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Radio Transcription
Ep 67: Dr. Chao's interview with Esmeralda and her apprehension about visiting the Dentist
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, hi everybody, welcome to the show. We have a lovely guest today.
Salvador Gaytan: We have a lovely guest indeed, one of your prized patients Dr. Chao, and she has a very fascinating story, doesn't she?
Dr. John Chao: Yes, she has a story that will make you smile.
Salvador Gaytan: That is right, and without giving away any details, we have Esmeralda here, how are you doing Esmeralda?
Esmeralda: I'm doing good, thank you.
Salvador Gaytan: And you are a patient of Dr. Chao's, isn't that right?
Esmeralda: I am.
Salvador Gaytan: Okay. And she has a very fascinating story, one that entails some anxiety that she had with a previous dentist, and then how she found Dr. Chao, and what he did for her procedurally that she is extremely happy with. It's a pretty interesting story. So, Dr. John, why don't you take it away?
Dr. John Chao: Well, actually what happened with Esmeralda, illustrates different issues that we have been talking about for weeks and weeks about how we can treat people who are anxious, who maybe even be phobic about dentistry, how we can overcome that, and how we can treat a gum disease non-surgically, even the very advanced ones.
And how we can actually just within one appointment, remake a smile, where the smile has gaps that may be unsightly. Even where the front teeth are loose, we can tighten them up with certain procedures, and we did all that for Esmeralda.
Salvador Gaytan: In? I have a hard time believing this, but it's true, you did this all in one day, is that right?
Dr. John Chao: Esmeralda, how long did it take us to convert your smile?
Esmeralda: I believe it was about four hours, but he did it.
Dr. John Chao: Now four hours, it didn't hurt, did it?
Esmeralda: No, not at all.
Salvador Gaytan: So, let's start from the beginning. You were telling me previously that you went to the dentist till you were about 18?
Esmeralda: Yeah.
Salvador Gaytan: Then, you didn't go for a long time; well it was kind of off and on.
Dr. John Chao: And ask her why.
Salvador Gaytan: Why didn't you go to the dentist, Esmeralda?
Esmeralda: I didn't like the needles and I'm pretty sure everybody is on the same page when I say we hate the drilling. I hate it. The sound is terrible, but the pain, the needle that I've felt before, was not for me.
Dr. John Chao: Well, I agree with you about the sound, I hate the sound too. I swear I lost some hearing over the years with those so called quiet drills.
Salvador Gaytan: You just go to Home Depot, spend a weekend there, you get used to the sounds, Dr. John.
Dr. John Chao: Not that kind of sounds. They only have those high pitched sounds.
Salvador Gaytan: What's wrong with a little zzzz -- come on now?
Dr. John Chao: What did you say? I'm hard at hearing.
Salvador Gaytan: Come on Dr. Chao, come on. Well now Esmeralda, okay, so you had a track record of not going, you had some anxieties, and then you decided to look for a dentist, why?
Esmeralda: First, because I didn't know whether something was happening. One of the biggest reasons was because my son was graduating, and it had to be done. I had that fear of calling and actually doing it, but I kept on telling myself, "It takes one day, one day to step in there. As soon as you're in there, that's it." They see you, they know what's going on, and you just keep on going. So, that's actually what I've been doing over there.
Dr. John Chao: Yeah, that's the biggest step for patients who are procrastinating on account of anxieties and so on. It's the first step. So, when they get to my office, I congratulate them. "You have taken a big step to even come here," and I congratulate them in a joking way. I say, "Well, the second big step is that you chose me."
We kind of joke about it, but I always congratulate the patients, because it is the hardest thing, isn't it? Just to call up to an office you don't know, and then say "I'm going to come in and have you take care of me."
Salvador Gaytan: And for anyone just tuning in, you're listening to SmileTalk, I'm Salvador Gaytan here with Dr. John Chao, and Dr. Chao, you're interviewing one of your patients, Esmeralda.
Dr. John Chao: Yes, she is a very lovely lady, and we were able to really help her with her different problems.
Salvador Gaytan: Tell the audience Esmeralda, how did you find Dr. John Chao?
Esmeralda: Okay. So, I found him online after realizing that I needed to go, one, because my son was graduating; two, because I noticed something weird was happening that wasn't there before.
Salvador Gaytan: And what was happening exactly?
Esmeralda: The loose tooth.
Salvador Gaytan: Loose tooth, okay.
Esmeralda: Yes. So, I decided to go online. So, I did, I found one doctor, read what he had to offer, didn't like it. Dr. Chao was the second person, so I read everything he had to offer. The fact alone that he does everything in his dentist in that place, was it for me, and because it said pain free. That's also what got me.
Dr. John Chao: You don't like to be referred from one office to another, and you had some experiences which were not so pleasant?
Esmeralda: No, I do not like being referred. I did go on one visit to have a root canal, and I was referred to another place, because they didn't do that there. So, I had to remain with the pain for about two to three weeks before my insurance gave the okay to go.
Dr. John Chao: So, you actually had to put up with the pain for two or three weeks? So, this is why you don't like that.
Esmeralda: Correct.
Dr. John Chao: So, if a dentist can do that for you in the same place, then you're much better off, aren't you?
Esmeralda: Yes, I am.
Dr. John Chao: So, that's something that sometimes happens when patients are referred.
Salvador Gaytan: Now, Dr. John, she saw this, Esmeralda saw this on your website, isn't that right Esmeralda?
Esmeralda: Correct.
Dr. John Chao: Yeah, we listed the different services that we do. By the way, we don't say pain free on our listing; we say something like "Cowards Welcome," because we cannot literally guarantee everybody to be painless, even though for the most part we're able to do that.
So, when we describe our services, we say things like "We Welcome Cowards." Things like that, that imply that this is something that we like to do, this is something that we are good at.
Salvador Gaytan: Well now, Esmeralda translated it in her mind as pain free, right Esmeralda?
Esmeralda: Yes I did.
Salvador Gaytan: So, when you actually had the experience with Dr. John, did it meet your expectation of pain free?
Esmeralda: Yes it did. I was in shock after I realized that -- well, at first I noticed that the needle was coming in, but I said that pink -- I don't know what the pink thing is called.
Dr. John Chao: It's a topical anesthetic. You apply it to the gums, and supposedly it will make the gums numb and take away some of the sting when the injection is done. But we don't use that, because we have a different technique at our office.
Esmeralda: Which is very good, with no pain…
Salvador Gaytan: So what did it feel like?
Esmeralda: Like really nothing. I just felt the pull, and that was it.
Dr. John Chao: That's interesting, she said pull. Now, you've had the same experience, didn't you Sal?
Salvador Gaytan: Absolutely. I'm a patient of Dr. John, been a patient for many years, and I've seen that big needle, and normally that scares people.
Dr. John Chao: It's not that big, Sal.
[Laughter]
Salvador Gaytan: Well, let me tell you, anything longer than a half an inch is long to people, okay? I don't know long that needle is, it's an inch, an inch and a half, isn't that right?
Dr. John Chao: The lower one, for the lower jaw is kind of long, yeah.
Salvador Gaytan: So, anyone that sees that needle like Esmeralda, you associate there's got to be some pain involved. I felt just like barely a slight pinch, she felt I guess just a needle being removed.
Esmeralda: Not even that.
Salvador Gaytan: Not even that? Okay.
Dr. John Chao: Yeah. Well, it's hard to describe. There are some very loose tissue, we call them mucosa. It's not where the gums are attached to the bone underneath, it's where it's flabby, and that's where the injection is.
But if we leave the needle close to the flabby tissue, and very quickly we pull the tissue into the needle, there is absolutely no pain. Have you ever cut yourself? You didn't feel anything, but you saw some bleeding later?
Esmeralda: Yes.
Dr. John Chao: That's the same principle. It's so quick and fast that the impulse doesn't even get to the brain. So, there's no pain, because we're not actually pushing the needle, we're actually just pulling the tissue very quickly into the needle.
Salvador Gaytan: Wow.
Dr. John Chao: Then, the secret also is, it's a very, very slow injection, because what really causes the problem with injections is that it stings. It's the sting when the plunger is being pushed.
It bothers you when the plunger is pushed too fast, pressure of the tissue and the sting of the fluid causes that uncomfortable sensation. So, we're able to avoid just about all the discomfort associated with an injection with that technique. It is something that I teach the students at USC.
Salvador Gaytan: Excellent. For anyone just tuning in, you're listening to SmileTalk, I'm Salvador Gaytan here with Dr. John Chao. You can reach Dr. John at 626-308-9104 or AlhambraDental.com. Dr. John is interviewing one of his excellent patients, Esmeralda, she's telling her story.
I guess the follow up question is, you found Dr. John, you had experience with previous dentists where you felt some pain, you didn't like that. You didn't like being referred out for other services, so you came to Dr. John, so you get everything done in-house, one-stop-shop so to speak. What did you have to have done?
Esmeralda: Many things. Well, after my first visit, he realized that there was more going on, so first he said we can help you, which was great. After that was my first appointment, and then I knew what was really going on, which was the gum disease, which I had no idea.
Dr. John Chao: I remember she was saying that she was very anxious about dentistry, about getting injections. Now, you also mentioned that your past experience was that having injections bothered you and that you didn't get quite numb enough, so that you still felt things.
Esmeralda: Yes, there was one occasion where I had gone to the dentist, and I'm not sure if it was because I was nervous or what it was, but I had a few shots.
Dr. John Chao: A few?
Esmeralda: Yes, it was a few, because I wasn't numbing. So, I remember having the dentist come and check on me, "Are you numb?" And I would have to say no, because I wasn't numb. I have had a past experience where it wasn't completely numb, and I was able to feel the actual drilling.
Dr. John Chao: So, you were anxious as you were coming into the office.
Esmeralda: Yes.
Dr. John Chao: Would you describe to us what it felt like, to look at the building and then walk into the office?
Esmeralda: Actually it felt very comforting, homey. The girls as well in the front desk were very welcoming, very welcoming. That is very helpful for us, to make us feel comfortable.
Dr. John Chao: Did you feel reassured? Were they reassuring with their conversation?
Esmeralda: Yes, they were very reassuring, especially Laura.
Dr. John Chao: What did she say?
Esmeralda: Well, she's the one that I've come to know more, because she's the one who actually took the first call. She is the one that usually calls me, and from the first time I called her, I spoke with her, she said that I would like it, that it was -- how can I say? Well, I'm not really quite sure how to put into words, but she said that I would be happy there, in other words, and just her alone. The way she spoke to me was comforting.
Dr. John Chao: Yeah, we have to make sure she tunes in.
Salvador Gaytan: Absolutely. She'd like that, because Laura is one of many of your assistants. You have many assistants that work at the front desk.
Dr. John Chao: Actually the reason I ask you is that treating a patient who has high anxieties is a team effort. It cannot be just the doctor. It cannot be in an environment where it's not reassuring. The place, the building, the way it's set up, the way it's decorated, the friendliness and so on is one statement.
Everything has to be consistent and congruent, this is what we try to teach at USC, that it is not just one person doing all the work. And for anxieties to be relieved, everybody has to be in on it.
Esmeralda: Correct.
Dr. John Chao: The patient needs the reassurance, and to feel that she's cared for and listened to, from beginning to end. From the first phone call to the time she walks in, and to the time when she sits in the chair and meets the doctor.
Everything is, so to speak choreographed for the purpose of relieving the anxiety. This is something that we teach at USC. This is something that we talked about Sal, we call that Iatrosedation, the doctor causing the calming of the patient.
When we say doctor, we actually really mean the doctor's office, the doctor's staff working together with the patient to bring this about. So, Esmeralda being here on this show illustrates what we talked about over three shows with Dr. Cecchini. Dr. Cecchini is the clinical psychologist with a PhD in psychology as well as being a dentist?
Salvador Gaytan: That's right.
Dr. John Chao: And we talked about how can we achieve painlessness with patients who have high anxieties In case you've just tuned in, we're talking about how anxieties can be treated with actually a patient who's gone through that experience at my office, and talking about it. So, let's go on from there, Sal. And ask you, you were concerned about your teeth loosening, weren't you?
Esmeralda: Yes, I was.
Dr. John Chao: And the tooth was actually moving during the daytime.
Esmeralda: Yes.
Dr. John Chao: So for the audience who have just tuned in, generally that’s advanced gum disease. When teeth are moving, the next step is for the teeth to actually exfoliate or come loose.
Salvador Gaytan: The teeth aren't just saying hi, they're not just waving.
Dr. John Chao: Just waving, actually they're waving goodbye.
[Laughter]
Salvador Gaytan: Waving goodbye, they're letting you know, "We’re about to leave unless you do something."
Dr. John Chao: We didn't let that happen to Esmeralda. Esmeralda, now you were concerned about the teeth coming loose, and you had some cavities too, didn't you?
Esmeralda: Yes.
Dr. John Chao: Yeah. So, what happened to you after that? Let's move on then to your treatment with me. We told you what we're going to do for you. Now, do you remember the different steps we were going to do for you to treat you for advanced gum disease?
Esmeralda: I do, I do remember. First, of course, was my cleanings. I went in for those. I had my deep cleaning.
Dr. John Chao: Deep cleaning?
Esmeralda: Yes, I had my deep cleaning.
Dr. John Chao: So, you had the numbing process too.
Esmeralda: Yes I did, and I'm in shock, because I had never had one. From the times I've gone, I've never had a deep cleaning. I heard from other people that they are very painful, and I'm surprised because people miss work because of that. But I had no pain after that, no aspirin, nothing.
Dr. John Chao: You didn't take the next day off, did you?
[Laughter]
Esmeralda: No! So, after my deep cleanings was -- I'm sorry, I don't know what it's called when you have that…
Dr. John Chao: Laser?
Esmeralda: Not the laser.
Dr. John Chao: The flossing?
Esmeralda: Not the flossing. When they take the samples of the…
Dr. John Chao: Yeah. What Esmeralda is referring to, is a bacteriological sensitivity test. It's a culture test to find out what kind of bacteria are causing the problem in her mouth.
The USC Dental School has a special laboratory run by Dr. Jorgen Slots, who sometime in the near future will be coming here as a guest. So, with that test we find out what kind of bacteria are behind the problem, and we use the appropriate antibiotics to get rid of the infection that way, in addition to other means of getting rid of infections we did the tests for you, didn't we?
Esmeralda: Yes, but while I was waiting for the test, I was continuing with my sessions, with the deep cleaning, which was also being followed by the laser.
Dr. John Chao: Tell us what the laser does; was something very special about the laser?
Esmeralda: It stops the bacteria where it's at.
Dr. John Chao: Yeah. What it does is -- it's an Antioch laser that targets infected tissue only. It preserves good tissue, and it only gets rid of tissue that has pigmentation. So, it targets pigmented tissue which is infected, and then it targets bacteria and these pigmented bacteria is what causes the problem.
Salvador Gaytan: So, Esmeralda, you had a lot of treatments going. You had the deep cleaning, and how often did you have deep cleaning?
Esmeralda: I had three sessions, well because they part the mouth, in parts of [crosstalk].
Salvador Gaytan: In thirds, okay. So, did you go once a week or…?
Esmeralda: I was going once a week.
Salvador Gaytan: Once a week, okay. So, you went once a week for that. You had the bacterial test. So, Dr. John, you were preparing her for the main treatment, right?
Esmeralda: Yes. Somewhere, while she was getting treated with the hygienist, we found time to address the front teeth problem, because you wanted to go to a graduation, didn't you?
Esmeralda: Yes I did.
Dr. John Chao: We found time to really take care of her and get her fixed up. So, we were able to find a long session for her while she was going through these sessions with the hygienist, because the hygienist worked on her front teeth. Of course, the hygienist worked on the front teeth first, so I was able to go ahead and do my treatment for the decayed front teeth.
Salvador Gaytan: So, your tooth, Esmeralda, that was trying to wave goodbye, as we say, was in the front?
Esmeralda: Yes it was.
Salvador Gaytan: So, that's more of a sightly thing, in the front.
Esmeralda: Yes.
Salvador Gaytan: So, what did Dr. John -- what treatment did he propose to you to take care of that loose front tooth?
Esmeralda: It's called the veneer bonding?
Dr. John Chao: Yes. We use the word bonding, bonding the teeth together. The technical word is splinting, to tighten up the loose tooth. Actually, the loose tooth was a little bit long and stuck out a little bit, because it was loose I was able to move it back when I bonded it. That's why it looks even when we got through. So, actually we did instant orthodontics.
Salvador Gaytan: I will say her smile looks very beautiful. Yeah, you wouldn't know that you had any treatment done at all.
Esmeralda: No? No.
Salvador Gaytan: Yeah, that's what's amazing.
Dr. John Chao: Now, tell us a little bit about what your friends said.
Esmeralda: Oh wow, what haven't they said. I was talking to a coworker of mine, and I had kind of mentioned to another friend of mine that I had it done. So, as I was speaking -- I was in between both of them talking to my friend on the left. My friend on the right was just looking at me, and out of nowhere she says, "Oh my God, I just love your teeth!" I said, "Wow, you have nice teeth too." She says, "But no, your teeth look really good." So, coming from someone like her…
Dr. John Chao: Now, you mentioned that she had very pretty teeth. She had the work done before. So, before you had your teeth done, you were aware that she had a pretty smile.
Esmeralda: Yes, she has a really, really pretty smile.
Dr. John Chao: So, now you have joined the club.
Esmeralda: Yes I have.
Dr. John Chao: The pretty smile club.
Esmeralda: Yes, yes. I have had a few people who have noticed when we speak, and have said, "You fixed your teeth?" And I'm like okay, that's embarrassing, but I've been put on the spot [crosstalk].
Dr. John Chao: Yeah, you were motivated to do so, because your son was graduating.
Esmeralda: Yes.
Dr. John Chao: Now, what did your son say to you when he first saw you with your new smile?
Esmeralda: We had actually gone to dinner, because I wanted to do a celebration of his birthday by ourselves after, his father and my family. So, we had a dinner, and he noticed, because from the dentist, I went to pick him up and I went straight to dinner. I smiled, and I said, "Do you notice anything different?" He said, "Mom, your teeth, that's cool!"
Dr. John Chao: So, you went right after your appointment with me to dinner, and there you were smiling and having a good time, and he says in teenage fashion, "Your smile is cool!"
Esmeralda: Yes.
Salvador Gaytan: I like it. Cool smile is always good. Well, we're coming to the last few seconds of our show, Dr. John. We still have just a little bit more to interview Esmeralda with. We'll probably ask her to come back to our next show. Is that okay with you Esmeralda?
Esmeralda: Yes.
Salvador Gaytan: Okay!
Dr. John Chao: Good, good, we'll have a little bit more fun.
Salvador Gaytan: Yeah, because you have to tell the audience the finished treatment which was very, very unique in how you accomplished all of this. It wasn't just a simple thing, but we'll get to that on our next show. You've been listening to SmileTalk. You can contact Dr. John Chao, spelled C-H-A-O at AlhambraDental.com or 626-308-9104.
Dr. John Chao: Tune in the same time next week.
Salvador Gaytan: Absolutely. Goodbye everybody.
Dr. John Chao: Bye.
Esmeralda: Bye.
[END OF AUDIO]
Transcribed and proofread by:
ScriptoSphere Audio Transcription Services
