The gift of a career
Dentist of the Year mike Gow recalls the defining moment in his student days that set him on the path to a special interest in dental anxiety and helping patients to alleviate their fears
It was when a grateful patient surprised student dentist Mike Gow with a Parker pen engraved with his name that he realised what he wanted to do with his career: to focus on patients with dental anxiety issues.
Mike, who qualified from the University of Glasgow in 1999, explained the significance of this event: “The elderly lady was very anxious about her treatment so I gave her the extra time and attention to help alleviate her fears. When she gave me the pen after her treatment as a gift, it really hit home how important this element of the dentistry was. I not only got the satisfaction of providing her dentistry treatment but also felt I actually made a difference in somebody’s life. In that moment I realised I wanted to focus on dental anxiety.”
Mike’s journey into this field took him halfway around the world to Australia where he worked for a short time with Dr James Auld, a world-renowned expert in hypnosis in dentistry who was based in New South Wales. After a year travelling in Australia, he returned to Scotland to work in NHS dental practices for the next eight years while honing his skills by training in conscious sedation, studying a part-time Masters in Hypnotherapy at University College London, followed by completing a PGCert in the Management of Dental Anxiety at the University of Edinburgh. In 2007 he joined the Berkeley Clinic to work alongside Jamie Newlands, who was pioneering new techniques in digital 3D dentistry, which allows some treatments to be dealt with in one visit.
It’s important to focus on the positives outcomes
He said: “Jamie introduced me to more technically advanced techniques using digital dentistry and very quickly I realised there was a huge crossover with these techniques and working with anxious patients. Being able to make a crown in a single visit was a huge advantage of working with anxious patients who would find multiple visits difficult.”
Although these new techniques can reduce the time a person spends in the clinic, the important work is done way before any treatment during the first ‘therapeutic consultation’ between Mike and the patient.
Mike explained: “One of the most important elements in this process is time, and getting to understand the patient and their particular needs. Every patient presents with an individual set of circumstances, so not every case is suitable for hypnosis or sedation.”
According to the British Dental Association, ‘one adult in three has moderate to severe fear of dental procedures’, but, in Mike’s experience, people’s extreme dental anxiety often stems from a bad experience in the past.
He said: “There are a number of different models of acquisition of dental anxiety, but, by far the most common is a bad past experience at the dentist. It’s either where the actual procedure was been painful, but, more significantly, about how the dentist managed the patient at the time. If the patient was made to feel it was their fault, particularly if they were a child, that is a strong message that is quite difficult to overcome.”
In addition to his dental practice, Mike has also set up the International Society of Dental Anxiety Management to bring experts together to better understand dental anxiety, fear and phobia as well as the use of pharmacological, psychological and clinical techniques and approaches. He is also involved in organising and chairing UK and international conferences and workshops in this area too.
Over his long experience, Mike has come to appreciate that in addition to anxiety, many patients also have acute embarrassment about the condition of their teeth, and this needs to be handled sensitively.
“I wish I knew about this aspect when I first qualified. It’s not talked about a huge amount, but a lot of patients are not only embarrassed about their own dental phobia, but also about their teeth.
“A lecture about oral health to this type of patient is not the approach to take as they have often plucked up a lot of courage to finally come to visit a dentist after decades. If they are chastised or lectured to in any way about their teeth they won’t return. Any negative comment on their teeth will just be too mortifying.
“That’s why it’s important to focus on the positives outcomes. The first thing I will ask any patient is ‘what do you want to achieve?”
Mike and the team at Berkeley have had to keep a positive outlook themselves over the last year following the tragic death of Jamie Newlands in July 2017. As well as being a friend and a valued colleague, Mike says Jamie was instrumental in helping him develop his skills further in anxiety management through his understanding of digital dentistry.
Mike said: “Winning the Scottish Dental Award and having the team there on the night was really a nice positive thing for all of us after what had been a very difficult year. That’s why I dedicated the award to all our staff because at the end of the day, they are the ones that make it all happen for our patients.”
What inspired you to go into dentistry in the first place?
When I was 12 years old, I had a conversation with my neighbour Bill Smith about ‘careers’. He offered to let me spend a day with him where he worked at The Glasgow Dental Hospital. I made my decision that day that I would become a dentist! I’m still friends with Bill and very grateful for his influence 30 years ago!
If you could change one thing in the dentistry profession, what would that be, and why?
I think stress experienced by dentists is a real problem that seems to have grown in recent years. I’d certainly like to see that change. The main causal factors being workloads, growing demands and expectations and, of course, the fear of litigation or reprimand. There’s no one easy solution to this, but I think there is at least a growing recognition of it as a problem and increasing support available for anyone struggling to cope. Dentistry should be and can be a fantastic and rewarding profession to be in.