Page 27 - GP Spring 2020

When a tooth becomes symptomatic, space since she had refused replacement of back and forth down the straightaways and
cognitive dissonance is created by the #30, and relieving the occlusion was all that around the turns from top to bottom till you
option of salvaging the tooth at a great cost, was needed to relieve her symptoms. come around the home stretch to the fin-
or extracting the tooth and creating another ish line! He looked excited. You can run
problem. The secret is to be dispassionate in How can concepts of hypnosis be applied in that race once or twice every day! I told
the informed consent discussion so that the everyday patient care? “Hypnosis is a hu- his mom in private not to ask him again to
patient will not have buyer’s remorse. Let man condition involving focused attention, brush his teeth, but only occasionally to ask,
the patient take ownership of the problem. reduced peripheral awareness, and an en- “How did the race go?”
hanced capacity to respond to suggestion.”
2
You see periapical pathology on the x-ray, Fear can suppress one’s ability to make de- It is important to find out what patients
but the tooth is asymptomatic. Did you cisions, so fearful patients are potentially like because talking about it can put them
ever have a patient that refuses treatment more vulnerable to suggestion. But how in their happy place. Associating what pa-
tients like, or are motivated by, with the be-
despite the fact that you tell them that they can we get their focused attention? When havior you want to suggest is one strategy.
have an infection? They are in denial and I endeavored to improve my conversational Another strategy involves autosuggestion.
I’m not talking about the river in Egypt! “If skills, I learned that people like to talk about Telling the patient to meditate and use au-
it doesn’t hurt, don’t fix it” is their man- themselves, their work, hobbies, beliefs, tosuggestion to help them stop clenching-
tra. I tell them that if they wait, the sac of etc., and that if, upon meeting someone for “Lips together, teeth apart.”, for instance.
pus and infection at the tip of the root may the first time, you ask them what they do Or monitoring clenching behavior overtly at
get larger and this may require surgical in- for a living, how they met their spouse, or first, then eventually subconsciously can be
tervention in addition to a root canal, post how they became interested in their favor- effective if you suggest that they suggest it
and crown if they choose to restore. There ite hobby, they are quite happy to tell you to themselves when meditating. I tell them
is also a chance that chronically infected all about it, and are glad you asked. I also that they can command their higher centers
lower molars can create a potentially fatal noticed that almost everyone is proud of of the brain to do things and it really works.
consequence (Ludwig’s angina). This cre- their heritage, and it seems that everyone Note that this also begs the concept of the
ates cognitive dissonance that may get the thinks their own culture is the best. So I of- Placebo effect; another powerful technique
patient to agree to treatment. ten will ask people about their nationality, that uses the power of your authority and
and, having learned something about their suggestibility with no side effects.
The patient needs an extraction of a hopeless culture, practices, or heroes, mention it to
infected tooth. You tell them that it needs to show my interest, love or respect for their Although we are not hypnotizing our
be extracted, but they are resistant. I will culture and people. I joke that everyone patients, these techniques utilize focused
tell them it is their decision and I will write thinks theirs is the best, but that isn’t pos- attention and enhanced suggestibility. Once,
it in the chart, but I also tell them that they sible, and that if everyone knew more about I think that I hypnotized a young patient
may get pain and swelling, lose work time all the different cultures, there would be no in the chair unintentionally. A young girl
or ruin a vacation. Many infections are like prejudice. These conversations build rap- needed a filling and I told her to imagine she
this; a “silent infection”. Then I stay qui- port, but because they are of interest to that is in the park on a nice sunny day. Imagine
et. Sometimes they change their mind. person, they will be motivated to focus their you are sitting on the swing and going back
and forth watching the sky go up and down
attention on things that they like. Building
Finally, PTSD. Yup, after 25 years or so, rapport builds trust and once people trust as the wind passes you and your legs pump
I discovered the dental version. Patients you, they are more apt to follow a reason- as you go higher and higher. Then I looked
who have had a toothache and had to have able suggestion. at her and she looked spaced out! Her treat-
ment went fine, but I was surprised at the
root canal treatment may have been “trau- amazing potential inherent in this stuff!
matized” by the experience. Fear is some- Now let us look at one of the “dominant
thing that doesn’t just disappear, but it can laws of suggestibility”; the Law of Bibliography
be repressed. When these patients have a Association. It states,”That whenever we 1. The Dominant Laws of Suggestibility – Savi-
sensitive tooth due to tooth decay or root repeatedly respond to one particular stim- pra Gorospe.
sensitivity, the memories of the painful pri- ulus in the presence of another particular https://savipra.wordpress.com › 2014/09/09
or experience can cause them to panic and stimulus, we will soon begin to associate the 2. Lynn SJ, Green JP, Kirsch I, Capafons A,
Lilienfeld SO, Laurence JR, Montgomery GH
believe they are destined to relive that pre- one with the other. Then, when either stim- (April 2015). “Grounding Hypnosis in Science:
vious horrible experience. I believed these ulus is present, the other is recalled.” Here The “New” APA Division 30 Definition of Hyp-
1
patient’s reactions for many years before I is an example of how this can be applied. A nosis as a Step Backward”. The American Jour-
realized that they are unintentionally exag- young boy came in with his mom who said nal of Clinical Hypnosis. 57 (4): 390–401.
gerating in response to a much smaller prob- that she couldn’t get him to brush his teeth no
lem. Be aware of this when making your di- matter what she tried. She told me that her Dr. Acquista graduated
agnosis. Temper your enthusiasm. You will husband was a car mechanic. I asked her, from Columbia College
be a true hero in their eyes if you tell them “What does your son like?” She said racing 10 1977 and Columbia
it looks like it is just a cavity (if that is the cars. I engaged the boy in conversation, and School of Dental & Oral
Surgery in 1981. He has
case). For example, I had a patient who had asked him if he liked cars. “Yes!” Racing been in solo practice in
#30 extracted and returned several months cars? “Yes!” How about the Indianapolis Brooklyn ever since. He is
later complaining that #31 hurt every time 500? “Oh yea!” Well, do you know how an independent researcher.
she bit down or ate. She thought it had de- those cars race down the straightaways and
cay or an infection. All that happened was turn around the loops? He nodded. Brush-
that the tooth had tipped mesially into the ing your teeth is a little like that; you go www.nysagd.org l Spring 2020 l GP 27