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A dentist's dream patient, Robin Meola went cavity-free for nearly 10 years.
"When I found out I had two small cavities, I immediately became anxious about it," she wrote in an e-mail to the Daily Record.
"Then when I found out I needed to wait an entire week to get it filled, I began to get a little panicky."
Anxiety and apprehension are natural reactions to anticipating a medical procedure, but when they magnify or develop into full-fledged phobias, intervention can help.
In Meola's case, the intervention came in the form of relaxation techniques administered by Beverly Hills Dentist Dr. David Grayson of Parsippany.
"I expressed my apprehension, and he told me we would do some relaxation therapy," she said. "After I sat down on the chair, he began with his very soothing voice, and I began to feel my tense muscles begin to relax. Throughout the entire procedure he continued to very soothingly talk me though the procedure, and then we were done."
A certified member of the American Society of Clinical Hypnosis and practicing dentist for more than 30 years, Grayson employs hypnosis to help put his anxious patients at ease.
In using this technique, Grayson wants to dispel the "you are getting very sleepy" stereotype used for entertainment, which often depicts a person doing something outside their conscious realm that they would not normally do.
"There's this image of hypnosis engendered by the media that it's about mind control or stage hypnosis," he said. "But hypnosis is not like that at all. It's about guiding the patient into a relaxed state, and it's all inner directed."
Such was the case with Meola.
"I was still fully aware of my surroundings and did experience some minor pain and discomfort, but this approach definitely made me more relaxed and comfortable," she said.
Grayson often incorporates self-visualization tactics, a method he found particularly useful in his younger patients.
"There was a 7- and a 9-year-old who needed fillings, and I said, 'Let's play a game of let's pretend," he said. "I had them close their eyes and that inside their eyes was a big TV screen. I then told them to name their favorite place -- a beach -- and as I filled the cavities, I talked to them the whole time as if they were on the beach. I asked them if they felt the waves and the warm sun."
Grayson first identifies the degree of anxiety or phobia to determine the type of session necessary.
Mildly anxious patients may take five or 10 minutes to relax. Others with a deep-seated fear may undergo a few sessions prior to treatment, he said.
"There are no drugs involved so the patient can just drive themselves home afterwards," he said.
Relaxation dentistry differs from sedation dentistry, in which drugs or anesthesia is administered.
"We have an anesthesiologist come to the office for IV sedation, or patients can take a pill hours before the appointment," said Dr. Andrew Howard of Howard and Banks in Morristown . "They just need a ride to and from the office."
Howard and Banks have been administering sedation dentistry for the last six years. Many patients affiliate their phobias to a bad childhood experience at the dentist, and more women appear to suffer from fears than men, Howard said.
Insurance coverage varies for sedation dentistry, he said.
Grayson, however, incorporates the relaxation aspect into his normal fees.
"If I'm just relaxing the patient before the work, then I don't charge," he said. "It's like giving novocaine. However, if there's a very phobic patient who needs more than one session, then I do charge."
Grayson earned his relaxation dentistry credentials from the American Society of Cinical Hypnosis, which is accredited by the Academy of General Dentistry .
As a science-based organization, the American Dental Association issued a position statement on relaxation or dental hypnosis, which falls under the umbrella of unconventional dentistry.
"Ancillary services, such as the administration of Botox, acupuncture or reflexology, should be performed by licensed individuals in accordance with local and state regulations," according to the ADA.
While neither endorsed nor refuted by the association, a presentation given by dentist and clinical psychologist Dr. Shirley Brown at the American Dental Association's 2003 annual meeting addressed the growing niche of relaxation amenities.
"Over a quarter of adults surveyed said they hadn't visited a dentist in over five years due to fear of pain," Brown said. "For a long time, pediatric dentists have created a happy, relaxing atmosphere for children's dental care by decorating their offices in bright colors and offering things like child-sized furniture, toys and fish tanks. Now, a growing number of dentists are creating the same effect for adults by offering pampering amenities."
Often termed "dental spas," practices such as Grayson's that offer services and amenities such as hypnosis designed to relax patients do not fall under the "spa" realm, Brown said.
While the 1980s brought a multimedia element, courtesy of headphones and music, to the dental office, distraction tools ranging from video goggles to color and lighting schemes continue to develop with technology.
"Anything that elevates the dentistry's appeal to the public is a good thing, in my opinion," Brown said.
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