October 28, 2020
You have just scheduled an appointment with the dentist. One of your teeth in the lower jaw has turned a bit black and a hole is pretty evident on the chewing surface. The past few days were completely uncomfortable due to that constant pain. At the back of your mind, you know this tooth is about to face the dental drill. Even worse, you are forced to think what if the tooth needs to be removed? Do I need to take that injection right in the inner skin of the cheek?
The chain of thoughts that can traverse before a dental visit right from the moment you leave your house till you take a seat in the visiting room can be an extremely anxious phase. This has direct effects on your vital signs and can ultimately show its effects when you actually sit on the dental chair.
Dental procedures commonly involves the use of dental drill, extraction forceps, injections and various pointed Hand-held instruments which can often cast a shadow of caution in the patient's mind. These anxiety-provoking factors when coupled with the patient's actual systemic condition (if at all there is any) can make it very difficult for the patient to breathe. There are certain patients who have a habit of predominantly breathing through the mouth. They are called mouth breathers and the habit often develops in response to the way the neck, the shape of the face and the way the teeth occlude during the developmental stages.
When you are seated on the dental chair, it is extremely crucial to breathe through the nose. A dental drill when used on a tooth also releases a thin stream of water that ensures that the drill does not excessively heat the surface of the teeth. A suction tube is placed in the mouth simultaneously that collects all the water that gets collected in the mouth. Despite its presence, the pool of water might get collected in the shallow depths between the cheek and the teeth or below the tongue that will make it extremely awkward to breathe through the mouth. In fact, the patient might even gag if he or she continues to breathe through the mouth.
Restoring a tooth with the appropriate dental material after removing all the carious portion requires strict conditions of the oral cavity. On of these conditions is keeping the mouth and the area surrounding the concerned tooth absolutely dry. A dry field allows the material to bind to the tooth aptly. However, a moist field might interfere and the material might not bind with the required adhesion. A poor bond between the tooth and the dental material might not last long and patient might see the material getting dislodged or another carious activity might begin below the placed restorative material. This moist field can be a result of patients breathing through the mouth. Hence, it is crucial for the dentist to instruct the patient to breathe through the nose.
Anxiety too might play a major role here. The constant thought of knowing what is going in your mouth can distract the brain from breathing through the nose following which mouth breathing kicks in. Breathing through the nose becomes easy when the patient is actually calm in the dental chair. Many dentists often use aromatherapy to calm the patient in the chair if normal communication is not effective. This involves smelling certain medications or listening to music with calming effect that can have a soothing effect on the mind.
Anxiety can also be reduced by bringing a family member or friend with you to the dental clinic. Moreover, dentists often use a reverse counting method to calm their patients. Be it drilling and removing a cavity or using the injection, on the count of a certain number, the dentist will retract the instruments from the patient's mouth and give them a mini-break. A non-verbal approach can also be used. The dentist might ask the patient to raise his or her hand when they feel any discomfort during breathing through the nose.
Challenges for a dentist can increase if a patient with a respiratory condition shows up. In this case the dentist might even have to consider inclining the dental chair based on the patient's comfort level for nasal breathing. In certain cases, forced respiration by these individuals can increase the effort on the lungs which can result in cardiovascular and neurological implications as well.
Another hurdle that a dentist faces is making a pediatric patient practice nasal breathing while on the dental chair. Children often cry in the dental operatory if their behaviour is not managed appropriately. Crying and mouth breathing of the patient while the dental instruments are functional in his or her mouth is another risky situation. Such children face the risk of aspirating a small instrument or a tooth fragment if the breathing discomfort persists.
These scenarios help us understand the importance of breathing through the nose while seated in the dental chair.