Dental Sedation can be done with a small injection in the back of the hand ( called IV Sedation ) or using a gas called Nitrous Oxide ( often called RA sedation). Clearly for anyone with a needle phobia the IV option already sounds challenging! Either way the aim is that you remain conscious throughout treatment but at such a low level that you will not be hugely aware of what is going on and preferably remember very little or none of it when you recover.
At Craigentinny Dental Care we have in the past provided some sedation services and found that for patients who were really anxious dental sedation was not always the answer they hoped for. Firstly as you are largely unaware of what is going on you have no learning experience. i.e. after treatment you will be just as nervous as before. So as a result you are still likely to feel very anxious on the run up to each and every visit. So over time your fear of the dentist and dental treatment is less likely to diminish.
Generally dentists who provide sedation have had additional training as have the dental nurses who support them, so you simply cannot arrive to see any dentist and be guaranteed sedation. Even if a practice does offer sedation, there may be issues if the right combination of staff are not on duty that day. This then leaves you with a terrible dilemma of living with the problem or facing your fears head on in a crisis situation. Neither option is a good one and likely to help you in your quest to feel more relaxed about dentistry.
For these reasons, I feel that the best approach for the majority of patients is to address their fears slowly and gradually with a caring and sympathetic dentist and nurse who have a genuine interest in helping them. This way we can treat your dental fear as well as treating your dental problems. In time most patients find that this approach leads to a reduction in their anxiety levels and they are more able to cope with routine care.
A typical example that I often hear from patients who come to our dental practice in Edinburgh is “I used to take a whole day off work when I came to the dentist even if it was just for a very short visit but now I just come along before or after work .”
I know that the non sedation route is not the fastest but in terms of treating dental fear in Edinburgh it has proved to be very effective for our patients in the long term. Let me know your thoughs on this........
Following two bad experiences at the dentist 13 years ago, I had developed a dental phobia and put off going to the dentist. 5 years ago I went to the dentist and had treatment using IV sedation. I found the recovery of this quite bad and agree with the comments in your article as I was still terrified of going to the dentist and had no learning experience by having IV sedation.
ReplyDeleteAt Christmas time, I developed an absess in my tooth and tried to register with a dentist. I phoned a couple in my area and was told that at that time they were not taking on any new patients. At this time I took a panic attack over the phone.
Following this, I realised that my fear had taken over and decided to do something about it. I have now found a dental practice that I am happy with and have had my firt couple of appointments. My first was a check up and the next two were with the hygeinist - I even went to this appointment on my own!!
Today was my biggest test however. I was due to have a filling and it was following my injection 13 years ago that I had a panic attack. I went in quite positive but as soon as I was injected, I felt my heart racing again and felt it very difficult to breath. I had an x-ray taken but felt that at this time to go through with any treatment would set me back and I am desperate to beat my fear.
I am due to return next week and my denist will now use the injection without epinephrine. I am concerned that this injection will not be effective. My GP has spoken to me about using Diazepam but again I am not sure if this will help and my dentist has recommended against this. In your experience, can you advise me on my next step?
Depending on the area, injections with Epinephrine can cause you to feel this way. The drug produces a very similar response to our body's natural fight or flight response so if you are alreay anxious this can really make you feel awful just as you described. In my experience the anaesthetics without epinephine can be fine for most treatments but the anaesthesia often wears off a little faster. Diazepam can be helpful but its effects are often variable when used for "one off" type scenarios. I would try without diazepam but have a very good conversation with your dentist ( by phone well in advance of the visit is best ) to let him know just how worried you are and of your concerns. Most good dentists will be happy then to walk you very gently through the process and stop to re assess the situation if you feel unwell. Good luck and let us know how you get on.
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