Word of Mouth

by | Aug 1, 2010 | Community, Features

An estimated 75% of adults have experienced some degree of dental fear, from mild to severe. A dental phobia forum on the web contains pages and pages of blogs from (mostly) perfectly sane people raging about their fears of dental work. And, no wonder. Pulling teeth was once considered a form of torture.
St. Apollonia, the patron saint of teeth, was martyred in 300 AD after having all her teeth violently extracted. Even Shakespeare mentioned toothaches several times throughout his writings. In Much Ado About Nothing, he wrote, “For there was never yet (a) philosopher who could endure the toothache patiently.”
During Shakespeare’s day, toothaches were believed caused by “worms” that burrowed into teeth or “an excess of humors” or body fluids. Adding to the pain, up until the late 19th century most dentistry was done by “barbers” who specialized in pulling teeth (and cutting hair?), mostly without anesthetics. First President George Washington was inaugurated with only one tooth left in his mouth. Despite popular myth, his dentures were made of ivory, not wood.
The reason many people are still afraid of dentists today is simply “instinct,” according to a Dental Hygienist on the web, who said mammals don’t generally like to be on their backs in a submissive position. Teeth are close to the brain, so any intrusion into a person’s mouth (hence brain) can be traumatizing, she explained.
Fortunately, dental procedures have come a long way since the “barber” days. During the 20th century, the dental profession began conquering the pain and uncertainty of dental procedures and licensed Dentists became the norm rather than the exception. Although Novacaine was developed in 1905 and has since been replaced by “caine” derivatives for dental work, these anesthetics work well to prevent the pain, if not the fear of injections. Nitrous Oxide (laughing gas) has surprisingly been around since the mid 1800’s and is now also used routinely on children and anxious adults to provide general relaxation and a feeling of detachment.
But the best cure for dental fear seems to be trust in your dentist.

“You have no idea how scared I am of hurting my patients,” said Robert Powell Smith DDS, who has been fixing the teeth of Johnson County residents for nearly 50 years. His technique must be working, because Smith has treated the mouths of over 9,000 patients over the years, with many third and fourth generation patients.
Talk about word of mouth. On the wall of Smith’s reception room is a plaque presented to him from the “people of Johnson County” for the 40th anniversary of his practice which reads “To the Best of the Best.” Beside it, hangs a framed poem written to him by a grateful patient.
Smith still practices in a 100-plus-year- old building above Teeters drug store across from the Johnson County Courthouse in Clarksville. Although the old building now has a motorized electric stair climber for less agile patients, the upstairs hallway with its dark wood and frosted glass doors and windows, looks much as it must have looked long before Smith went into practice in 1961.
While Smith’s office still has old fashioned glass “cuspidors” to spit into and patients look out on the Courthouse across the street instead of at a high-tech monitor suspended above the dental chair, Smith uses modern high speed air-turbine drills and has diligently kept up with his training. He was also the first Dentist in Johnson County to use computers.
“I always loved technology,” said the trim and spritely Arkansas native, who still walks two miles per day. “I’ll probably keep practicing until they carry me out feet first. Deceased Dentist William Hunt, who originally enticed Smith to set up practice in Clarksville, died in his office.
Important changes in dentistry have also made a trip to the dentist much less intimidating. Besides better medications, the use of high powered drills and improved teeth cleaning techniques, filling materials like the FDA approved amalgam, a mixture of“silver, other things and a tiny (but safe) bit  of Mercury”, composite fillings and porcelain have vastly improved dental care,saidSmith. Although Smith recommends amalgam for back teeth and composite fillings for front teeth, some Dentist’s want to replace all amalgam fillings with the newer “composite” material. “I don’t think that’s doing my patients any justice. It’s just another way to get into the patient’s pocketbook.”

Gold, once considered the Cadillac of restorative materials, is seldom used today because of the cost. What used to cost $35 an ounce is now $500 per ounce, said Smith. In the early days of his practice, amalgam filling used to cost $3 per surface and an extraction was $4.
“Nothing we get today from food, clothing, housing etc. seems to be worth what we have to pay for it anymore,” said Smith who tries to keep his prices reasonable by today’s standards.
Although Smith no longer does root canals, or works on children, he remembers the days “when people got as excited about getting their driver’s licenses at age 16 as getting dentures at middle age.” Fluoride in the water and fluoride toothpaste has improved dental hygiene immensely, and while some people are now against the use of fluoride, it has been a good thing, he added.
Today, the dental profession has many specialists for specific problems, including Orthodontists (braces,) Periodontists (gums,) Prosthodontists (dentures,) Pedodontists (exclusively children) and Oral Surgeons.
“When I started here there were no specialists in Clarksville or Russellville. The nearest one was in Ft Smith at the time,” he remembered.
However, the biggest change in dentistry has not been so much the equipment, materials and techniques, but Dental insurance and regulations by OSHA and CDC (Center for Disease Control,) said Smith. Today, more than 50% of Smith’s patients are covered by insurance or Medicaid and his computer holds information on 285 different dental insurance carriers. Each claim takes a lot of paperwork when done manually, he said. As a testament to Smith’s expertise, he has never had a liability claim filed against him.

From his office windows overlooking the courthouse, Smith has also seen a lot of changes in Johnson County.
“Downtown Clarksville used to be the hub of all activity. Before I-40, Russellville used to be a long way from here. There used to be only two paved roads leading in and out of Clarksville; one was Hwy 64 going east and the other Hwy 64 going west, with the pavement ending at Rogers Ave on the East and Poplar on the west. Located where the Clarksville Light and Power Company now stands, the city had a movie theatre and the Ford Hotel and the county hospital was located on Rogers Street, he explained.
Despite all the changes in the dental profession and the city in general, Smith said, “I still love my work. The people of Johnson County have been awfully good to me and I hope I have been good to them.”
“I know my #1 priority in life is to God, my fellow man and then to myself, but my first love today is my wife.” Smith and his wife, Billie, will be married 57 years at the end of December and have two children, four grandchildren and three great- grandchildren.  

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