Tag Archives: Nitrous Oxide

Sensitive to Novocain

I have a high sensitivity to Novocain and any type of numbing medication, but want to get porcelain veneers. A friend of mine with a similar condition said that when they put the numbing medication on her she became very shaky and had a hard time calming down. I don’t want that to happen to me so was wondering if there was a way around this.

Callie


Dear Callie,

a porcelain veneer being held up to a tooth

I think you are going to be okay to get the porcelain veneers. Your friend’s reaction is unlikely to be from the Novocain. There’s a very slight possibility that it would be in the epinephrine that is often present in Novocain, but I find that unlikely. The reason for that is the amount of epinephrin in Novocain would be significantly less than what is present in your body when you become fearful.

It is more likely that your friend has dental anxiety which made her shaky. If you have dental anxiety as well, then I would recommend you have your cosmetic dentist provide you with nitrous oxide. Don’t let a dentist talk you into a stronger sedation for your porcelain veneers procedure. It is not a painful procedure at all. This will relax you enough that you won’t have anxiety.

With nitrous, your dentist can switch it back to oxygen and you will be back to normal in just a couple of minutes and can approve or disapprove your smile makeover. If you use anything stronger, then you will be way too groggy to approve anything. You could end up with a smile you hate.

You also want to make sure whoever is doing your smile makeover has extensive post doctoral training in cosmetic dentistry. It would be ideal if they were AACD accredited. These are the top cosmetic dentists in the country and will give you a stunning smile makeover. At the very least, make sure that they have a beautiful smile guarantee which allows you to approve the smile. If you don’t love it, then they should be willing to go back to the lab and make any changes you want.

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

Can I Use Sedation for a Smile Makeover?

I want to get a smile makeover but I am a nervous dental patient. Would I be better off getting dental sedation so they can just knock me out, do the work, and I wake up with a beautiful smile?

Candy


Candy,

Woman resting in dental chair from dental sedation

I am sorry for your dental anxiety. I want you to know that you are not alone in feeling this way. Hopefully, you go to a dentist who is understanding about your fears. It can be very helpful to go to a dentist who is compassionate with patients who are anxious.

While I am a big proponent of using dental sedation, the one concern I have about using it for your smile makeover is that, depending on the type of sedation you use, you won’t get to approve the smile before it is bonded on permanently.

If you are getting porcelain veneers, very little shaving needs to be done on your teeth. The dentist will give you something like Novocain, which will make you completely numb. If that still scares you, then you could have some nitrous oxide. Unlike oral conscious sedation, which will make you too sleepy/loopy to make an informed decision in approving the porcelain veneers, your dentist can switch the nitrous to oxygen once the porcelain veneers have been placed with a temporary try-in paste. This will enable you to be lucid enough to decide if they are to your satisfaction and ready to permanently bond on.

Never allow a cosmetic dentist to bond on your veneers without your getting to see them and approve them. If you don’t absolutely love how they look, the dentist should make the changes needed.

Unfortunately, smile makeovers are not adequately taught in dental school. In order to develop the technical skill and artistry necessary to create beautiful smiles, they will need post-doctoral training. I would look for a dentist who is accredited with the American Academy of Cosmetic Dentistry. AACD accredited dentists are the best cosmetic dentists in the world. You can feel confident that they will give you a stunning smile.

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

Need Advice about a Tooth Extraction

Years ago I had an infected tooth. I avoided the dentist because I have never had a good experience with one. When I could not take the pain anymore, I schedule an appointment. He said the tooth was infected and performed a root canal treatment. I was supposed to schedule a follow-up appointment for the cap, but never did. I probably should have because it seems like the tooth got reinfected. It hurt again and pieces started falling off. I went to another dentist who confirmed the infection. I received quite a lecture about the state of my teeth and not getting regular care. He told me it would be a tough extraction. The best he could offer me was nitrous oxide. If I didn’t think I was able to handle the procedure, he could refer me to an oral surgeon. I was thinking I would go with the oral surgeon. However, it turns out they are a LOT more expensive. Would I be able to get this done with a dentist and it not be an absolute nightmare or do I need to take out a loan and see the oral surgeon?

Imogen

Dear Imogen,

Woman resting in dental chair from dental sedation

I am going to say right off the bat that this dentist you saw will not be the best dentist for you. What you need is compassion and a solution, not a lecture. That does not lend toward helping patients feel comfortable going to the dentist.

You should not have to take out a loan and go to an oral surgeon for this extraction. The right dentist can do this extraction for you. What I think you need is a dentist who offers other, stronger, dental sedations options, such as oral conscious sedation.

They are generally more compassionate with anxious patients than the dentist you just experienced. Let them look at the tooth and tell you whether or not they can do the extraction. My guess is you will find someone. It sounds more like this dentist was out of his comfort level and was trying to push  the blame off on you.

With oral conscious sedation, you are not knocked out, but will be so completely relaxed that you will be able to sleep completely through the procedure if you want to.  Most patients who use dental sedation find it completely changes their life and they are able to get the dental care they have always wanted.

The only downside is, because of its strength, you will need someone to drive you to and from your appointment, as well as stay with you for a few hours after the procedure. They will want to make certain you are lucid and steady on your feet.

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

Should I Take My Son to a Sedation Dentist

I’m sort of kicking of myself for how my son’s last dental appointment went. He’s been going to my dentist for all his check ups. This last appointment didn’t go so well. He’s six year old and normally does so well. This time, however, he was a bit fidgety. Our dentist said he had a cavity and mentioned that he could take care of it right then. My son melted down and slid out of the chair and started crying. He didn’t let anyone touch him. Now I’m wondering if I should have not tried to bring him to a sedation dentist. Now I am afraid he’ll never cooperate at the dentist again. Did I ruin his view of the dentist by not planning ahead?

Callie Anne

Dear Callie Anne,

Children in a line smiling

I’m glad you wrote. I don’t think you’ve completely ruined your son. Hindsight is always 20/20 so don’t judge yourself too harshly. You obviously care about your son and have been careful to take care of his oral health. It is equally obvious that your dentist is not used to working with children. Had he been familiar with children, he would not have just sprung a new procedure on your son like that. Children need a little bit of preparation for the unfamiliar.

My suggestion to you is similar to what you’ve already figured out. It would help him adjust back to the dentist by having sedation for this filling. I don’t think he would need anything strong, such as oral conscious sedation. Just some nitrous oxide would be enough to relax him enough to be calm and allow the dentist to do the work.

However, I am also going to suggest you look for another dentist for your son. It does not have to be a pediatric dentist. Instead, you could see a general dentist who is good with children. One way to know if they enjoy children is to ask what age they are first willing to see them. If they first see children around two years old, you can know that they enjoy working with children. If they want to wait until they are around five years old, then I would look for someone else.

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

Dentist Is Growing Frustrated with Me

I have problems in the dental chair. I don’t know what it is but every time the dentist or hygienist comes at me with something sharp looking, I can’t help but wiggle and sometimes even have trouble breathing. I thought my dentist was understanding. We’d had a couple of appointments where he waited for me to calm down. However, at my third appointment, he said, “You’re an adult and should be able to handle this by now.” I was so embarrassed. I know I’m an adult. I know I should be able to handle this by now. But, I don’t know any solutions. Have you had patients who’ve struggled as I do?

MaryAnne

Dear MaryAnne,

Woman resting from dental sedation

I am going to tell you right off the bat that your current dentist is not going to be the best dentist for you. To be frank, he was rude and insensitive to your very real anxiety in the dental chair. Adult or not, many patients are uncomfortable in the dental chair, some so much that they can’t even go and end up only going in for dental emergencies.

I don’t know where you live, but what I would like you to look for someone who considers themself a sedation dentist. Not only will they be compassionate, instead of rude and judgmental, but they also have the tools to give you an anxiety-free/pain-free dental appointment.

What Type of Sedation is Best?

My recommendation is to start with the lowest level of sedation that is useful to you. The lowest level is nitrous oxide, which people used to call laughing gas for the floaty, happy feeling it can give you. This will relax you in the dental chair. A benefit to nitrous is that you can get right back on with your day once your appointment is completed.

For invasive procedures, I recommend oral conscious sedation. This is administered by pill. However, it is so strong that you will need someone to drive you to and from your dental appointment as well as stay with you for a few hours after your procedure until you are lucid and steady on your feet. Most people find they completely sleep through their procedure, leading some to dub it sleep dentistry.

Look for a dentist who offers these options and I think you will find your life changed.
This blog is brought to you by Lafayette, LA Dentist Drs. Foreman and Thimessch.

Dentist Cut Me and I Want a Refund?

My last dental appointment was a disaster. I needed a crown on one tooth and a dental filling on another tooth. It was a two-hour procedure that went from bad to worse, he splashed some type of chemical that got in my eye and burned like mad. Then, he cut my lip with a dental tool. As if that was not enough, he then slipped with the dental drill and cut my tongue. In all this, not only did he not once apologize, but he tried to blame me. He said that none of it would have happened if I would have stayed still like I was supposed to. Is there a way to get a refund from this jerk?

Sunny W.

Dear Sunny,

Woman resting from dental sedation

Unfortunately, though he seems to have very poor skills, I don’t think you’ll be able to get a refund…or an apology. A lawsuit would not really be worth your time or money because I don’t think you could demonstrate there has been enough damage to even cover the cost of the suit. The only thing you can do is write a review warning other potential patients about his lack of abilities and consideration. That will make a dent in his business.

As for the wiggling. Even if you were wiggling, he could have stopped and figured out why you were so uncomfortable so the procedure could have continued safely. My suggestion is for your next dentist you look for someone who is a sedation dentist. They can offer you medication that will completely relax you for the duration of your procedure.

Some options are mild, such as nitrous oxide which allows you to get on with your day as soon as the procedure is completed. If you want something stronger, I’d recommend oral conscious sedation. Though it is administered with a pill, it is so strong that you will need someone to drive you to and from your appointment as well as stay with you for several hours after the procedure. You will be loopy and unsteady on your feet.

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

Twelve Shots to Get Numb?

I recently had a lower second molar extracted. The appointment was a nightmare. First, it took twelve shots for him to get me numb. How he could miss the area that many times is beyond me. Then, I had a bone spur in the area that took the dentist over thirty minutes to get. Now, I seem to have a sharp edge on the extraction site. I’ve sort of lost confidence in this dentist. Can you tell me if this is normal or if I need to have another procedure done to deal with this?

Cassidy

Dear Cassidy,

Woman holding her jaw in pain

I would find it hard to think any dentist would actually miss the spot that many times. The more likely scenario is that you had some dental anxiety going in and, as a result, your body was fighting the local anesthetic.

Unfortunately, not enough dentists currently understand the connection between dental anxiety and the inability to get numb. I am going to recommend for your next appointment where you need any work done you see a sedation dentist. Even just some nitrous oxide will help relax you, which in turn enables the anesthetic to do its work.

For those with a more severe level of anxiety, I recommend oral conscious sedation. While it is administered by a pill, it is so strong that you will need someone to drive you to and from your dental appointment as well as stay with you for a few hours afterward until you are lucid and steady on your feet again. Most people who use oral conscious sedation sleep through their appointment.

As for the bony ridge. sharp edges do show up during the healing process. You don’t notice them at first because your gums are swollen. As the swelling goes down the ridges appear. If it stays a problem, your dentist can clip it.

One thing I want to make sure your dentist addressed is the need to replace that second molar. If you leave the space open, your other teeth can drift or tip into the space, which will throw off your bite. That can lead to painful TMJ Disorder.

If you want the best tooth replacement, I’d look into a dental implant. However, you do have other options.

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

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.

Daughter Broke Her Front Tooth

My daughter fell and broke a chunk off her front tooth. I immediately called our pediatric dentist and he said the soonest he could see her is six months from now. I told him we are pretty anxious to get it fixed and asked him to recommend somewhere. His response was that everyone will tell us that the nerves need time to calm down and then they can see us. For some reason that felt like an excuse to me. If not, why not say that upfront instead of originally saying he’s booked for six weeks? Is there really a necessary time to wait?

Belinda

Dear Belinda,

Your instincts are good. There isn’t really a reason you should have to wait. I’m guessing your pediatric dentist just didn’t want to lose any business. This can be treated right away.

If you have the piece that broke off, a good cosmetic dentist can reattach it. If not, the solution would be to have dental bonding done. This will also need to be done by a good cosmetic dentist. It doesn’t necessarily need to also be a pediatric dentist. There are general dentists who work well with children.

As she ages, the pulp of her tooth will get smaller. At that point, it may be necessary to do a dental crown. Until then, bonding or reattachement are your best options for her.

If she gets nervous at the dentist, look for someone who offers dental sedation. They can give her something to relax her. It doesn’t have to be very strong, even just nitrous oxide will be enough.

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

Are CEREC Crowns Better for Anxious Patients?

I have never been crazy about going to the dentist. I had a toothache and decided to go in because it means something is wrong. It turns out I have a large cavity. Now I have to have a dental crown. I’m really nervous about this. What can I expect?

Belinda

Dear Belinda,

A tooth receiving a CEREC crown

It’s good that you went in. The fact that you did despite your dental anxiety means you are courageous. If you’d allowed your fear to get the better of you, you would have ended up with a dental infection. That would have meant an additional procedure of a root canal treatment. Or, possibly your tooth would not be able to be saved and you’d need to have it extracted and replaced. To get a great replacement, like a dental implant, requires surgery. Obviously, you made the right decision.

What to expect depends on the type of dental crown you’re getting. Did your dentist mention whether you’re getting a traditional crown or a CEREC crown?

What to Expect with a Traditional Crown

If you’re getting a traditional crown, it takes two visits. First, your dentist will have to remove any decay as well as grind down enough tooth structure to make room for the dental crown. You can see how small your natural tooth has to be in the image above. After that, your dentist will make an impression of your teeth and fit you with a temporary crown. The impression will be sent to the lab to make your permanent crown.

It takes a couple of weeks for the permanent crown to be made and sent to your dental office. Then your dentist will call you, fit you with the permanent crown and bond it on.

What to Expect with a CEREC Crown

Given your anxiety, this will be a better option for you. First, they can be done in just one appointment. That minimizes how often you have to come in. Second, many patients hate having to do impressions. The goo is messy and bad tasting. With CEREC crowns, you just have a digital image made and a computer designs the crown. Not only is this less nerve-racking, but it’s also faster and more accurate.

While you’re at the office, the computer will mill the crown immediately and your dentist can then bond it on before you leave.

This is a must simpler procedure. Plus, if you’re still nervous, it’s very compatible with a sedation such as nitrous oxide which can relax you.

A Front Tooth Requires an Expert Cosmetic Dentist

You didn’t mention which tooth is being crowned. If it’s a front tooth, there’s an additional consideration. It’s very challenging to match a single crown to a front tooth. You will need to find a dentist with both technical expertise and artistry.

In your place, I’d look for a dentist who has reached accreditation with the American Academy of Cosmetic Dentistry. Simply go to aacd.com and look for an AACD accredited dentist in your area. They can give you a beautiful crown that blends in perfectly with your other front tooth.

This blog is brought to you by Louisiana Cosmetic Dentist Dr. Mike Malone.