By Dr. Robert Luther, Jr. DMD

One of the most rewarding aspects of my practice is helping people to overcome their fear of dental treatment. Those who have been paralyzed with fear and are able to overcome it, become wonderful ambassadors by referring others who share their concern, but decide to give it a try.
Dental phobia may be based on fear of pain, needles, the sounds and smell of a dental office, or fear of being criticized or embarrassed for allowing dental health to deteriorate. Some of these people have had a bad experience in the dental office or may have been frightened by stories told by family or friends.
Vast improvements in technology have made the delivery of comfortable dentistry much easier, but, the most important factor in overcoming fear is trust between the Doctor, staff and the patient. This trust is developed when a person senses that they are being treated in a caring fashion and that their individual needs are being addressed. A new patient in our practice must feel that they are being taken care of in a professional manner, that they are in competent and caring hands, and that they are always in control.
We want to know of the patient’s fears or concerns so that we may address them and provide solutions. For some people we may have to go slowly, until the confidence grows and fear melts away. The patient will learn that we are able to perform nearly all procedures without pain and that we will stop a procedure if any discomfort occurs. Topical anesthetic allows for near painless administration of novocaine. Lasers allow for many cavities to be restored without novocaine and without the sounds of a drill. Headphones or cable tv provide a solution for those who hate the sounds of the dental equipment. Many people comment that they enjoy listening to a relaxed conversation during treatment, and often will even join in. Nitrous oxide or “laughing gas” is wonderful for relaxing a person during treatment. Candles are often in use in our office to provide a pleasant scent, different from the one often associated with dental offices.
In a few cases, medication may be used to relax the person before a visit.
With the help of a caring dentist and staff equipped with modern technology, you can overcome fear of the dental experience and you will not only return to good dental health, but, you may gain a sense of accomplishment as well.
Dr. Robert Luther, Jr. can be contacted at (412) 788-6300 or you can visit his website at www.pittsburghlaserdentist.com.

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Functional Cosmetic Dentistry The Best Way To Go
By Lois Thomson

Functional aesthetic dentistry is a step above regular cosmetic dentistry. But to perform it properly, your dental practice must also be a step above. And that describes the practice of Dr. Steven R. Crandall, DMD, who gained expertise in the post-graduate dental program at the Pankey Institute in Florida.
Dr. Crandall described the concept of functional cosmetic dentistry: "It requires additional information to be gathered during the exam, and a lot more is involved with the diagnosis, treatment planning and case presentation. We have about 10 different stages we go through to accomplish getting the optimal makeover."
He said the first step is to have a conversation with patients to discover the outcome they are looking for.
"It's very important to get feedback on their expectations, although we do want to make sure their teeth are positioned functionally to last a long time. So after a discussion with the patient, we go through a very comprehensive examination process. It takes approximately an hour-and-a-half to gather the information we need, and it typically includes models and photographs and X rays, as well as an examination of their muscles and joints."
Following the evaluation, Dr. Crandall does what's called a laboratory wax-up on the patient's study models. He then waxes the teeth to the shape he and the patient would like them to be. "So we get the form (esthetics) and the function established on these models.” This is done using the photos that were taken.
He clarified his comment by saying that when a person's jaw moves in different directions, the front teeth are supposed to interact with one another in a certain manner. However, dentists in other practices don't often take the time to do that, and just hope for the best.
"But it's very important to work all of those things out, and we typically do that on models prior to doing any dentistry," he said, adding that the patient then usually goes through a temporary restoration. "That's something we make out of acrylic, and it's based on the pre-approved wax-up we already did on the model.
"So the teeth are restored with provisional restorations, and patients can 'test drive' it. They come back in and we evaluate, to see if the bite is correct and if they like the way they appear cosmetically. We modify the provisionals to establish the look the patient is hoping for and fine-tune the function."
Dr. Crandall concluded by saying, "It's a little more elaborate than what typically goes on in a dental office. In an insurance-driven practice, a lot of these steps don't take place. People do not consider the functional portion of dentistry very often, and that can lead to failure and discomfort if it's not integrated into the restoration."
For more information, call (412) 833-6166 or visit www.stevenrcrandalldmd.com.

For more articles, download the Winter '09 issue (PDF)