A host of everyday figures of speech associate dentists with pain. Only a root canal hurts more. It's as comforting as the sound of a dentist's drill.

Dentists removing tartar feel like archaeologists digging for periodontal artifacts in your mouth.

These comparisons would qualify the average dentist to play a reality television version of the classic torturous dental scene in "Marathon Man," originally featuring Laurence Olivier and Dustin Hoffman.

However, Barton McGirl, DDS, with dental anesthesiology offices in Rochester and Hampton, says most dentists are aware of patient angst and are gentle, and don't fit the profile depicted in John Schlesinger's big-screen thriller.

Even so, he says there's a real need for dental care while the patient is asleep for several reasons.

McGirl says about 35 percent of his patients have a "true" and "profound" dental phobia. Twenty-five percent have a procedure-specific need. Twenty-five percent are elders or individuals with special needs.

The remaining 15 percent is divided between the three groups. Imagine completing a root canal on a patient alternating between biting their fingernails and wiping nervous sweat from their brow, removing impacted wisdom teeth with just local anesthesia, filling a tooth for a patient trembling from Parkinson's disease. McGirl says physical and psychological comfort is critical in encouraging individuals to seek dental care before a crisis situation erupts.

"Their condition doesn't deteriorate orally because of their disability," McGirl says. "It's the avoidance of dental care that precipitates the problem."

Understanding the need for his current specialty practice evolved during McGirl's academic journey at the University of Toronto, University of Western Ontario, and University of Pittsburgh. McGirl, currently certified in anesthesiology and implantology, alternated between completing fellowships and residencies and teaching classes.

"That's when my path decided to guide me more toward patient comfort and complex situations," he says, referring to his time as a student and faculty member at the University of Western Ontario. McGirl describes himself as a voluntary "perpetual" learner, who continues to cull through dentistry trade journals and attend seminars and lectures, learning about advances in procedures and materials.

"It was always enjoyable," he says. "It was never a hardship."

As McGirl noted earlier, visiting a dentist is a hardship for many. McGirl says he and his staff of four, including his wife, Mitzi McGirl, understand sedating and reassuring a patient or guardian starts the moment they enter the front door for a consultation.

"We certainly have to be extraordinarily understanding and certainly empathetic," McGirl says, sitting in the patient waiting area of his new Hampton office.

"Some of it is very personal for people," McGirl says.

During the first visit, McGirl says it's important for him to listen, offering a non-judgmental ear, allowing the patient or guardian to lead the treatment discussion. Procedures include dental surgery, implants, cosmetic dentistry, periodontal or gum therapy, endodontic or root canal therapy, crowns, bridges, and dentures.

Mitzi McGirl, who schedules patient appointments and managed the Hampton office renovation, says it's disheartening to see people of all ages, lifestyles, and professions waiting with heads bowed and mouths closed in embarrassment or pain, especially if dental visits have been infrequent over the years.

In the same token, it's gratifying to see a patient leave with a sigh of relief tugging at corners of their mouth, resulting in a partial smile. As many patients require extensive work, the transformation doesn't happen instantly, but may require a series of visits. McGirl says the average patient travels between one and one half to two hours for each visit, as he is the only certified dental anesthesiologist practicing in the Granite State.

"We were busy essentially from the beginning," McGirl says, referring to his first office, opened in Rochester about 10 years ago. "It's simply been cultivated through word of mouth."

In August 2003, McGirl opened the second office on High Street in Hampton, allowing him to spend more time with his wife and their active children, Brandon, 7, and Morgan, 5.

"It cuts the commute for two days," McGirl, a Hampton resident, says. Being closer to home allows him to participate in his sons' extracurricular adventures.

"They're involved in everything the community has to offer," McGirl says. Just as McGirl can sense when Brandon and Morgan are anxious for Dad and Mom to close the office for the evening, he says he can sense when a patient needs special attention, including anesthesia and a dose of compassion.

"It is second nature," he says. "I don't have to be Sherlock Holmes to figure it out."