidly and you can tell from her face that she thinks she’s going to die. She lifts her mouth to get the last gasps of air as the water level reaches the top. She makes her last attempt to break a window. Then silence as she gives in. Air bubble stream flows out of her nose as she must exhale. The eyes close. She remembers somebody telling her that drowning is a kind way to leave this earth. She floats with her eerie looking hair moving around here head.
Can’t breath. I will drown if I breath.
Then just before the last air bubble comes out of her mouth the hero of the movie breaks the car window and pulls her out. She is taken to the shore and given first aid by the hero. She coughs and opens her eyes. She’s alive! She didn’t drown! The hero saved him and they fall in love and live happily ever after.
Drowning at the Dentist
Most people are pros when it comes to dealing with dental treatments. But every once in a while you notice the patient being in trouble with the water in their mouth when we use our rotary instruments or the sonic scaler. They keep on swallowing rapidly or raise their hand to signal that something is wrong. Some even try to get up while the instrument is still whirring inside the mouth (this is something we strongly discourage as it is a safety hazard).
Once they get a chance to speak they sound like they just ran a marathon and say:
“I need a break to breathe…”
“There’s so much water…”
“I feel like drowning…”
Well, is it possible to drown at the dentist? To my knowledge no-one has drowned at the dentist. And I doubt no-one ever will. But we will keep on getting these patients that struggle with the water. It probably has got something to do with the survival instinct – My mouth is filling up with water! Get up and swallow or do anything to be able to breath or you are going to die!
Of course the patient is not thinking exactly like this but their subconscious is. And their actions are driven by their subconscious when it comes to the matters of life and death.
The big question is:
How can you help the patient to deal with their unreasonable subconscious that is telling them they are going to die when they are most definitely not?
Firstly, tell the patient how they can signal if they are in trouble, need a break or if they have something to say. My advise for my patients is to lift the left hand. Always stop immediately if they signal that they want to have a break. This builds up the trust. Tell them also that you will anyhow take breaks every now and then so that they can have a break. And then remember to give breaks!
Secondly, tell the patient that they should concentrate on breathing through their nose. You would be surprised how many of the patients get this eureka-moment when they realise they can effortlessly breath through the nose even though the mouth is filling up with water.
Thirdly, tell the patients who are still in trouble even though they are breathing through the nose that they should focus their mind to think about the fresh, cool air flowing inside their nose, their lungs and out again when they exhale. This will help to take the focus off from the rising water level inside the mouth. Speak slowly and with relaxed voice when you give this advise – almost like a yoga instructor. It is also helpful to tell the patients to think that they are somewhere pleasant like the Maldives. Under the palm tree and just relaxing.
With these steps patients will get through the most unpleasant moment of the treatment.
Advise for the Patients Who Struggle with the Drowning Feeling
Practice at home! Take a gulp of water and lay back on your sofa without swallowing. Open you mouth and breathe slowly through the nose. Stay there as long as you feel comfortable. Next time take two gulps of water and repeat the above. Slowly your brains learn that there’s no danger having water inside your mouth as you can breath through the nose.
Remember that if you have a blocked nose, use nasal spray before the dental treatment to relieve it. Or reschedule until you are able to breath through the nose effortlessly.
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