A message from Robert Korwin DMD MAGD

Before I obtained my dental degree, I received a college degree in psychology. During my dental career, I attended courses in hypnosis and in biofeedback while looking for methods to reduce stress and anxiety in patients in a manner that is medication-free. With this background, I understand the psychological trauma that patients undergo when they cope with stressful medical and dental situations. About 40 percent of the US population avoids the dentist because of dental anxiety. This anxiety is partially due to a lack of trust in the procedure or in the practitioner because of previous negative experiences that are generalized to the present.

Sedation dentistry is a blessing to those people because they can obtain the care they have long avoided. My dental practice with sedation medications showed me that anxious patients were helped by drug use, but there were some major unavoidable side effects, including

• The major patient time commitment required to use the drug protocol.
• Prolonged drowsiness and impaired judgment, sometimes consuming a patient’s entire day and making normal activities very risky.
• Restricted availability of care, since very few dentists are qualified to provide all levels of sedation dental care.
• Increased expense for provider and staff training, medication and monitoring.

I realized that many patients were even fearful of medications, and there was a need for a better route to anxiety control during dental care.

After helping many sedation patients, it became clear that most patients do not need medications for repeat visits after a single treatment visit with me, since they develop trust in the practice and in my care. Astoundingly, they cheerfully say they are happy to return without any medications at all.

This revised trust relationship derives from their feeling that we can and will help them by delivering pain-free and anxiety-free visits that do not surprise them in any way. This is done by discussing plans to improve their health in all aspects before treatment. We then decide on the best options in advance, obtaining agreement before treatment is started.

We engender trust by anticipating patient discomfort and proactively responding. My staff and I carefully observe eyelid blink rates, hand tightening and position, facial, arm and leg movements, breathing rate, and speech patterns in non-sedated patients to make sure that we are constantly in touch with their feelings non-verbally. We use a distinct vocabulary and a verbal cadence and tone to eliminate threatening verbal unconscious fear associations. We make sure that they are the focus of our attention in every way during their visit, so they feel they will be well cared for and pain-free. We monitor their reactions non-verbally and respond with chair adjustments, changes in treatment and/or changes in local anesthetic, before the patient realizes he or she is nearing any level of discomfort. We even communicate with each other non-verbally so there is a coordinated series of treatment activity that is “invisible” to the patient, thereby avoiding any anxiety-provoking distractions.

I was introduced to the beginning techniques of Calmistry^SM by Kerry Gillespie, MS, when a family member who was a patient in my office developed dental anxiety. Kerry and I began the first stages of dental anxiety reduction without drugs while helping that patient. We both realized that this technique could help many people who are fearful of both dental treatment and medications. We began to develop the program that is available today through Calmistry.

By removing the distractions of prior experience and negative associations, Calmistry provides a feeling of safety and relaxation during the dental visit by drawing on emotional resources that are developed outside the office in a safe environment. When practicing the self-relaxation techniques of Calmistry, a patient can have the benefit of quickly and easily developing a trust relationship with his/her health practitioner.

While we are prepared to help reduce anxiety with our specialized psychological approach, a dental visit with the aid of Calmistry can bridge the medication gap by helping patients develop a calm, secure emotional state before their visit. A relaxed and calm patient is our goal. They can have access to that same internal resource within the office or whenever they are feeling stressed and anxious in any situation.

We are fortunate that with Calmistry we can practically eliminate the need for anxiety medication in most fearful dental patients.

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