Libertyville dentist David Potts is looking for patients who don’t want anything to do with him or the dental profession. He is catering to people so fearful of dentists that they choose to let their teeth decay rather than seek treatment.
These anxiety-prone, untreated patients are not exactly the most sought after group in dentistry, but through word-of-mouth recommendations and now radio ads, Potts has started reaching out to people who may not have been inside a dentist’s office for so much as a cleaning for decades. His solution for easing his patients’ anxiety comes in the form of a tiny blue pill, roughly a quarter-inch in diameter.
Swallowing the sedative, known generically as triazolam or by the trademark Halcion, puts the patient in a kind of sleep while in the dentist’s chair. Yet the drug allows the patient to respond to commands.
Seventy to 80 of the 1,500 patients Potts sees at his Milwaukee Avenue office are “sleep” patients, he said. Some of them had avoided dental treatment because of bad experiences during childhood, because they fear pain or because they tend to gag when dental implements are placed in their mouths.
Potts, who conducts seminars for other dentists on patient relations, said he and his staff treat such patients with great care because of the effort it takes some of them just to get up the nerve to call for an appointment after neglecting their dental care for years, sometimes decades.
Potts has worked with patients who have not been inside a dentist’s office in more than 50 years, he said. More typically, patients may not have been in to get their teeth checked in 5 to 30 years, Potts said.
The longer people put off seeing a dentist, even for a routine cleaning, the more likely they are to be embarrassed by their smile’s appearance, Potts said.
“If they smile, they’ll put their hand in front of their face,” said Potts, 51, who opened his practice in Libertyville in 1974.
He doesn’t believe in lecturing people about how they should have been more attentive to their dental health, Potts emphasized, considering that “even lifting the phone to make the call to come see us is a very hard thing to do,” he said.
An added plus for sleep patients is that because they are sedated, Potts can do several procedures in fewer sessions without having to worry about patient fatigue, as he would with standard patients.
“You’re able to do a lot more at a time,” Potts noted. “Virtually anything that can be done in dentistry can be done” using this procedure, called conscious sedation.
Potts’ specialty has brought patients from as far as the Peoria area as well as towns near the Iowa border, he said.
“To me, it’s very rewarding to see the difference in these people,” said Donna Goodwin, a registered hygienist who has worked with Potts for about two years. “They will actually smile again. For years, they forgot how to smile; you can see their self-esteem rise.”
Though many of his sleep patients are reluctant to go to the dentist let alone speak about it, Bob Maness, 46, of Island Lake agreed to comment. Maness, who has undergone sleep dentistry twice since June, said he felt like he was sleepwalking once he swallowed the pill.
“It was a very pleasant experience. They made me feel comfortable right away,” said Maness, who has seen Potts for some extractions and bridgework.
But the sleep procedure does cost money in addition to the dental work: $150 on top of whatever dental procedures are done, according to Potts.
Here is how the procedure works. Patients must not eat or drink anything six hours before their appointment, to prevent regurgitation. They swallow one or two pills an hour before they are scheduled to see the dentist. Someone must drive them to and from the appointment, because most people will be drowsy by the time they get to Potts’ office.
Some people might require more medication at the dentist’s office, depending on how alert they are, Potts said. This procedure, which relies on oral medication, differs from the sedation practiced by some dentists, which involves inserting an intravenous needle in the patient’s arm.
Potts believes that the pill is a safer method.
“When you’re making injections directly into the bloodstream, there is a different level of risk,” he said.
Even so, Potts and his staff check patients’ blood-oxygen levels and blood pressure while they are sedated. Patients are always in the company of the dentist or a staff member while the procedure is taking place, he said.
While Potts works on the person in his chair, the patient is alert enough to respond to such requests as “open wide,” he said, noting with a grin that some patients relax more than others.
“People actually snore in the chair. I’ve had people snore through root canals,” Potts recalled.
The medication does not promote any personality changes or odd outbursts, Potts said.
“People are just like themselves, only they don’t remember what they said,” Potts observed. “If someone’s a cut-up, they still are, only a very sleepy one.”
Though Potts has been working with this latest sleep dentistry procedure for about a year, he has always employed some type of sedation in his practice for patients requiring it. Previously, he offered Xanex, a relaxant that relieved patients’ anxieties but left them conscious, and also had nitrous oxide, or laughing gas, available.
“It’s a tool I’ve used for a long, long time,” he said.
Some form of conscious sedation is not uncommon in dental practices, according to Kenneth Burrell, senior director of the council on scientific affairs of the Chicago-based American Dental Association. “Admittedly, people are fearful of discomfort that they sometimes may experience in the dental chair. Historically, because of that, dentists have had a lot of experience” in sedating nervous patients, Burrell said.
Burrell said he was not aware of any statistics to indicate just how many dentists use triazolam to help their patients.
“We want everybody to have access to care,” Burrell said. “If fear or anxiety keeps them from dental care, we like to offer them a service that will allay that fear.”
Probably the most common sedation method is nitrous oxide.
Potts learned about the conscious sedation method he now practices by studying with Dr. Michael Silverman, who has a dental practice in Philadelphia. Silverman, who said he knows of only one other dentist teaching this method in the United States, travels the country to present seminars on the technique.
Potts, who studied with Silverman a year and a half ago, was the first to learn the procedure from Silverman and the only one Silverman could recall from Illinois out of the approximately 100 dentists he has taught. Potts and Silverman still talk weekly to share stories and new ideas, Silverman said in a recent telephone interview.
“He’s a fast learner, and he knows a lot about dentistry,” Silverman said, adding, “Dr. Potts is a very warm, compassionate man who has a really keen ability to listen to people to get to know them. He’s also very detail-oriented.”
Potts, who said he always had an interest in science while growing up in Naperville, received a biology degree from Drake University in Iowa, then got his dental degree from the University of Illinois at Chicago. He and his wife, Lorraine, who works as a lab technician in Potts’ office, have two children, Jeff, 21, and Whitney, 19.
For Potts, one of the most rewarding things about practicing sleep dentistry is seeing how appreciative formerly fearful patients are about their healthier mouths. Some are even able to return to the chair without sedation for minor procedures, such as cleaning.
One 40-year-old Waukegan woman, who asked that her name not be used, recalled that she once considered getting dentures so she would never have to go to the dentist again.
She said of Potts: “He’s the only reason I’ve been able to get my mouth up to speed.”
It was as easy as taking a nap.
