Is fear of the needle
worse than fear of the mask?
Without them, we suffer
Many of my adult patients remembered going to the dentist when they were children and having to be put asleep under a black face-mask. This memory instilled in them a life-long fear of visiting dentists.
The day after the 17th of March 1982, when I qualified as a dentist, I was legally allowed to administer general anaesthetics for dental procedures without an anaesthetist being present. General anaesthesia is hazardous enough but without the assistance of an anaesthetist, the risks of problems multiply. I could have accidentally killed a patient on my first day in practice. For the record, I have never ever administered general anaesthetics with or without an anaesthetist.
For a brief while, a few months in the 1990s, I worked in a practice that specialised in treating dental patients while they were under general anaesthesia. The anaesthetics were administered by a visiting hospital anaesthetist, who was assisted by a fully trained anaesthetics technician. The patients, when unconscious, were intubated to maintain their breathing and all the right things were done to ensure their safety. When the patients were ‘under’, I worked on their teeth, as quickly as I could because the anaesthetist wanted to keep the patients ‘under’ for as short a time as possible.
Children were given gaseous anaesthesia through a face mask. Once, I sniffed the gas briefly. It was terrible stuff. It felt as if a knife were shooting up my nose. Most children were, quite naturally, terrified at the prospect of anything that was happening in our clinic. Getting them to accept the black mask with its attached rubber tube was often difficult. The anaesthetist was a friendly man from the Middle East. He would say to the children things like:
“This smells of peppermint.”
The child might reply:
“I don’t like peppermint.”
The doctor would then say:
“I’ve got strawberry flavour.”
“I don’t like strawberry.”
“How about some lovely banana?”
And so, it went on.
One mother impressed me. She said to her child that if he allowed the mask to be put on by the count of three, he could have a treat at McDonalds later. She counted “one”, and the child refused. And, then “two”, but the child still resisted. Then, I wondered how different it would be when she got to “three.”
I was impressed when she said:
“Two and a quarter,” and then “Two and a third”, and so on without ever reaching “three”. Eventually, her child cooperated.
I must to admit that although we got a lot of work done on fully anaesthetised patients, I did not enjoy working under these conditions. However, I enjoyed my weekly encounters with the friendly anaesthetist, ‘Dr A’. He was extremely fond of fiery chillies, which he consumed during our lunch breaks. He was always seeking hotter chillies. This was probably because his taste-buds had become partially damaged by his excessive consumption of these almost corrosive chillies.
One lunchtime, Dr A and I were sitting in the staff room with a male anaesthetic technician from an agency. Wickedly, Dr A passed him a long, thin fresh green chilli, saying:
The young man put the whole green chilli in his mouth and started chewing it. Soon, his face went bright red, and he rushed to the sink to fill a glass of water. When he recovered, he turned to Dr A, and said:
“I thought it was a bean.”
PS: Nowadays, general anaesthetics for dentistry cannot be administered anywhere in the UK except in a fully-equipped hospital.