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Patient comes in nervous and she pissed away a good tooth. "I'm too scared of needles so that's why I don't come in." Looked at the tooth and I tell her I can't save it. Gotta pull it out, sorry. See you in a week.
2 months later she comes back because it's starting to hurt again. "I don't want a shot" and I swear she's regressing in age. She's looking like a 4 year old which coincidentally allowed me to give her two shots. I told her you can go to an OS (oral surgeon) and get sedated but you gotta pay (a lot I think). "Okay, lets try it," she says. I'm about to give her the injection when she closes up. "Please open", I tell her. "I'm nervous and I know I'm going to close my mouth", was her quick reply. Okay, I'm thinking oral surgeon, but she opens just wide enough for me to give her an injection. 5 minutes later she's numb.
I explain to her what she's going to feel and "Is it going to hurt?" comes up which I say not if I gave the right injection. I test the area out by poking her with a sharp explorer, and she says, "Owww." to the first poke, but she says nothing about the 2nd, 3rd, 4th, or even 5th poke. She says that it hurts. I prepare her 2nd injection but she objects. I tell her if it hurts, then you're probably not numb enough. I give her a second one and 1/3 of another one just around the tooth.
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Every single time I try to loosen the tooth, she tucks her chin to her
chest and bites down on my finger. She's afraid that I'll slip and jab
her tongue. Obviously she's not aware of my other fingers holding onto
the instrument. Yeah she's numb but she swears she can feel it.
So things don't go well because she's not cooperating. As I'm loosening
the tooth I tell her honestly (because everyone needs blunt honesty),
"In the future, you should definitely go see an oral surgeon because
you'll be more comfortable and less nervous. You're so nervous that
you're making me nervous and all stressed out." She says she feels it.
She doesn't even care anymore about the tooth and she wants to stop
which I oblige.
"You're rude to me because you told me that I stress you out!" as she
sits up and straightens herself out. I'm trying to hold my anger in and
I tell her in one deep breath, "Listen I said you're so nervous that
it's making me nervous. I said you should go see an oral surgeon
because you ought to have an efficient extraction. I'm not attacking
you. Okay, we'll stop here and I'll give you a prescription because you
said it was starting to hurt. Also go find an oral surgeon with oral
sedation because you definitely need it. No hard feelings." I wrote her
Rx and left. An hour of doing nothing wasted.
What really sucks isn't that she's going to blame me somehow because I
was the bad guy in this scenario. What sucks is she's never going to
confront her fear, such as seeing a general dentist that does sedation,
and let her teeth slowly rot out. She seems to be only in her 20's but
I'm pretty sure by the time she hits 40, she'll need some kind of
denture. Good luck. You'll need it.
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