Think about an appointment for your average patient. Let’s say it’s an adult patient already living a busy, hectic life.
A day at the dentist is already less than comfortable. Either, it’s happening during a workday, meaning your patient had to book time off, which can be stressful; or, they’re coming in after a long day at the office. Or they’re visiting your practice during what should be R&R time on the weekend.
From there, they’re coming into the office to get poked and prodded. And they’re being told to brush and floss more.
So, what about patients with chronic pain conditions (e.g., complex regional pain syndrome, fibromyalgia)?
Average, everyday life causes enough problems for people dealing with these problems.
Never mind the inherent discomforts of a dental office.
How Can Dentists Make Life Easier for Their Chronic Pain Patients?
Here’s a brief list of various pain-killing approaches most dentists can provide in their practice (we’ll get more specific in a later section):
- Local anesthesia
- Nitrous oxide (providing excellent analgesia)
- Benzodiazepine (both valium or triazolam help patients relax)
Some dentists perform more specialized pain-based care, utilizing a heightened multimodal therapy that doesn’t veer outside their practicing license. The dental care providers who can offer this more enhanced level of pain control are:
- Oral surgeons
- Dentist anesthesiologists
- Practitioners with substantial postdoctoral training in pain management or anesthesia
Due to their more thorough training, the above practitioners can sedate patients intravenously when performing pediatric or general dental procedures or oral surgeries.
Yes – specialized practitioners have a few more tools at their disposal to help afflicted patients. However, any dental practitioner can take steps to better support their chronic-pain patients:
Start with a Consultation and Evaluation
Developing a plan to best manage your patient’s pain levels necessitates starting with a comprehensive evaluation and consultation.
What will this process entail?
- Compile and review dental and medical histories
- Discover whether co-existing mental health conditions involving panic, anxiety, depression, or PTSD are at play.
- If necessary, communicate, coordinate, and collaborate with other healthcare providers (e.g., pain management doctors, surgeons, neurologists, and internists).
Once you’ve gathered and analyzed this information, you’ve got the initial framework on which to build a dental and anesthetic treatment plan.
Transition to Multimodal Treatment Strategies
Every multimodal treatment strategy should include a pain management plan for:
- Preemptive analgesia
- Physical therapy
- Intra-operative comfort
- Postoperative pain relief
Your objective as a practitioner with these strategies is to neutralize all potential pathways to discomfort throughout the perioperative period. Additionally, each element of the plan must be personalized to each patient’s needs and the rigours of their specific procedure.
Here are some possibilities of what can be used:
- Antihistamines
- NMDA receptor antagonists
- Opiates
- Acetaminophen
- NSAIDs
- Alpha agonists
- Benzodiazepines
- Antiemetics
- Local anesthetics
- Sedative hypnotics
- Steroids
These treatments can be administered topically, intravenously, orally, or intramuscularly.
There is a delicate balance with these medications–only using them appropriately and skillfully will minimize nausea, swelling, pain, and anxiety.
One last approach to knock down pain-based hurdles for select patients is talk therapy with a mental healthcare provider or a dentist.
Encourage Questions and Be Prepared with Insightful Answers
Being a dental professional often means being an unsung hero. You’re providing care that can vastly improve your patients’ health. Yet, the widely-shared fear of the dentist’s chair is as universal and time-honoured as the profession itself.
It’s even worse for your chronic pain patients, who are extra sensitive to all potential pain pathways. Their fear is well-founded. But those concerns can successfully be managed first by following the previous steps. Then, you must be prepared to answer pain-management-based questions thoroughly and empathetically.
Be ready to explain the type of training you’ve received and detail how many patients with similar chronic-pain conditions you’ve treated. Plus, you’ll likely be asked about how frequently you perform the type of procedure in question.
You could also streamline the process by providing information about your pain-management approach and treatment philosophy on your website. Even then, you should let chronic-pain patients know they should give your practice a call if they have further questions and that you’ll be more than happy to provide detailed answers.
A Shining Example of the Difference a Dentist Can Make to a Chronic-Pain Patient’s Life
A recent case study investigated by DentalTown looked at Dr. Agatha Bis’s treatment of her patient Lorraine.
Lorraine had initially visited Dr. Bis’s practice to “redo her bonding.”
While Lorraine had one treatment in mind, Dr. Bis noticed she looked retruded and overclosed. So, the highly skilled dentist asked her patient about chronic pain, headaches, and jaw issues.
From there, it was revealed that Lorraine suffered severe pain throughout her entire life, possessing all symptoms of a temporomandibular disorder (TMD). Moreover, Lorraine had seen several doctors, visited multiple pain clinics, and worked with alternative medicine practitioners, osteopaths, chiropractors, and massage therapists. And none of it offered lasting relief.
As highlighted in the link provided above, Dr. Bis ensured that Lorraine was not only left with gorgeous temporaries but also with no more headaches. By digging deeper with her patient and asking the right questions, Dr. Bis took someone who avoided the dentist in Lorraine and turned her into one of her most frequent patients.
You might not have all the tools of a pain-specialized dental professional, but following these tips can encourage chronic-pain patients to visit your practice. Because they’ll have peace of mind in knowing you’ve prioritized their best interests and optimal, pain-free comfort!