An option for patients "turned off" by traditional methods
Jason H. Goodchild, DMD
Sometimes you never learn why patients decide not to follow through with treatment recommendations. As clinicians, we assume it is because of finances, a busy schedule, fear of the drill, fear of the needle, or the dental team not properly educating patients and building value. In the case presented here, it was none of the above. It was only because the patient was the boyfriend of my hygienist that I learned "impression phobia" was the major reason he continuously avoided treatment.
My patient's name is Sean. Between having braces as a child and sports accidents that necessitated crowns on his maxillary central incisors, he had suffered through too many uncomfortable dental impressions. So when I recommended two new crowns on teeth Nos. 8 and 9, he balked (figure 1). In his own words, "I was not looking forward to getting impressions. In fact, it was my biggest source of anxiety. When I was much younger and getting braces, taking impressions was a horrible experience. They put so much in your mouth that I was always gagging."
Wouldn't it be nice to be able to have greater control of how much impression material you use and where it flows?
After discussing the entire procedure with Sean, I decided that the Aquasil Ultra Cordless Tissue Managing Impression System (Dentsply Caulk) was the ideal tool to capture his final impression. It allows precise delivery of Aquasil impression material through an ultrafine tip, which ensures that I capture the needed preparation details without excess material in unwanted areas. The Aquasil Ultra Cordless Tissue Managing Impressions system is made up of three parts: the "digit power" dispenser for placement of wash impression material, a regulator that connects to an air line at the dental chair via commonly available connectors, and a specially formulated tray and wash Aquasil impression material.
Instead of loading a backfill syringe or squeezing the 50 mL impression gun, I can hold this system's dispenser in a pen-style grip and step on the rheostat to start the flow of wash material. The small diameter intraoral tip on the impression cartridge lets me passively place the wash material around a prepared tooth or implant component. Best of all, this impression material and dispenser minimizes or eliminates the need for retraction cords and pastes. Sean and I discussed which impression tray would be most comfortable and then practiced placing it in his mouth a few times.
After taking the impression, Sean's feedback was as I'd hoped: "This impression was a lot nicer. It seemed like a lot less material was used because there was no runny excess. It also felt like it took less time. I think it was only in my mouth for a few minutes, and I was pretty happy with it."
