I'm Worried About Dentistry, So I Took A Pill!

Every now and then a patient will come in and explain they had to "take a pill" to be less anxious. I totally understand the rationale. Millions of people avoid coming to see guys like me, and have to take measures to relax. I'm a big fan of how effective that choice is for patients.

But self-medicating comes with significant risks. Take, for example the aforementioned patient. She drove herself to the visit while under the influence of the drug. I don't care if it's a time-release capsule or there is a late onset of effect from the drugs. That's a black-and-white no-no without a driver or an escort. It's a recipe for impaired judgement, a motor vehicle accident, or an accidental injury.

May people are surprised when I tell them it is a serious medical risk without close monitoring and controlled prescribing and dosing efforts. "But I feel perfect!"  some say. Most every common sedative will create respiratory depression, or mess with the brain's ability to regulate stable and consistent breathing. Then there's the physical changes to balance and communicating. The ability to reason starts to diminish. And most patients I see are using at least one other medication. Some patients metabolize or process the drugs differently; some get quick effects, some get little effect. That needs close management. There are countless drug interactions with sedatives. And those interactions need to be studied and managed for patients prior to taking the drugs.

So back to the question: why do patients self-medicate with sedatives instead of letting us administer them? It's mostly due to cost avoidance, in my experience. I get that. But I can't take on the liability of  patients using sedatives unless I can closely monitor administer, and control the drugs. And there's the point: risk management and monitoring patients while using sedatives will cost money. But ultimately the costs are lower given the numerous risks every patient faces.

We Have Evolved. It's Official!

Interesting article I read about the correlations between the introduction of  local anesthetic for dental treatment in kids and the reduction in 3rd molar formation and ocurrence. See below.

Spear article

Don't Run With Scissors, Don't Pour Gas On A Fire

My 3-year old daughter wanted to do some artwork last week. Upon the request to "go get some scissors," she ran to the office and ran back with the shears flailing in front of her face. Parenting Rule #856, Don't Run With Scissors, was then practiced for the umpteenth time.

There's plenty of new rules emerging in the dental world as we learn about the long-term effects of soda on teeth. My hygienist sent me a link about the wisdom of not drinking soda--'cause it's bad for your teeth--with a new twist. Not only does soda rot your teeth, it does it faster than we thought, and probably as well as meth and cocaine.

Methamphetamine and crack cocaine users suffer from dry mouth when using. Lethargy and thirst also increase, and users often turn to soda consumption to increase energy and satisfy the dry mouth. The triple whammy is that in addition to a dry mouth and acid erosion from soda, smoking the drugs will burn, erode, and decay teeth. It's like pouring gas on a fire.The photo below is pure meth mouth.

Non-drug users can suffer the same devastating results after long-term soda use. Caffeine will reduce the flow of protective saliva, and the pH of soda is so acidic, it will erode enamel quickly. This is a patient who has enjoyed Coke and Diet Coke for a decade.

 

 The good news is that soda erosion is manageable. Neutralizing the acidity of the soda immediately after drinking it will reduce the risk of this kind of decay. Chewing sugar-free gum, drinking water, or brushing your teeth are all effective choices.