Dentists Try to Overcome an Old Foe: Fear
By: Ramin P. Jaleshgari
 Dr. Linda Golden |
Kerry Kehoe looks forward to visits to her dentist. That is when she gets to sit back and relax because while the dentist, Linda Golden, works on her mouth, Ms. Kehoe gets a foot massage. Later she gets her neck, shoulders and back rubbed, too.Practices like these, called distraction treatments, that aim to ease the anxiety and worry of dental patients, are turning up increasingly in dental offices on Long Island.
"Anything a dentist can do to make a patient feel more at peace or at ease is beneficial - for both," said Matthew Messina, a dentist who is consumer adviser for the American Dental Association. "It's easier to work on a calm patient and a calm patient feels more comfortable with the work that's being done."
While the association does not have any formal position or statistics on nonmedical stress-reduction practices for dentists, Dr. Messina said that anecdotal research did point to value in these treatments, which vary from massage therapy to musical or visual stimulation. Dr. Messina, who has a practice in the Midwest, also said that not all distraction methods were conducive to practicing the best dentistry.
"I could see how video glasses, for example, could remove a patient from the situation too completely, so they could not participate in their own care such as moving their mouth a certain way" he said.
Dr. Golden is one of a number of Long Island dentists who promote distraction techniques for patients who experience a lot of stress during dental work. "Massage therapy is just one way to help patients with anxiety" she said. "We also offer stress balls for patients to squeeze and provide information on an acupuncturist that will come to the office to treat them during a visit."
Dr. Golden said she was first exposed to distraction treatments when she worked for seven years in a Manhattan dental office that catered to celebrities. Six months ago she introduced the foot massage into her three year old Manhasset practice; she has also arranged her office using the Chinese art of feng shui, the practice of arranging furniture and using color and aromatherapy to create maximum harmony in a physical environment.
Michelle Engels is one of three massage therapists who collectively work five day a week at Dr. Golden's office. This is the first time Ms. Engels, a licensed massage therapist with a specialization in reflexology, has worked in a medical office. She gives chair massages to patients in the dentist's waiting room and performs foot massage and reflexology while they are in the dental chair. There is no additional charge to patients who use her services.
"Working in a supporting role, where massage is a pain management technique, rather than the whole purpose of a visit, has been different for me," she said. "It's been a good experience - especially since the patients react so well to the program."
Other dentists have also reacted well: Ms. Engels said she had been approached by three other dentists who are considering adding the services of a massage therapist.
Dr. Jay Piskin, a dentist in Floral Park, offers headphones to patients and a massage chair. He has also considered, but decided against, having a manicurist doing patients' nails while he is working on their teeth. His next purchase will likely be video glasses.
For dread-filled patients like Carey Wolen, whose dentist is Ira Newman of Old Brookville, anxiety reduction techniques are not a nicety but a necessity. "I'd rather not see what he's doing because that causes me too much anxiety," he said, adding that his tension was relieved when Dr. Newman offered video glasses and a C.D. Player.
"The glasses make me take my mind off what's coming next," he said. "Plus the sound from the headphones drowns out the drill. Before, I would come to the dentist and be heavily Novocained or get nitrous oxide gas - even for a cleaning. Now I don't use the gas, and I don't put off making follow-up appointments."
Distraction techniques are old hat to pediatric dentists and dentists who routinely work with phobic patients. "Years ago it was board games and coloring books," said Lee Weinstein, a Roslyn dentist who has an office filled with video games and pop music on portable C.D. Players. "But the premise was the same: Take the patient's mind off the fear of the unknown. Make the visit a pleasurable experience."
Not everyone agrees with such methods. In fact, Dr. Mark Solvin, the head of the Dental Phobia Clinic at SUNY Stony Brook, said that in truly phobic patients, some of those approaches may make matters worse. "I don't, for example, see a patient with an actual phobia being comfortable in video glasses or a virtual reality viewer because they are so confining" he said. "And as a dentist working with that kind of special needs patient I wouldn't like to use a method that would eliminate my ability to connect with them."
Barry Wilder, a dentist in Selden, also expressed skepticism about distraction procedures. Although he has occasionally used hypnosis and allows patients to bring in their own C.D. Player, he mainly opts for good communication to put patients at ease.
"I think foot massage is a bit extreme." he said. "I'm not very big on using anything out of the mainstream or anything that could prevent me from communicating with a patient. I think they are just a way to draw patients to a practice."
For Ms Kehoe, however, who became wary of dental work after getting her first migraine following a root canal five years ago, Dr. Golden's offer of a foot massage has made it easier to go to the dentist. Today, the Port Washington resident tries to schedule appointments during times a masseuse will be on staff.
"I think it's a great idea to have the alternative practices involved with medical professions" she said.