Patients who are nervous or downright phobic typically do not want to visit any other dentist once you help them overcome their fear, whether you've used sedation or simple kindness.  This is why so many dentists are developing themselves into what has become known as the Super Dentist.

Of course in dental school, we were all trained in the various disciplines.  (Orthodontics was the exception.  For some reason orthodontics was kept secret.)  But once most general dentists get into private practice we are urged to refer out endo, perio, pedo, prostho, ortho, and oral surgery, leaving us to do mainly fillings, crowns, bridges and dentures.  However, once  you earn the trust of a patient who hasn't been to the dentist in many years due to fear, the patient may not want to leave your office for the extractions, perio and endo they need.  This is why it is vitally important to immerse yourself in continuing education to learn everything you can about all the disciplines.  

I recently saw a new patient who had never been to the dentist in his 29 years.  His wife had never seen him smile.  His mouth was in dire need of care.  The only reason he came to my office is that he had been to the hospital emergency room with an abscess the previous weekend.  His wife found us on the internet and made the appointment.  He was so scared that he cried in our consultation room.  His mouth was so devastated that there was only one tooth that did not need care.  He needed root planing on the teeth we were going to save, as well as 7 root canals and 19 extractions.  And of course he was going to need partial dentures made to a new bite.  

We started out with the scaling and root planing.  Because we used oral conscious sedation he had a fabulous visit.  When I saw him for post op the following day, I was his new best friend because he realized that I was going to be able to give him a healthy new smile--painlessly.  The next step was paved, but we had our work cut out for us.  He did not want to see anyone else.  I did enlist the services of an endodontist to do the 7 root canals in one visit, but I was there for him to do the sedation.  The endodontist advised me to refer him to an oral surgeon for the extractions because his roots were really long, but the patient wanted me to do the work.  We blocked off a whole day and did 19 surgical root extractions.  At post op the next day, to my amazement he was in no pain.

The next step was to prep his remaining teeth and to deliver crowns and partials.  The day of delivery there was not a dry eye in the house--and not from any pain.  His wife and kids saw him smile for the first time.  The whole family was extremely grateful to us.  

My point is that this happened because 1) We were trained in oral conscious sedation 2) We were trained to remove difficult teeth 3) we were trained to do difficult fixed/removable prosthodontics to a new vertical dimension.  We have also been trained in modern endo, but 7 root canals in one day is a bit much for me!  I guess I have to take more C.E. and hone my skills to be a true Super Dentist!