Josh Bernstein, DDS, Cosmetic Dentist

Am came in with a cosmetic emergency – loose porcelain on his left front tooth! He also had a chip on his right front tooth and some discolored old bonding on his right lateral incisor (next to his right front tooth). We decided to do a conservative case – whitening, followed by 3 porcelain veneers and some cosmetic polishing of his left lateral incisor (next to his left front tooth). In 2 easy visits, Am left with a confident all new smile. A special thank you to our master ceramist, Bob Clark, of Williams Dental Lab in Gilroy, California, who always does an outstanding job with our porcelain cases.

No matter how much progress the dental profession makes, some things don't change--a lot of patients HATE the dentist. While dentist are excited about new porcelains, laser treatments for gum disease, and implants, patients are worried about the same old things--they hate the shot, they hate the "drill," and they're afraid it's going to hurt. What are dentists doing to understand their patients and what are they doing to directly address their patients' concerns?

First of all, many dentists are facing the reality that patients are afraid and that as a profession we have not overcome the hurdle of fear and pain that goes hand in hand with dentistry. Many dentists are getting training in sedation to help patients who are nervous. In the medical profession, doctors would not think of doing even a minor surgical procedure without sedation. But in dentistry, we often treat multiple teeth with fillings, crowns, root canals and extractions using only "Novacaine." No wonder the patients are terrified! Now, patients can take a pill one hour before their appointment and they will be completely relaxed and comfortable through the entire appointment--and they may not even remember their visit. This is called Oral Conscious Sedation and some dentists have a special license just for this procedure.

For patients who don't want to be sedated but just want to be comfortable, there are incredible new topical gels that are placed at the injection site for 5 minutes before the injection so that the injection will be almost completely comfortable. There are also excellent new anesthetics that get the teeth much more profoundly numb without numbing the whole jaw. For patients who just can't get numb, there is even a way to deliver the anesthetic directly to the tissue surrounding the tooth to virtually guarantee numbness.

Dentistry has come a long way, but we still need to face up to the fact that the patients still have the same old concerns. Our past reputation will be hard to shake, but some of us are trying hard to do just that. Patients and dentists will all benefit from comfortable dental care.