There are four reasons why zone analgesia—as we call the pain-relieving properties of zone therapy—are not more generally used by dentists. One is that the dentist doesn’t wish to put himself in the embarrassing position of suggesting such a foolish-seeming thing to his pain-racked patient. Another is that the patient herself thinks she’s conferring a favor upon the dentist by permitting him to spend five or ten minutes’ valuable time in attempting to alleviate her sufferings, and make the ordeal of cavity preparation or scaling comparatively painless.
Also, to press over the roots of a tooth for three, four, or more minutes—exerting, after toleration is established, all the force of which the operator is capable—is hard work. It’s much quicker and easier, and less likely to numb the dentist’s thumb and finger, to “slap” a gas cone over the patient’s nose, or inject cocaine around the gums—which, to my mind, hurts almost as badly as having the tooth extracted.
There is yet another reason, however, which partially justifies the previous three. The analgesic results of zone pressure are not sufficiently uniform to “bank” on. In other words, a dentist, led by previous successes, might be tempted confidently to assure a patient of the painlessness, under zone analgesia, of a certain operation. But when he commenced to work he might almost lift the top of his victim’s head off. To obviate this do not limit the pressure to three minutes only, and do not attempt to operate or extract until a puncturing test with a sharp instrument shall prove the part to be desensitized.
Also, I would here emphasize that there is no use in attempting, with zone analgesia, to relieve pain if it is desired to remove a nerve. We do not pretend to explain why it is possible, for instance, to work thirty-five minutes, (as demonstrated before the Mass. Dental Society by Dr. B. A. Sears, of Hartford) and cut the jaw bone all to pieces in order to remove an impacted wisdom tooth, while we are unable to thrust a nerve broach into a root canal. But the fact remains, and some time, when pathologists and other experts have studied these problems, we may know why. But for the present, we must be content to be guided by dearly-bought experiences.
There is no known way of telling in advance, just what degree of analgesia success is assured. Dr. M. W. Maloney, of Providence, R. I., and Dr. Wm. J. Hogan, of Hartford, Conn., claim successful results with about 80% of their cases. Dr. Everett M. Cook, of Toledo, Ohio, writes that he is easily successful in 75% of his cases. Dr. Thomas J. Ryan, of New York, is quite uniformly successful in desensitizing the gums for pyorrhoea treatment. While other dentists range on down to as low as 50% of successes, or even to zero.
There are probably very definite reasons for this, although it may be difficult to convince the average dentist that such exist. First, it requires a fine technic to find the various dental nerves, and, by commencing gently, and gradually increasing pressures, to anesthetize them without hurting the patient more than the operation might have hurt him. In which case he has the pain of the operation plus the pain of attempting to analgesize his unresponsive nerve points.
Next, when pressures are made over the fingers, especially where no clamps or rubber bands are used, there is a tendency to skimp on the time devoted to the finger squeezing. The dentist or his assistant will give the job a “lick and a promise”—and let it go at that. They don’t use sufficient time or sufficient force really to accomplish anything.
And third, they won’t take the time properly to learn the zones and the teeth relations, and apply in a serious way the knowledge so acquired.