Dental Hypnosis in Dentistry Perhaps the greatest blessing of technological advancement in the 20 th century was the improved routine dental therapy. There is a tradition of using hypnosis and mesmerism to ameliorate the agony, pain and dread associated with dental treatments. The effects of dental anxiety include rigid and restless patient in the dental chair. One adult out of three has a mild-to-severe phobia of dental treatment procedures. The problem is however common in children. Most dentists who make use of hypnosis have acknowledged the fact that the procedure reduces the stress associated with routine dentistry. Similarly, hypnosis can be used during emergency treatment of patients diagnosed with acute dental abscess. Discussion In the recent past, a visit to the dentist was associated with unavoidable pain, dread and agony. This is may be what contributed to the use of dental hypnosis and mesmerism in dental treatments. Despite all the progress achieved in minimizing the agony pertaining to dental treatments, there is a high prevalence of anxiety associated with visiting a dentist. One of the common signs of dental anxiety is a rigid and restless patient in the dental chair, which makes the patient and the dentist feel restless. Genuine dentally phobic individuals do not visit a dentist at all. This may result to the entire mandible sequestrating in extreme cases. The cause is osteomyelitis, which may separate the mandible in a single piece (Fromm and Shorr, 1972).The other problem associated with dental procedures is gagging. Constant gagging in the course of dental treatments leads to unsatisfactory results. The gagging patient may fail to wear dentures and keep returning to the surgery due to endless complaints. The answers to virtually all problems associated with dental surgery or treatments can be realized by using dental hypnosis. According to acknowledgements from many dentists, dental hypnosis can greatly reduce the stress associated with routine dentistry. Moreover, dental hypnosis can be extremely rewarding 1 / 6
and less strenuous for a medical practitioner. Similarly hypnosis plays a role in emergency therapy like in the case of a patient diagnosed with dental abscess (Fromm, 1972).There are some general considerations to take note of when using dental hypnosis to relieve stress and anxiety. First of all, it is essential to create an environment that is reassuring and ambient. This is a crucial step towards relieving a patient s anxiety. This should begin with the reception staff that should portray friendliness and warmth when they take appointments through calls, and greeting the patient in a pleasant way. A similar attitude should be adopted by a dentist and nurse. The waiting area can be made more homely and less clinical by incorporating appropriate pictures. Placing pictures on the ceiling above the dental chair has been known to aid in claming patients. This is in addition to soft music (Auld, 1989). Giving patients a full explanation on the entire procedure in a language that is non-threatening enhances the trust and rapport between the patients and the dentists. Trust or rapport is not essential for trance but it makes work much easier in a clinical situation. It prevents undue shock or surprise. Parents should be permitted to keep their children company. Instruments that may seem most threatening to the extremely anxious patients should be kept as far as possible from the patient s sight. Taking the measures mentioned above would help in eliminating the sting associated with any painful dental procedure. The measures are also essential in achieving success in any dental hypnotic interventions of procedures (Gerschman, 1989).Listening to a patient is part of developing trust and rapport. Clinicians ought to learn to listen to what the patient hears and not the message the clinician is conveying to the patient. Communication is not limited to verbal form alone. Eye contact, facial expression, physical contact and body language can act as essential ways through which patients can communicate with clinicians (Corydon, 1990).. The most essential aspect of any dental procedure, and one that is most vital during the use of hypnosis, is some form or sign or signal that a patient can make indicating the halting of treatment. Without, the signals, patients hold on to the fear of losing control. There is a widely known misconception of hypnosis taking away personal control. Hence, patients often have a fear of getting hurt without having the potentiality to so something about it. The most significant feature of dental phobia and anxiety is losing control. The key application of dental hypnosis is in helping anxious patients relieve their pain, agony, stress and anxiety during dental procedure (Heap and Aravind, 2002).Amelioration of pain and discomfort is one application of dental hypnosis. The public mind associates dental treatment with discomfort, pain and anxiety. However, dentists hold the assertion of patients overestimating the exact pain experienced during routine dental treatments. Perhaps the key problem is that of patients anticipating pain. The sense of apprehension and uncertainty is further contributed by the fact that patients are rendered passive and unable to witness the action taking place in their mouths. Many patients have more general anxieties that are linked to injections, medical settings and even the sight of blood (Heap, 2002).Dentists with the expertise in hypnosis have postulated that imagery and simple suggestions conducive to comfort and calmness can help in preventing 2 / 6
discomfort and unpleasantness that patients experience during dental procedures. Some dentists prefer the use of hypnosis prior to relative analgesia. The use of imagery, suggestions and distraction techniques help to clam patients with a less degree of anxiety. Patients may be asked to try self-hypnosis techniques at home as a way of helping them to deal with discomfort and unpleasantness (Spiegel and Spiegel, 2003).As noted earlier, one out of three patients visiting any dental surgery procedure experiences some degree of anxiety to panic level. An effective tool that can help such patients to confidently go through dental procedures is dental hypnosis. Hypnosis with further ensure that a visit to a dentist is a regular experience to such patients. Signaling is an essential aspect in dental treatment. Patients are required to signal in cases where they need to halt the procedure or discuss of a problem with their dentists. The most efficient way of communicating during dental hypnosis is the use of finger or hand signals to indicate a No or a Yes or Stop immediately (Yapko, 2003). During hypnosis, the patient should first of all be made to gain confidence in a form of imaginary rehearsal of the entire treatment procedure. Once the patient has gained full confidence, the actual dental treatment can begin in a stepwise manner. Plenty of feedback and reassurance should be given for every sign of success in order to strengthen the patient s ego. The patients should be reassured and encouraged that everything is proceeding in the right manner. This implies that the next step or ext treatment procedure would be much easier. It is unfortunate that some patients may have a form of anxiety that is so severe that they may fail to see the dentist. This means that dentist may not see several dental phobic at all (Heap, 2002).There are two methods used by dentist to reduce anxiety in patients through dental hypnosis. The first method entails a direct and symptomatic therapy for anxiety, which depends mainly on reassurance and relaxation during hypnosis. The results achieved using this method is most of the times satisfactory. In the second method of performing dental hypnosis, the dentist has knowledge of the psychological nature of the problem, which may be originating from the past. The dentist may be tempted into utilizing psychiatric methods for dealing with anxieties. It is however not appropriate for a dentist to step outside the dental role for which he or she has the expertise. It is therefore clear that the second method of treating dental anxiety using hypnosis is more controversial due to the fact that most dentists do not have psychodynamic skills (Spiegel, 2003).There may be one of two sources of severe phobias and anxieties. One cause of severe anxiety may be past unpleasant experiences with dentists, and this may date from childhood. A vicarious experience transmitted empathetically from a person who related an unpleasant experience with a dentist is the second common cause of anxiety. A patient s fears and anxieties may enhance the pain following the beginning of dental procedures. Hypnosis plays a role of preparing the patient for the intended dental treatment partly by separating the past from the present (Kroger, 2007).There are several cases that have been used to illustrate the effectiveness of dental hypnosis in relieving fear and anxiety in patients prior to undergoing dental procedure. One reported case is of a woman aged 29 who visited a dentist sweating and trembling due to fear. 3 / 6
The woman had not seen a dentist for a period of nine years and was extremely frightened. She was diagnosed with acute alveolar abscess in one of her few remaining teeth. The dentist obtained information of the case history and was reassured that contraindication of chemical anesthetics was not appropriate. He carried out a brief hypnotic session on the patient and many of the overt signs of anxiety subsided. The patient relaxed and was then informed about the entire procedure. Eventually, tend dental procedure was carried out successfully with minimal pain, anxiety, fear and agony (Hilgard and Hilgard, 1994). It is therefore clear that hypnosis serves the function of reducing anxiety and fear. Incidentally, the process leads to enhancement of the pain threshold, which means that it may have ancillary effects in aiding postoperative recovery and controlling bleeding. In some cases where chemical anesthetics are not advised, hypnosis alone can serve to reduce dental pain to a great extent. Evidence has shown that hypnosis can serve as the only anesthetic dental procedure for highly hypnotized patients who are adequately motivated. This means that hypnosis can be employed as a means to reduce pain during dental treatment (Hilgard, 1994). A research study carried out by DiClementi, Deffenbaugh and Jackson (2007), indicated that hypnosis serves the role of attenuating anxiety especially in the highly hypnotized patients. The results further indicated difficulty in talking patients out of their anxiety once the dental procedure has began. Stopping dental procedure in order to talk to patients helps to minimize the level of anxiety. The use of various relaxation techniques also proved to help in claming and relieving anxiety in patients prior to dental treatment.in conclusion, it is clear that dental hypnosis is a fundamental step that helps in relieving anxiety, discomfort, fear and pain associated with dental treatments. References Auld, J. M. (1989). Uses of Hypnosis in General Practice. Anesthesia Program, 36(1), 137-139 4 / 6
Corydon, D. H. (1990). Handbook of Hypnotic Suggestions and Metaphors. New York, NY: Norton and Company Inc DiClementi, J., Deffenbaugh, J., & Jackson, D. (2007). Hypnotizability, Absorption and Negative Cognitions as Predictors of Dental Anxiety Two Pilot Studies. Journal of the American Dental Association, 138(9), 1242-1250 Fromm, E., & Shorr, R. E. (1972). Hypnosis: Developments in research and New Perspectives. Hawthorne, NY: Aldine Publishing Company Gerschman, J. A. (1989). Hypnotizability and Dental Phobic Disorders. Anesthesia Program, 36(1), 131-136 Heap, M., & Aravind, K. K. (2002). Hartland s Medical and Dental Hypnosis. Tottenham, United Kingdom: Harcourt Publishers Limited Hilgard, E. R., & Hilgard, J. R. (1994). Hypnosis in the Relief of Pain. Levittown, PA: Brunner/Mazel Inc Kroger, W. S. (2007). Clinical and Experimental Hypnosis (pp. 313-325). Philadelphia, PA: Lippincott Williams and Wilkins Spiegel, D., & Spiegel, H. (2003). Trance and treatment. Arlington, VA: American Psychiatric Publishing Inc. Yapko, M. D. (2003). Trancework. New York, NY: Brunner Routledge 5 / 6
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