PAINLESS MANAGEMENT OF DISEASE
One barrier to consumer acceptance of even conservative nonsurgical periodontal treatment is still the fear of pain. Treatment must be provided painlessly, if at all possible. In order to achieve this, analgesia must be used. It has been estimated that 15% of the US population declines dental care primarily because they fear oral injections.23 Nitrous oxide/oxygen analgesia relaxes patients and reduces their anxiety enough to allow treatment without pain. New technology allows the use of digital flow meters, such as the Porter Instrument Conscious Sedation Flowmeter. To achieve a successful result, analgesia must be available for the patients who require it. A recent innovation (developed by the author) using topical anesthetic spray (such as Hurricane [Beutlich Pharmaceutical]) and a light-cured extended contact topical fluoride varnish (such as Vanish XT [3M ESPE]), makes it possible to perform scaling/root planing without having to use injectable local anesthetics. Previously sensitive roots, which could only be instrumented after administering local anesthetic, can now be treated after a single application of Vanish XT. After being light-cured, the fluoride varnish seals the roots with a durable layer of protection, thus relieving dentinal hypersensitivity and permitting the painless instrumentation and removal of all deposits. Being able to control root sensitivity, while improving the integrity of the root of the tooth where the toxic bacteria collects, gives the dentist/hygienist the opportunity to help control the risk of disease. Reduction of this sensitivity via an extended contact topical fluoride varnish (that can last up to 6 months) can also help to improve patient compliance for performing the required at-home daily hygiene routine; thus making it easier to control the chronic disease risks and improving the future success of dental care.
