(Dr. R. D. "Sean" Longacre taught me much about hypnosis for dentistry.)

Dentistry is a rich field for the use of hypnosis and not only for the control of pain. The alleviation of fear and anxiety is of as much aid to the client as any anesthetic procedure. Also, excessive salivation and bleeding can be controlled hypnotically and the gagging reflex can be subdued. The client's ability to tolerate dental appliances can be increased and healing can be facilitate. Naturally, the dentist, oral surgeon, or orthodontist should refer the patients to the hypnotherapist.

1. Elimination of the patient's tension, anxiety or fear of pain and related discomfort.

2. Accustoming the patient to orthodontic or prosthetic appliances after the patient has agreed to accept them.

3. Maintenance of the patient's comfort during long and arduous periods of dental work.

4. Modification of unwanted dental habits, such as bruxism, the unconscious grinding of teeth.

5. Reduction of anesthesia or analgesia during dental procedures.

6. Substitution for, or in combination, with premeditation for general anesthesia.

7. Prevention of gagging and nausea.

8. Control of salivary flow.

9. Control of bleeding.

10. Postoperative analgesia. (Visualization and Guided Imagery for Pain Management R. D. Longacre. Kendall/Hunt. 1995 p. 95-96)

PRECAUTIONS: The major precaution for the use of hypnosis in dentistry is symptomatic pain removal. Except in emergency situations, professional hypnotherapist should not attempt to deal with symptomatic pain due to oral dysfunction or disease without consulting with a dental patients.

Clinical Applications: Modern dental techniques and preventative care have enabled a majority of patients to experience a relatively painless and unremarkable dental appointment. However, this is not the case for 'fussy' patients.

Fussy patients often put off going to the dentist until the pain or dental problem can no longer be ignored. These patients, for a variety of reasons, are fearful, tense, nervous and anxious before and during the dental visit. Often these fussy patients will request a tranquilizer or complain of extreme anxiety one or two days prior to seeing the dentist for a simple check-up.

Fussy patients may be a small minority in the population of an average dental practice, however, they often present the majority of problems the dentist encounters in his/her daily routine. Fussy patients take extra time and require special consideration by the dentist and his staff.

Hypnosis can readily ameliorate the tension, nervousness and unreasonable fear of pain often exhibited by fussy patients. The hypnotherapist should meet with this type of dental patient two or three days prior to the scheduled dental appointment.

After inducing hypnosis, have the patient imagine their special or favorite place. This should be a place that always makes them feel safe, happy and relaxed. Ask the patient to recall all of the feelings, sensations and memories about this place using their five senses. Suggest two or three word pictures of different places, like the mountains, the seashore or a country lane or meadow.

When painting this word picture you might say something like, "If you are in the mountains, you are smelling the aroma of the pines, feeling the sun gently warming your face, picturing the clean blue sky and marveling at the shapes of soft white puffy clouds lazily floating by," etc. It is not necessary to solicit information from the patient regarding the place they are recalling or remembering.

Before awakening the patient give them a post-hypnotic suggestion that they will be able to relax as deeply as they are now and enjoy this special place as soon as they sit down in the dental chair or lounge. Instruct them to close their eyes when they sit down in the dental chair and take three deep breaths. Suggest that every time they do this they will instantly relax and enjoy their favorite place.

Other applications of hypnosis in density: As I have pointed out, there is a close relationship between anxiety and pain. Many takes specific forms such as gagging, excessive salivation, blood flow, bruxism (teeth grinding) and tongue thrust against the teeth.

One of he most troublesome problems with that a patient may bring to the dentist is that of gagging as soon as anything is inserted into the month. Ordinarily this gagging response will occur only if the object is inserted deep into the month and into the troth. It is a natural reaction to protect against choking. The trigger lies so deep that the reflex does not normally affect the person who is having dental work. For some people, this trigger has moved forward through conditioning to the lips, or the tongue, or some other area touched in the dental examinations. Unless controlled, the gagging can make dental procedures difficult or impossible.

Fortunately, patients with only light hypnosis can learn to eliminate the gagging response so the dental work can proceed. Control can be achieved in many cases by direct suggestion or properly developed imagery, but sometimes more complex methods such as a releasing technique or ideomotor question may be needed.

Bleeding may present a problem either by bleeding too much or too little such as with dry sockets. For too much bleeding, suggestions such as: the blood is flowing around the extraction area . . . allow just the right amount of blood to flow to the area, healing it naturally and normally. For too little bleeding, the suggestion may be: blood is flowing to the socket to allow the right amount of blood to the area, healing it naturally and normally. Suggestions for the control of bleeding, salivation and gagging should paint word pictures of tissue healing and blood vessels become smaller. Suggest that the mouth is very dry during periods of dental work and the gag reflex is inoperative until the patient is awakened or alerted by the dentist.

Teeth grinding, which is technically called, bruxism can create several problems. An estimated one in 20 adults and three in 20 children unconsciously grind their teeth at night. It is the sound of bruxism. While the noise may disturb spouses or children, it has a far more distressing effect on the sleeper. Nocturnal grinding can exert many pounds of pressure per square inch on the surfaces of teeth. It can be rough not only on teeth but on the supporting bone, the gums and jaw joint. Bruxism was attributed to the release of tension from emotional stress and from an unconscious effort to correct irregularities of the chewing surfaces of the teeth. They grind away to eliminate a spot that is too high or to find a comfortable place to fit the upper and lower teeth together. To help a person overcome this habit, is with proper suggestions and teaching the client self-hypnosis and relaxation techniques. If needs be releasing techniques and/or ideomotor questioning can be used to help the client release the need to grind their teeth.

To help a patient adapt to a dental prosthetic device, induce hypnosis and then give strong and positive strong and positive end result imagery suggestions. These suggestions should reinforce how comfortable the patient is with the appliance, how nice they look and how confident they feel when wearing the appliance. Post-hypnotic suggestions should be directed at how comfortable the appliance are in one's daily life.

ADDITION:  A LETTER FROM KAREN GOLOB REQUESTING INFORMATION ON HELPING A CLIENT WITH "GAG REFLEX". ("Gag Reflex" reply by Artie McMurtrey}

Artie McMurtrey composing a reply to Karen

Dear Rev. Durbin: I received a phone call from a new client that was referred to me by my personal Dentist. My Dentist's had told me that this person had a gag reflex problem and that it's been impossible to take x-rays and perform the proper dental work on him. The new client is a very successful person who is extremely analytical. Since I've never worked with this disorder, I did my research and could only find a small amount of info in the Handbook of Hypnotic Suggestions. Do you have any suggestions as to where I can read on this and learn the appropriate techniques for working with this new client? I would appreciate any information you can help me with. Thanks, Karen Golob

I sent some material to include "Hand to Face for Therapy" that I have used working with dental patients, referred her to Dr. R. D. Longacre's book Visualization and Guided Imagery for Pain Management (Kendall/Hunt) and to Artie McMurtry who works with a dentist and he responded to her request as follows:

Reference "Gag Reflex Control- Waking Hypnosis- Tell them with authority-I am now going to put a pencil in your hand and I want you to hold onto it firmly and continue to do it and as long as you are holding this pencil you will not have the urge to gag at anytime and nothing that I do or the dentist does in your mouth will cause you to Gag. #2 Waking Hypnosis- I want you to close your eyes and I'm going to count from 5 to 1 and when I get to 1 you will no longer have the urge or need to Gag. #3 of course you can also do this in Hypnosis. Sir, it always works but it must be done after rapport has been established and of course with authority." Artie amcmurtrey@clis.com

Hi Paul: I received the mail you sent to me, today. I also saw the addition to "Hypnosis in Dentistry" on "Gag Reflex" by Artie. It does my heart good to know that this very important information is on your website. My "gagging" client is doing extremely well. The "Hand to Face" technique was one I actually used on my client on his first session. I used it after I had brought him out of hypnosis, to show him how he could use the finger spread, and as his fingers touched his forehead he would automatically go into hypnosis again. I suggested that this was self-hypnosis and anytime he used this "hand to face" technique he would again feel relaxed and calm and at that time he could say to himself a positive suggestion/and or an affirmation that he could create himself that reflected his elimination of gagging when brushing his teeth or at the dentist.

I can't thank you enough for helping me and taking the time to send me the information as well as email the information. If there is anything I can do to assist you in anyway, please let me know. I have already given my thanks and appreciation to Artie, and I hope we can share our knowledge in the future. I am Certified as a Chemical Dependency Counselor, so if a addict is open to hypnosis, I teach them self-hypnosis to assist them with Recovery. Thanks again for your time, Paul, and God Bless. Karen

FOLLOW UP TO ARTIE AND CHAPLAIN DURBIN FROM KAREN:

Hi Artie: Yesterday (3/15), I had a 2nd session with my gag reflex client. He had canceled the follow-up appt. due to nausea (coincidental?...I wonder). He then couldn't come in the next week due to his heavy work load. So, it was 20 days since our first session. He felt the suggestions were fading, although he was not gagging any more when he brushed his teeth and could brush for a longer duration. I reinforced in waking hypnosis and in trance all that the first session had accomplished and then some. I had him image himself at home brushing his teeth and at the Dentist's office without any gagging, etc. The pen held firmly is his favorite technique. I emphasized the importance of deep breathing and taught him how to effectively inhale relaxation and exhale his stress.

I had requested that his Dentist send me children's size x-rays (the kind that the dental techs. actually use) and adult size, also. I intend to have him place the children's size one in his mouth, during hypnosis. If that goes well, then I'll graduate him to the adult size. Any ideas on this?

I mentioned to him that I had wondered if his relationship with his Dentist was comfortable and did he have a good rapport with him. His answer...."A few years ago he asked me to do some research for him, which I didn't want to do...it was about that time, that my gagging accelerated in his office." He very quickly said, "but, I've had the gagging problem for years, even before that." I asked him if he would like to find out if perhaps there was anything else that he was not consciously aware of that might be causing this gagging; and, he said he was sure there was not. As long as he is resistant to any type of regression, I need to leave it alone. That's the scoop for now! Any feedback you might like to email to me is always appreciated. Karen 

Artie McMurtrey teaching a class on hypnodontics in Oregon 2002