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Radio Transcription
Ep 62: Part 3 of Dr. Chao's Interview with Dr.James Cecchini
Salvador Gaytan: It's time! SmileTalk is on the air, featuring the latest news and developments in dentistry, as well as other interesting topics that make people smile. I'm Salvador Gaytan, and I'm here with?
Dr. John Chao: Dr. John Chao, we'll continue with our two guests to make things interesting and entertaining for you.
Salvador Gaytan: That's right. We have our two very special guests back for our third show. They've volunteered to come back, brave souls, Dr. Ernie Follico and Dr. Jim Cecchini. How are you gentlemen doing today?
Dr. James Cecchini: We're doing great.
Dr. Ernie Follico: Just great, thanks.
Dr. James Cecchini: Dynamite.
Salvador Gaytan: Alright. Now, just to give the audience -- in case you haven't heard all the other shows, Dr. Jim Cecchini, well he was a practicing general practitioner dentist, and Dr. Ernie Follico was an orthodontist, and they have a very colored history and interesting stories. And we're going to finish up a little bit with our Iatrosedation and what the end result of that is, isn't that right, Dr. John?
Dr. John Chao: Yes, we're going to continue to talk to Dr. Cecchini and Dr. Follico about Iatrosedation, but we were just talking a little bit about Dr. Cecchini's background. We had talked about how Dr. Follico was part of the championship team that USC had in tennis, but it came out that Dr. Cecchini was also on the baseball team.
Salvador Gaytan: Don't tell them, don’t tell them. Let Dr. Cecchini -- what is that?
Dr. John Chao: Would you tell us about your participation in baseball at USC?
Dr. James Cecchini: Well, I played three of the four years. I played my sophomore junior year, and then I got accepted to dental school, so I had to make a choice. They were going to sign me at that time to go to Sacramento, but I decided to go to dental school.
Then, in the following year, in '58, SC went back and won the nationals. So, to give you a sequel on that, my son is also a former graduate of SC baseball team, played under the same coach.
Dr. John Chao: Dr. Dedeaux, right? What was the coach's name? Dr…?
Dr. James Cecchini: Rod Dedeaux, yeah, Rod Dedeaux. And he played three years there, got accepted, got signed by Montreal Expos, and then played for about four years, didn't make it. So, now he is a practicing dentist, so…
Dr. John Chao: So, baseball runs through the family.
Dr. James Cecchini: It does.
Dr. John Chao: And dentistry.
Dr. James Cecchini: Yes it does.
Dr. John Chao: Yeah, and I understand that one of your grandchild is also playing baseball, isn't that right, or one of the daughters, one of the granddaughters?
Dr. James Cecchini: Oh yes, one of the granddaughters.
Dr. Ernie Follico: Yours, Jim?
Dr. James Cecchini: Oh yes, yeah, I went out to see her last night, and she is doing very well, I'm impressed with her. She's getting tall. She's about 12 years old, she's got to put some meat on, but she's a pitcher, and she's got a pitcher's attitude. It's like I'm at the top of the…
Salvador Gaytan: That's good.
Dr. John Chao: Great.
Dr. James Cecchini: Yeah, I mean I've got that attitude, I'm on the top of the hill here, and nobody is going to knock me down, that sort of thing, and I got a {couple} here.
Dr. John Chao: It runs in the family, fearlessness.
Dr. James Cecchini: Well, maybe {she} is fearless.
Salvador Gaytan: Dr. John, have you noticed a pattern here, about how the sons follow the father's footsteps?
Dr. James Cecchini: Yeah, yeah.
Dr. John Chao: This is very, very uncanny.
Dr. James Cecchini: And it's interesting, because I never thought he was like me, but as he's getting older -- I'm sitting side by side with him last night, and his jargon is the same as mine, his adlibs, his intensity of the game. I said, "Holy cow!"
Dr. John Chao: I understand he's also kind of a daredevil motorcyclist, at least for a while he was.
Dr. James Cecchini: He was, he's got one.
Dr. John Chao: Yeah, he's also fearless in many ways.
Dr. James Cecchini: Yeah, I gave him a rosary bead just in case.
Salvador Gaytan: A little extra protection.
Dr. James Cecchini: Yeah, just to keep it in his wallet when he drives.
Dr. John Chao: Okay, now we're talking to Dr. Jim Cecchini, Sr. who is a dentist as well as a PhD in psychology, and we were talking about Iatrosedation, which means doctor calming the patient who has dental anxieties to do with dentistry.
And we have been talking the last two shows about how the process was developed at USC, how this is done with anxious patients, and so far we've gotten to how to treat an anxious patient by, number one, recognizing and accepting the condition that the patient is presented to the doctor.
Then, now we're going to talk about how we can alleviate those fears, and we're going to talk about how the doctor, using this Iatrosedation method, can bring out the origin of the fear, so that these fears can be addressed, and the patient can be relieved of that.
Now, Dr. Cecchini, would you tell us how do you we get to the origin of the patient's fear, so that we can help the patient eradicate that fear, and be able to live a quality of life without that encumbering phobia?
Dr. James Cecchini: Well, by asking them questions about their specific fears. Once they tell me what the specific fears are, and it's sometimes not that simple. Sometimes they come up with saying, "I don't know what bothers me, I just know it bothers me," that sort of thing. So, you have to use your know-how in order to get down and focus to the specific fear or fears that bother them.
Dr. John Chao: But if you make the patient talk about their fears, does that make the patient more anxious and more fearful?
Dr. James Cecchini: No. I think it's a process, that's why it's called the Iatrosedative process. That is part of it, because what that does is it let's the patient know that you have the expertise that it takes in order to clean out the specific fears, and then after that's done, then we will design a specific treatment plan that will be designed around those things which the patient fears.
Dr. John Chao: Yeah, well what I'm hearing is that it requires a doctor who has the aura and the actual feeling of confidence that this problem can and will be addressed by this doctor. In that context, getting at the origin of their fears, does not increase their fear, but actually helps to relieve it. Is that correct?
Dr. James Cecchini: Well, the doctor has to be assured of himself, yes. The doctor has to put himself aside, and put the patient in front. In other words, his goal is to act like a protector for that patient, for that which the patient fears. So, it's like putting a shield in front of the patient in order to protect him from that which he fears.
Another metaphor, and sometimes I say that to patients, I take them by the hand, and I walk them around the side of the mountain to daylight. So, the daylight being now they understand why they are, and they can go from there.
Dr. John Chao: Yeah, the daylight is a safe environment.
Salvador Gaytan: Now, Dr. Cecchini, Dr. John and yourself have mentioned about how you try to find out what a patient's individual story is and what their fears are, and every patient is different. Once you find out a patient's story, what do you do to then help them alleviate the fears?
Dr. James Cecchini: Okay, there's other things that I need to know, and I alluded this to the second half. And that is, I need to know the origin of the fear, when it happened, was he a kid, was he an adult and so on, because as a kid, the trauma is deeper engrained, more difficult to eradicate.
So, I make the analogy. It's like a pyramid. If I have a pyramid with age one down at the base of the pyramid, and age 12 at the top, if I were to take blocks out at the bottom here, it would make this pyramid more stable as opposed to me taking the blocks out at the top.
And that's the same thing with early psychological traumas. The earlier they are, the more devastating they are to the psyche, and that goes for all things, not only dental fears, but kids that experience incest at age five and six.
Dr. John Chao: Yeah, just so we'd clarify, if you take more blocks off the bottom, it would unstabilize, more likely to unstabilize the whole pyramid, it makes it more unstable.
Dr. James Cecchini: I'm glad you clarified me, I might have said [crosstalk].
Dr. John Chao: I think you may have said stable
Dr. James Cecchini: I said stable, didn't know it.
Dr. John Chao: Yeah, okay, it's actually more unstable, yeah.
Dr. James Cecchini: Unstable, yes. So, it makes the psyche more unstable, and if it does that as they grow up, many times we find these people do not have the coping skills to deal with the stresses in life. So, it makes it more difficult for them to eliminate fears and phobias because of that.
With that in mind, at this point I'll interject an empathic response like, "I can understand why you feel this way. I would feel the same way." Or to coin your phrase, "You're certainly not a coward. Cowards are not people that would come in and face their fears like you do, and I have to compliment you for it."
Dr. John Chao: One of the first things that we should compliment the patient for is the very fact that they got there. "The fact that you're sitting in my chair with such high anxieties, that's a wonderful, wonderful step," and then they had to overcome a lot of their anxieties just to physically be there.
Dr. James Cecchini: Absolutely, and right after that I would kind of pair it back to them their specific fears, so that they know I know exactly that I listened to them while they were telling me those specific fears, because active listening is a very important part of developing a relationship, as you know, with a person.
Dr. John Chao: Well, the problem was started, because someone did not really listen to this little child, and the fact that the doctor can now show the patient that what she says is important to the doctor, and that something will be done to help her. Isn't that very helpful, very healing?
Dr. James Cecchini: Absolutely, absolutely. Another thing I would also consider saying to him, and this is a very important key element in tapping into their belief system that's associated with their specific fears, and that is all fears are learned. Okay, let's back a step.
A child, at the infant stage, there are a couple of instinctual fears that we learn, fears of falling, a loud sound, but outside of that all fears are learned. If all fears are learned, they can certainly be unlearned.
Okay, so with that suggestion, a powerful suggestion that's tapped into the unconscious mind, and now this suggestion is fighting with the belief system that surrounds the behaviors of fear and anxiety.
So, now they have that to deal with, along with what they're going to hear afterward, okay? So, afterward I might say, "You understand that each time you come into my office, you bring all those danger related memories, and you relive them all over again, right in my chair."
These danger related memories, you relive them in your chair, and that's called transference, and transference happens to all of us all day long. It happened to me this morning coming down here, a soft music on my radio, I got kind of emotional, and all of a sudden, I remembered that was my dad's song.
So, transference happens to us all the time. So, then I say I am going to be committed to taking this danger in my related memory out of the dental experience.
Dr. John Chao: Great. So, we will help then unlearn that transference?
Dr. James Cecchini: That's right.
Dr. John Chao: Sal?
Salvador Gaytan: And anyone just tuning in, you're listening to SmileTalk with Dr. John Chao, spelled C-H-A-O. I'm Salvador Gaytan, and anyone that wants to get in contact with Dr. John, you can go to AlhambraDental.com or 626-308-9104.
And we're in the middle of our interview with our interesting guests, Dr. Jim Cecchini, and Dr. Ernie Follico, and talking about Iatrosedation, which is how to alleviate patient's fears without sedation, without shots, and I'm sure everyone is interested in that. Isn't that right, Dr. John?
Dr. John Chao: Well, without shots in terms of anything intravenous or using general anesthesia. But the important thing is to help the patient know that new experiences would not involve the kind of pain that the patient associates with dentistry.
Now, we're at a very important juncture of this interview regarding the process, and up to the point where we're saying, "Listen, you have transferred a lot of fears and anxieties to the dental experience. You learned that, and we're going to help you unlearn it."
So, Dr. Cecchini, who is a PhD in psychology, as well as a dentist, would you take us from there, how do we help the patient unlearn their transferred attitude and fears?
Dr. James Cecchini: Okay, we lift off the danger related memories, and each time they come in, they relive them. And I'm probably going to say to my patient, this is how we're going to get rid of these danger related memories.
So, many times what I'll do is I'll write on the bracket table, I'll write a little equation. I'll write the dentist, and then I'll write the danger related memories, and then on the other side, fear and anxiety.
So, here is the equation, there's danger related memories that are associated with the dentist every time the patient comes in, and as a consequence of that, they get anxious and they get scared.
We're going to take that danger related memory out of the equation, what do you think is going to happen? Amazing things happen when you take the fear, the anger, the danger related memories out of the equation.
It means that the other side, fear and anxiety is going to change, it's going to reduce. It doesn't mean that it's going to go away completely, that doesn't mean the patient is going to love us or anything. But it's going to drop significantly to the point where the patient will probably go see the dentist more often.
Dr. John Chao: And I've seen where the patients become very, very grateful. And there's a lot of affection for the person that can help the patient overcome that.
Dr. James Cecchini: And usually the dentist will never leave you. Even if they leave the state, they'll come back.
Dr. John Chao: Yeah, the patient does not want to leave that person, who has helped with this problem.
Dr. James Cecchini: That's right. Yeah, I've seen that many times. So, then it's time to let them know what the strategy is.
Dr. John Chao: There's going to be the proof of the pudding, right? You say that this is going to be a good experience for you, now you have to perform.
Dr. James Cecchini: Yes, yes, but prior to that, I'm going to let the patient know the strategy for each one of these fears. This is key also. I'd say, "Mr. Jones, this is how I think it's going to go. Mr. Jones, I think this is how it's going to go." And I would say, "As far as the pain with the injection, I feel quite confident that I can give you an injection without any discomfort at all -- if any, at all."
And then I'll back off and I say, "This is how I'm going to do it. I'm going to put a surface anesthetic on the gum tissue. We'll go through the atraumatic injection technique."
Dr. John Chao: So, SC has a special technique that's developed, that will allow the patient to have an experience that's comfortable.
Dr. James Cecchini: Yes, and I'm going to explain that. So, I would say to the patient then about pain with the injection. "I'm going to start with putting a surface anesthetic on the gum tissue, and this way it will make your gums numb. And then, I'm going to take the needle, and I'm going to inject it very slowly in the anesthetized area, so you feel no discomfort.
And as I proceed forward with the needle, I will always be dropping a drop of anesthetic ahead of the needle. So, as the needle progresses forward, it will be in an anesthetized area, so you should feel absolutely no discomfort. But if you do, I want you to tell me exactly how you feel. And at any time, you feel uncomfortable, you let me know, I will stop, because I want you to know that you're just in much control of this procedure as I do."
Dr. John Chao: And this is helping the patient to overcome the sense of helplessness that she experienced in the other dental experiences.
Dr. James Cecchini: Right, but we don't degrade any of the other dentists. We just go forward with…
Dr. John Chao: This happens.
Dr. James Cecchini: Yes, and then at the last phase with the doctor's behaviors, then I'm going to say to her, "I am truly committed to making this as pleasant of a procedure as I possibly can. And again, if there's any time you want to stop, we will stop. So, we go."
Dr. John Chao: This is what's called, when we teach this course, the pledge of protection. We are the patient's protector, and we will protect this patient from danger.
Dr. James Cecchini: Yes, that's right. Yes, you switch, it's transferred from a pledge of danger to a pledge of protection.
Salvador Gaytan: Now, Dr. John, our other guest, Dr. Ernie Follico, who is an orthodontist. How did you deal with patients who had stress and maybe didn't want the braces? You had mostly children, and so what were your experiences of alleviating stress?
Dr. Ernie Follico: Well, first of all, there wasn't near the amount of stress that there would be with the general dentist and their patient, with drilling and injections. And the setting; set up a nice situation for them, and that is that our operatory had maybe three or four chairs in it, without being blocked off by a wall like private operatories that the general dentist has.
So, when they came in, if there was a little bit of fear, they could immediately look at the other chairs, and they're going to have patients in them, and see that there are not any problems. And so, that was the beginning.
But if I had one that was a little bit extra anxious, I would sometimes bring in the parent, and we would start talking. "Maybe it isn't a good time for Johnny to have braces right now." And I'd say, "Did you ever have braces, Mrs. Jones?" And she'd say yes, and then I'd look at the patient and say, "Gee, mom had this experience. Look at her, she's got a beautiful smile," talking softly and gentle and putting the message across that way."
And usually they would settle right down, and be willing to cooperate. And so, our problems were greatly reduced in that area, but it was delivery, bringing the parents in, bringing the other patients into the situation, which really was a great help.
Salvador Gaytan: So, if you had three or four chairs and no partitions, and then they looked around at each other, the patients, and then one patient started crying, it rattles all the patients, doesn't it?
Dr. Ernie Follico: Right. Thank goodness we didn't have too many kids. We weren't leaving them in the chair if they were crying, but there wasn't -- it's really, in orthodontics, there wasn't a great fear of anything. They wanted to come in, and they wanted to improve their smile.
Dr. John Chao: Okay, Dr. Cecchini, do you have a comment?
Dr. Ernie Follico: Yeah, it's a good point you mentioned there, because children model behavior to other children, and if Ernesto -- and I didn't see this happen in Ernie's office, but I can see it happen in an office, where you have three or four kids, all lined up in chairs, and other kids in the background. These kids in the chair are going to model the behavior for these kids behind.
And studies have shown that you can reduce anxiety and phobias and fears through modeling behavior. That's a behavioral technique that some psychologists use. So, yes, you're right, these people are significant to the people that are waiting in the background.
Dr. John Chao: Now, previously you had talked about how some patients are very, very grateful for the dentist helping that patient overcome this phobia. Dr. Cecchini, you're a psychologist. Would you tell us what the effects on the personality would be, not necessarily just the fact that they've overcome the dental fears. What is the impact on the personality, on the psyche when a phobia is dropped?
Dr. James Cecchini: If it's a long standing fear or a phobia, and not always, but I've seen it enough times to warrant it. Anecdotally, in my experience, and I think John will go along with me, it's that significant changes happen to the psyche of the individual.
One of which is, when they realize that they've overcome a fear that has debilitated themselves for years, it taps into their self esteem and self concept. It makes them feel stronger. It makes them feel okay, rather than "I'm not okay, I'm okay."
Many times those type of people will go out and generalize this positive attitude in different walks of their life. A good example of that, I had a lady -- well, this is a few years back, that happened just like that. And she says, "I feel so good." She says, "I'm going to go home and tell my pool man that I don't like the way he's doing my pool."
Salvador Gaytan: Yeah, get that pool guy.
Dr. James Cecchini: And that's a true story.
Dr. John Chao: Now, these kind of stories are repeated thousands upon thousands of times, isn't it? Since this course has been instituted at USC, I would say that thousands of patients have benefited from this in your practices, in my practice, and the practice of doctors who use this method. Now, how can a patient find a dentist who can use this?
Salvador Gaytan: Well, we can quickly answer that question. We're coming to the last like minute or so of our show, and why don't you grab your guitar, Dr. Cecchini, and get ready. Yes, grab your guitar, we're going to get ready to end this with a little music.
Dr. John Chao: Well, while the music is getting done…
Salvador Gaytan: Yeah, go answer your question.
Dr. John Chao: Yeah, and I'll answer the question. Remember the word Iatro, like intro, except it's I-A-T-R-O sedation. You can call up any office in your area, and ask that office whether they know the Iatrosedation method. Generally, if they're from the USC Dental School, if they're trained at USC Dental School, they should know that method. If you still cannot find out, call USC Dental School or contact Alhambra Dental.
Salvador Gaytan: And we're wrapping up our last interview with Dr. Jim Cecchini and Dr. Ernie Follico. How are you doing over there, Dr. Follico?
Dr. Ernie Follico: I'm hypnotized, Iatrosized by the beautiful guitar playing.
Dr. John Chao: I am being calmed by the doctor.
Dr. Ernie Follico: Thank you for the great day and the great hospitality you've shown us.
Dr. John Chao: We enjoy having you.
Salvador Gaytan: Fantastic. You can contact Dr. John at AlhambraDental.com or 626-308-9104.
Dr. James Cecchini: Let's go to Alhambra Dental, yeah, yeah.
Dr. John Chao: Thanks for listening everybody, see you next week.
Salvador Gaytan: Take it away, Dr. Cecchini. Play it!
Dr. James Cecchini: [Music] Let's go to Alhambra Dental.
Salvador Gaytan: .com.
Dr. John Chao: Or Dr. Anthony Follico in Orange County, and Dr. Jim Cecchini in Montebello.
Salvador Gaytan: That's a wrap ladies and gentlemen, next week.
[Music playing]
[END OF AUDIO]
Transcribed and proofread by:
ScriptoSphere Audio Transcription Services
