443: Are Your Patients Getting Comfortably Numb? - Dr. Alan Budenz - a podcast by ACT Dental

Are Your Patients Getting Comfortably Numb?

Episode #443 with Dr. Alan Budenz

How sure are you that your patients are comfortably numb? Are you 100% sure? Do you just hope they are? There's a better way to know than just guessing! And to help you know with 99.9% certainty, Kirk Behrendt brings in Dr. Alan Budenz to share some techniques you can start using today. Numbing is the first step to high-quality dentistry! To learn how to give patients the most comfortable experience, listen to Episode 443 of The Best Practices Show!

Main Takeaways:

Learn as many anesthesia techniques as you possibly can.

Always ask patients about their history with anesthesia.

Tell patients what you're doing. Don't surprise them!

Know the best ways to assess anesthesia.

Even experts will miss from time to time.

Quotes:

“Getting your patients comfortably numb is incredibly important. You can't do good-quality dental work if the patient is feeling pain and fighting you, so you've got to have good control.” (2:28—2:40)

“I want to deliver local anesthesia as efficiently as possible, because I've never had a patient beg me to give them more shots. I always think of the movie, Little Shop of Horrors, with Steve Martin and Bill Murray, and Bill Murray’s like, ‘Oh, yeah, doc. Hurt me!’ It’s like, no, no, no, no, no. That's not real people. So, we’re not going there. I want to be really efficient with local anesthesia. And in giving the shot, inherently — you don't want to cause the patient pain giving the shot either.” (2:43—3:15)

“Although the injectable needles are still, by far and away, the most reliable, we’re still looking for better ways, easier ways, more comfortable ways to deliver the anesthetic. And that's encouraging.” (9:33—9:46)

“I think we’re still going to be using needles for a good while. But I think that some of these patch delivery techniques, like the iontophoresis, some of the things that have been developed more for medicine and trying to adapt them for dentistry. Part of the problem with dentistry is that versus putting a patch on the skin for anesthesia like they do in medicine, we’re dealing with a very moist environment. So, a patch may not stick well onto the mucosa. We’re usually trying to get deeper nerves. Like, the inferior alveolar nerve is rather deep through the tissue. It’s hard to direct the anesthetic that deep from a patch. So, I think these things may have promise, but I think it’s going to take quite a while to get developed.” (10:05—10:59)

“When I'm delivering local anesthesia to the patient, before I do it, I tell them what I'm going to do.” (15:39—15:47)

“As I go along, I'm walking through and I'm talking to the patient as I'm [administering the anesthesia]. I'm telling them what to expect, what they're going to feel. And so, for example, if I'm going to shake the cheek, I tell them, ‘I'm going to shake the cheek,’ rather than staying stoic and silent, and then I'm suddenly doing something, the patient is startled, ‘What? Why is this guy shaking my cheek?’ or these kinds of things. I want to avoid surprises.” (16:38—17:05)

“I'm trying to tell the patient what I'm doing and what to anticipate in terms of feeling and so forth. But I know that sometimes patients totally tune me out, and all they're hearing is, ‘Blah, blah, blah, blah, blah,’ in a calm, quiet voice. But you know what? If that's hypnotic to them, that's fine too. It still works to relax them and remove some of that anxiety. But the bottom line is that as I'm doing everything, I'm telling them what I'm doing to make this more comfortable for them. I'm telling them what I do to make this a better experience for them. That, to me, is extremely important.” (17:09—17:53)

“How do we normally assess anesthesia? We ask the patient, ‘Do you feel numb?’ ‘Uh, yeah.

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