Atlanta Center for Cosmetic Dentistry Media Coverage

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Spa dentistry has been called a trendy novelty for high-end dental practices, but the concept may offer you creative solutions to your most common patient-care challenges.

By Debra Gray King, DDS, and Daniel R. King, JD, CPA

Recently, a Denver news station polled more than 1,800 people on how much anxiety affects dental visits. Only 23 percent said, "No, [the dentist] doesn't bother me." Twenty-one percent said that they were afraid and refused to go. The rest of the respondents were either afraid or didn't like dental visits, but went anyway.

Similar anecdotes can be found across the country. Our profession is begging for reform in this area. Numerous studies cite that up to 15 percent of the country is so fearful, they don't visit the dentist regularly. If our profession could convince just 10 percent of that population that an office visit can be a pleasant, pampering experience, would more people look forward to regular care? Would more patients get that beautiful smile makeover they've always wanted?

A number of years ago our practice envisioned that world—one in which a visit to the dentist is relaxing, pampering and enjoyable. The amenities we offer and the ambience we've created is often called "spa dentistry." For many practice owners we're sure that this sounds suspiciously like an expensive, superfluous fad with a quickly approaching expiration date.

We don't know how long the term "spa dentistry" will be around; and, yes, part of this concept may be trendy. But we believe that the movement toward making a dental visit more pleasant will be the standard rather than the exception in years to come. More than just "perks," spa dentistry addresses many patient-care challenges, such as anxiety, sedation, pain management and temporomandibular disorder (TMD).

It's already working in our practice. As our patients embraced the initial pampering changes in our practice, we became focused on the goal of making a dental visit even more stress-free and restful. We wanted the treatment of patients at our practice to be so pleasant, so opposite to what the average person expects from a visit to the dentist, that it actually created a slew of missionaries telling others about their visit to our practice.

Spa dentistry doesn't have to be expensive or elaborate. In fact, we encourage a conservative approach when adding amenities and other special touches to your patients' dental visits. In this article we will touch on the patient-care benefits of spa dentistry and provide you with sensible and economical guidelines for any practice.

Why we did it

It was the "torture chamber" perception many patients have of dentistry that motivated us to help transform the process of a dental appointment.

We have a very esthetic-focused practice, which is elective care for the most part. But even if the goal is to get a beautiful smile, patients don't want to go through hell to get there.

So, along with the new technology and techniques for delivering appearance-enhancing care, we incorporated the relaxation aspect that a spa brings. This ties in nicely with well-established views from organizations like the American Dental Association, which has long-recommended stress-reduction techniques in the dental office—especially for patients with anxiety or heart disease.

What does spa dentistry involve?

Spa dentistry means different things to different people and practices. To us, one of the most important services we offer patients is our on-staff massage therapist. Therapeutic massage not only helps patients relax and reduce anxiety levels, but also provides many other important health benefits. It relaxes the nervous system and increases blood circulation and joint flexibility. The psychological benefits of massage include an improved sense of well being, reduced stress and anxiety and increased body awareness—all so important for overall health.

For the most part, our business model calls for offering this support therapy to patients on a complimentary basis rather than creating a separate profit center. We sought and located a full-time massage therapist, who is not only certified in Swedish and deep-tissue massage, but also neuromuscular therapy. In addition, she has expertise in TMJ reflexology and myofacial release. In our practice, these techniques have proven to be effective when treating the pain associated with TMD and the related headaches.

Along with shorter complimentary sessions, our practice offers full sessions, which last about an hour and includes elimination of trigger points and tension in cervical and upper-shoulder muscles, intraoral massage and stretches to help increase mobility and range of motion. We offer these to patients at a very reasonable fee.

Does massage help me perform better dentistry?

The relaxation obtained through spa-like amenities helps reduce patients' stress. When people are frightened and tense, their blood pressure rises and their body produces more adrenaline. Besides the obvious benefits of relaxation, anesthetic works more quickly and effectively in a relaxed patient. Studies have shown that massage releases endorphins and lowers patients' blood pressure. Put another way, a sort of "organic sedation" occurs due to the spa-like amenities; patients need less anesthetic (and other drugs) for the same numbing or distraction effect. A happy patient is a relaxed patient.

But this only works in upscale practices, right?

It may sound like this spa stuff is just for a high-end, elective practice and wouldn't really be accepted in the general practice, much less a public-health setting. But a study conducted by Larry Lawton, DDS, a dentist for the State of Washington Department of Social and Health Services (DSHS) residential facility for developmentally disabled patients, shows otherwise.

His findings, reported in the December 2002 issue of the Journal of the American Dental Association, noted that before adding any spa-like amenities, many DSHS patients were agitated during simple dental procedures. They often required pre-sedation, sedation and manual restraint to safely undergo procedures.

As a result, he found that about 30 percent of DSHS patients were receiving sedation for dental work. Additionally, some patients routinely required mechanical positioning devices. A number of patients also required pre-sedation, as well as sedation and positioning devices, to be calm enough to be cared for safely. Dr. Lawton and his staff were looking for ways to reduce the use of chemical and mechanical restraints.

Massage therapy and other spa-like amenities seemed to provide a way to relieve anxiety and help calm the patient and decrease the amount of chemical or mechanical restraints used during the dental procedure. Dr. Lawton described the incredible effect of the pampering on DSHS patients:

"As a result of using massage therapy during dental treatment, we have recorded a decrease in resistant behaviors and a more positive response to treatment. Pre-sedations have been reduced to almost zero. The dosage for sedation has been reduced by one-third to one-half the amount used previously. Use of the mechanical positioning device also has been drastically reduced (again, to almost zero). Patients who are relaxed as a result of massage seem less resistant and more receptive to dental treatment. Recovery times for patients who do require sedation have been reduced as well."

Like our office, Dr. Lawton uses aromatherapy in the clinical setting to help patients feel more comfortable.

Essential oils with calming properties are diffused in the operatory for relaxation benefits, and oils with stimulating aromas are diffused to refresh the patients after dental treatment. There are a number of sources for purchasing these oils, and certain vendors can custom-blend essential oils.

Whether in a cosmetic boutique or a public health setting, massage therapy can include head and neck massage as well as hand or foot massage by a massage therapist. Depending on the state licensing requirements, if any, for massage therapists, dental staff can be trained in simple massage techniques to assist the massage therapist.

What other amenities can be involved?

To help further ease patient anxiety we have taken a whole-office approach to create a soothing, peaceful atmosphere.

Unlike the sterile feel and smell of many dental offices, our practice has tried to create an ambiance reminiscent of a fine, upscale resort.

The reception area is accented with comfortable furnishings, flowers, high-speed Internet access and a refreshment center with coffee, tea, bottled water, juice and freshly baked cookies. This immediately tends to relax patients anticipating a dental visit.

Instead of assistants in scrubs, cheerful dental concierges, dressed in designer lab coats and suits, greet patients by name. The gentler, softer tone and surroundings go a long way toward calming patients' fears.

Our office is housed in a Twelve Oaks-style mansion. The environment is carefully controlled, right down to the pervading scent of lavender and the soothing sound of waterfalls in the operatories.

In the treatment areas, patients can have their teeth cleaned while receiving a warm paraffin hand-wax treatment, complete with heated mittens.

Cosmetic dental treatments are performed in unique "dental zen chairs," which send soothing sound waves from head to toe. With a complete spectrum of relaxing comforts—from a warm neck pillow, cozy blanket, headphones to listen to a favorite CD, or escaping into a movie on one of our flat-screen TVs—our patients are able to relax and enjoy their dental visits.

What about the cost?

We've found that the increased costs of adding spa-like amenities to our practice has more than paid for itself in happy patients and referrals. But all these amenities should be undertaken conservatively and not be a distraction from fulfilling the core competencies of your practice.

Amenities should be added one by one, so you can gauge patient reaction. The idea is that patients will hardly notice you performing their dentistry.

I am not sure if I am ready; can we just 'fake it 'til we make it'?

As with many trends, there are practices that jump on the bandwagon without meaningful conviction or a change in how they practice. Here, I urge caution. Our practice was contacted by a reporter for People magazine who had been in touch with a number of "dental spas."

The reporter said, "The only things that I could find that was any different from any other dental office is that they added some juice, baked some chocolate chip cookies and lit a few candles." Ultimately, the magazine did not run the story. As this reporter felt duped, so your patients and prospective patients can sense a superficial effort to add a couple of items and act like the entire experience has been transformed. People can see through this.

Sure, be innovative and toot your own horn. But our advice is also to be authentic—be the real deal—of whatever you are holding yourself out to be.

Even if you forgo an expensive amenities overhaul in favor of little flourishes that enhance your patients' dental-care experiences, it will help you realize the long-term success that you are seeking. ¦

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