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Dental Analogies

by Dr. Greg Janikian


A typical day in your practice....

"Mr. Smith, you have an infection in your tooth. You need a ROOT CANAL to save the tooth or I could extract the tooth but then you will need a bridge, implant or partial denture to replace the missing tooth."

Beads of perspiration start to form on Mr. Smith's brow, he makes a loud gulp your front desk person can hear 30 feet away. He is stricken with fear and thinks to himself "Root Canal - Oh My God! Could they be as bad as my coworkers, family and the population at large say they are?" Visions of gigantic drills buzzing and whining their way through his tooth perforating his sinus and into his brain fill his head.

You watch his digression. You've seen it before, a thousand times, and you say to yourself "Was it something I said?"

Mr. Smith begins to speak. His voice is dry and cracked. His tongue barely able to move in his arid mouth. "Do I really need a Root Canal? My Aunt Betsy had one in 1968 and has not been the same since." You answer yes, excited that Mr. Smith wants to save the tooth and do the right thing. But, you can tell the patient is frightened...

Well, what if you had some fantastic way to tell the people you treat about the procedures you need to do for them without instilling the fear of God into their timid hearts? Analogies and Word pictures can do just that. The problem is finding the right ones.

The purpose of this article is to create a forum in which we can exchange ideas on how to present treatment to patients in a non-threatening manner they will understand and appreciate. What will follow is a starter list of analogies and word pictures I use. Please feel free to use them and if you like, add your own favorites. The way I look at it is, why reinvent the wheel? We all must explain the same treatments to our devoted lambs. So, if ya got a good one share the wealth.

Root Canal Therapy

Mr. Smith you have an infection in your tooth. If you cut your arm it will heal, right? Well, unfortunately, nerves in your teeth do not have the ability to heal themselves like your arm. So if the nerve gets insulted by a deep filling, cavity or trauma the darn thing just dies. The infection travels to the roots and a grape forms around the root. The grape is filled with infection and this is why it hurts when your chew on it or I tap on the tooth. The grape gets squeezed. Nerves feel temperature changes and pain sensations. The reason the tooth is so sore to cold is because the nerve is losing its ability to do its job. Normally when you drink something cold the nerve turns on and off like a light switch. Now, due to the damage, the nerve stays on after you have had something cold to drink because it has lost its ability to work normally. To solve this problem, I will clean out the infection with small baby bottle brushes, rinse the area out with a special antibiotic solution which kills all the germs and fill the roots with a soft rubber like filling and special glue. Once this is done, your body senses that the dead nerve is gone and the grape will disappear on it's own.

Once the roots are filled, your tooth is ready to be restored. Now, the nerve is gone and the tooth becomes very brittle. If you break a branch off of a tree and let it dry out it becomes brittle and can snap. Well, when the nerve is taken out of a tooth the tooth loses its water supply. To help your avoid this I will place something on your tooth that will hold it together when you chew-like a cast on a broken arm. It will chew look and feel just like a regular tooth. This is called a crown.

Sealants

Mrs. Smith, Bobby needs sealants. Do you know what they are? No, Dr. Greg, what's a sealant? A sealant is a protective, preventive coating we place on Bobby's permanent molars. Your son's teeth have very deep grooves on the chewing surface. What it looks like is Mountains and Valleys. When you come to the dentist we explore the deepest part of these valleys looking for soft spots. This is what a cavity is - a soft spot. If Bobby needs a filling at his young age of seven that same filling 20 years from now will need to be replaced. The tiny hole in the tooth will become larger as the drill tends to take some tooth structure with it in cleaning out the old filling. After this is done a few times the tooth can become very weak and eventually need a crown. So, if we can prevent Bobby from ever getting a cavity and filling, he may never need some of the more involved dental procedures.

The sealant is the same consistency as nail polish. To apply the sealant takes three easy steps. First, we clean out the deepest grooves with a special cleaner that has scrubbing bubbles, Second, we paint on the sealant with a very fine paint brush. Last, we dry the sealant with a special blue light the hardens the sealant into place. The total procedure takes about four minutes per tooth and is painless. Typically, a sealant will last through the child's cavity prone years and into early adulthood. Bobby will have to be careful with that sealant as anything sticky can pull the sealant out. The same chewy sticky foods that would pull out a filling will pull out a sealant.

The cost of the sealant is less than a filling and will protect your son's teeth. Sealants are like air bags you never know if you will need them but, if you ever do, you are sure glad they are there.

By using word pictures and lay terms we allow our patients something very important - conceptualization! Agreed, they may not understand all the technical nuances but, do they want to know every detail?


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