Tag Archives: Dental Anxiety

Sedation Dentist

Wisdom Teeth and Dental Sedation

I have a daughter who is nineteen years old. She needs her wisdom teeth extracted but has terrible dental anxiety. My dentist has always had trouble working with her and is suggesting we take her somewhere that can do the procedure with general anesthesia. That scares me. Is there an alternative for her?

Penny

Dear Penny,

Unless there is some highly unusual complication with your daughter’s case, which I doubt, then there will be no need for your daughter to have to do this procedure under general anesthesia.

You mentioned your daughter has always had trouble at the dentist. Many dentists don’t realize the connection between dental anxiety and the inability to stay numb. It causes too many patients distressing dental appointments. The good news is there is a solution.

You need to have her wisdom teeth extracted by a sedation dentist. Specifically, you will want one who offers oral conscious sedation. This is administered by a pill, but is so strong that you will need to drive her to and from her dental appointment as well as stay with her for a few hours until she is lucid and steady on her feet again. With this, she will be so relaxed that she will likely completely sleep through her procedure.

Some more good news for you and her is that she is at the perfect age to have her wisdom teeth removed. The bone is still pliable. Plus, there has not been time for cementum to have accumulated on the roots of the teeth. It should be a fairly easy procedure.

This blog is brought to you by Lafayette, LA Dentist Drs. Foreman and Thimmesch.

Pediatric Dentist

Numbing Medicine Doesn’t Work On My Daughter

My seven-year-old daughter developed a cavity on a back tooth, which is weird because they have sealings. I took her in for them to do the filling and they could not get the numbing medicine to work. She is in agony and ended up thrashing about. He did seven shots to no avail. He finally just sent her home without the tooth dealt with. Where do I go from here?

Maggie

Dear Maggie,

Little girl smiling in a dental chair

I am sorry you and your daughter had to go through this. It is agony watching our children suffer. The good news is I have a solution. It appears that your current pediatric dentist is not aware of the connection between anxiety and numbing medication.

If a patient is very anxious, it has the effect of metabolizing the numbing medication very quickly. Sometimes so quickly that the patient gets no benefit out of it. I feel this was what happened to your daughter. Traumatic experiences like this are what keep people away from the dentist in adulthood.

Our goals right now for her are two-fold. First, get the cavity dealt with before it blows up into something more substantial or even a dental emergency. Two, give her a positive experience at the dentist so she can feel good about her oral health care.

I want you to find a dentist who is good with children that also offers dental sedation. It doesn’t have to be a pediatric dentist. There are many general dentists who enjoy treating children and are qualified.

Under normal conditions, she would only need some nitrous oxide to relax her. However, after her recent experience, I am concerned that will not be enough. Look for someone who offers oral conscious sedation. It is so strong that she will sleep through her whole procedure. In fact, some people call it sleep dentistry for that reason. She is still conscious. This is not anesthesia. It just completely relaxes her which will allow that numbing medication to do its job.

Be aware that she will still be woozy for a few hours after that procedure. You might want to set her up a little castle on the couch and let her binge watch something like “A Series of Unfortunate Events,” which will entertain her while simultaneously realizing her life isn’t so bad.

As for her sealants. Sometimes those will come off. Make sure you have the dentist check that the others are still intact.

This blog is brought to you by Lafayette, LA Dentists Dr. Foreman and Thimmesch.

Uncategorized

Can I get all this work done in one setting?

I’ve got a lot of dental work to get done. I have to get at least four root canal treatments, and I need to have a couple of teeth ground down as TMJ treatment. I also may need to have a dental bridge placed, though my dentist is still considering the best course of action in that case. I also need some dental bonding done on a chip on my front tooth. The problem is that I seriously freak out in the dentist’s chair.

I’d like to get this all done at once. I don’t have much time off of work, and I just want to get it over with. My question is, how much can be done in one sitting?

Frank from Escanaba

Dear Frank,

Time of treatment is determined by the patient’s ability to tolerate treatment. The placement of the teeth that need root canal treatments will affect the amount of time necessary for treatment.

The amount of treatment you need will probably require the services of a sedation dentist. This would have the added benefit of easing your anxiety. If you can’t locate a sedation dentist, or don’t want to go to one, then the length of treatment is largely decided on your ability to tolerate treatment. Your anxiety will probably lessen your ability to spend long hours in the chair, so consider this when you are deciding whether or not to go with a sedation dentist.

If you can’t locate a sedation dentist, you may want to consider going to an endodontist. A specialist will reduce the amount of time you need to spend in treatment.

This blog post created for Lafayette Louisiana cosmetic dentist Dr. Mike Malone.

T

Uncategorized

What if Novocain doesn’t work for me?

I have a problem. The numbing medications used by dentists simply do not work on me like they do on other people. Added to that, I have put off some pretty extensive dental work that needs to be done, and now the thought of having to go through that without adequate pain medication is literally keeping me up at night. Between my aching teeth and the idea of what I am going to have to go through to get them fixed, I am missing a lot of sleep.

I really think the only way I am going to be able to get this done is if I am out cold. Are there dentists out there that will knock you out to get extensive treatments done? I know oral surgeons can put you out for wisdom teeth removal and things like that, but I have never looked into what can be done if pain meds simply don’t work.

Lula in San Francisco

Dear Lula,

Yes, there definitely dentists out there that can help you. They are called sedation dentists, although you will sometimes hear them referred to as “sleep dentists” or their practices called “sleep dentistry”. This is not a technically correct term, as their patients are not actually sleeping.

Most of these dentists use what is called “conscious sedation”. This means that you are not fully unconscious for the procedure, though most people don’t remember anything about the treatment. Conscious sedation medication is usually administered through an oral pill, taken before the appointment. For this reason, if you are undergoing a procedure that involved oral sedation, you must have someone available to drive you to and from your appointment, and you probably will not be able to return to work that day.

We should mention, too, that sometimes the Novocain or other numbing medication is not as effective in patients who have a high level of anxiety. Many dentists have great success using nitrous oxide (also called NO or “laughing gas”) to help their patients relax, and then administering the numbing medication. The really great thing about that is that you don’t have to have someone drive you to and from the appointment. The effects of nitrous oxide wear off very quickly, and have no lingering effects that preclude driving or returning to work.

If you and your dentist talk through all the options and you are still not comfortable, then some dentists are trained to administer general anesthetic. Only you and your dentist can decide what level of intervention is necessary for you to get the treatment you need.

Good luck to you.

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