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patients that tighten their lips

Other than cotton rolls, what do you do for people to tighten their lips/tense their chins? I gav a pt that is so bad, even with cotton rolls, when im cleaning the mand ant his lower lip goes over thr Incisal and blocks my vision. GOV ME TIPS!! HAHA



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9 Answers

This makes me crazy! Not only because it makes it hard to work, but it’s actually dangerous to both you and the patient. I had a patient knick their own lip with the ultrasonic because of doing this. Let me tell you that was a lot of blood! I have patients like this hold their own lip out of the way. If that doesn’t work, I have them hold a mirror with one hand and their lip with another to show them what they are doing. When all else fails I tell them that I will need to anesthetize them (left and right incisal) if they can’t relax. Needless to say, I’ve never had to anesthetize someone because that gets their attention! If that still doesn’t work, recommending sleep dentistry (and how anesthesia can cause major nausea) might be best for them, safety-wise.

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I have the pt close part way which relaxes the lip some so I can really retract that lip. Also, just telling them to relax their lip. In the twelve o’clock position have then close part way and use your non-dominant thumb to pull / push the lip down.

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Same here- I have my patient hold his lip out of the way. Just seeing him make the effort reduces my frustrations.

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Having the pt close a bit helps me too. I also like to “wiggle” the lip with my left hand, while telling them to relax, I find that helps a lot of the time. When they begin to tighten again we just go back through the cycle, tell them to relax while wiggling again.

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I have a patient like this. We call him the lip muscle clenching champion. He does it because he’s anxious and he even chuckles at himself for doing it. I just have to constantly say “Just relax….relax….relax” and that calms him down. It sounds strange and it was a little awkward at first but it really does make him release the tension because he is consciously thinking about it. Give it a try!

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I tell him to relax constantly throughout the appointment. doesn’t work 🙁

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exactly kara! I try to fulcrum ANYWHERE that won’t be affected by their crazy lip….so ftustrating

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I am a HUGE believer in LA – no epi will wear off quickly and help so very much. if all the above examples do not work LA is the answer. Generally I find people are surprised at how easy it is and how fast cleaning that area can be if they are not fighting back. In the end we need to take care of our bodies so we can give the best possible care, if we are getting worn down by the lip fighter it will shorten our lifespan in this career.

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One trick that has often worked with these patients is asking them to smile. It’s impossible to smile and push up your lips/tense the chin at the same time ! Sometimes you have to keep reminding the patient to smile- just keep encouraging them !

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