Category Archives: Sedation Dentistry

12 Shots of Novocain to Get Me Numb

I recently had a tooth extracted. The whole procedure was a nightmare. It took twelve shots to get me numb. I don’t know how a dentist can miss a spot that many times! Have you heard of this happening before? Is there a way for a dentist to find the right spot the first time so I don’t have to go through that again?

Paula

Dear Paula,

woman wearing nitrous oxide nose piece

While it is possible that your dentist missed the spot to numb your tooth over and over again, it is much more likely that you had some dental anxiety in the beginning which worked against your numbing medication. Then, as you were still in pain, your anxiety went up even more, creating a vicious cycle. There are too many dentists who do not realize the link between anxiety and the inability to get numb in the dental chair.

The simplest solution to this is to find a dentist who offers dental sedation options. It may be all you need is some nitrous oxide, which is administered with a nose piece, as in the image above. This can relax you enough to enable the Novocain to do its job properly. However, if your level of anxiety is super high, you will be better served with oral conscious sedation. This is significantly stronger, in fact, you will likely sleep through the entire appointment. Be aware though, that it is so strong you will need someone to drive you to and from your dental appointment. You will not be able to do this on your own.

Those who have dental anxiety have found that by using the appropriate level of sedation for stressful dental procedures, they are able to have stress-free as well as pain-free dental appointments.

Dealing with a Missing Tooth

You didn’t mention what tooth was extracted. In most cases, it will be very important to replace the tooth. This isn’t just for appearances sake, though that is important. Without that space being filled, the adjacent teeth will start to drift or tip into the empty space. This will throw off your bite, which can lead to painful jaw problems and even daily migraines.

The best option for replacing a single tooth is a dental implant. This is what I would recommend to a patient of mine.

This blog is brought to you Gilbert Dentist Dr. Matt Roper.

Must I Go to an Oral Surgeon to Get Dental Work Done?

My dentist tried to numb me for two different procedures. Neither time worked. I’ve always ended up having to go to an oral surgeon and have my work done with an I.V. that knocks me out. That makes getting any dental care quite expensive. Am I condemned to spending a fortune and still not having healthy teeth? Have you heard of someone in my situation before? Is there a different solution?

Matt

Hi Matt,

Someone asleep from dental sedation

Yes, I think I know exactly what is going on here. The great news for you is there is a solution. One thing I’ve found is that patients with dental anxiety have trouble getting numb. Sometimes it will seem like the numbing medication is working but once the work starts, they can feel pain. However, if they can be relaxed with something like nitrous oxide before the Novocain is administered, then when they are relaxed give them the numbing medicine, it works almost every time.

Some patients have such a high level of anxiety that they need a stronger level of sedation. For those patients, I recommend oral conscious sedation.

For either of these, you will not have to see an oral surgeon. Just do an internet search for a “Sedation Dentist”. They are able to help you in the office, saving you a good amount of money. You will also find that if you use oral conscious sedation, your dentist will be able to do a lot more work in each sitting. This will allow you to catch up on your work more efficiently. In fact, you’ll probably sleep through all the work.

One thing to be aware of, however, is oral conscious sedation, though administered with a simple pill, is so strong you will need someone to drive you to and from your appointment.

Once you’ve caught up with your work, if you’re looking for a quick, inexpensive way to improve the appearance of your smile quickly, I’d consider teeth whitening. That one procedure takes years off the appearance of your smile.

This blog is brought to you by Gilbert Dentist Dr. Matt Roper.

How Much Dental Work Can be Done at Once?

I will be honest and admit that I have neglected going to the dentist for many years now. However, it has gotten to the point that I need to do something. I can see decay and a couple of broken teeth. I’m sure I need even more work than I think I do. In order to get this over with fairly quickly (you can probably tell dentists aren’t my favorite thing), how much work can be done in one sitting, so I can minimize the appointments?

Kirk

Dear Kirk,

Someone asleep from dental sedation

While each dentist varies from office to office in how much they’ll do at each appointment, you will find the dentists who are willing to do the most in one sitting are sedation dentists. There is a procedure, oral conscious sedation (OCS), that enables both the patient and the dentist to get through more work at a time. Some people have dubbed it sleep dentistry because they are so relaxed they end up sleeping through the entire procedure.

There are many reasons patients avoid the dentist. One of the leading causes is dental anxiety, which can usually be traced back to a traumatic dental appointment. Having a means to experience stress-free and pain-free appointments with OCS has changed many lives.

Avoiding a Dental Emergency

Hopefully, you’ll find a sedation dentist fairly soon. I am especially concerned about the broken and decayed teeth. These can quickly turn into a dental emergency if the pulp of the tooth becomes infected. When you think about how close your jaw is to your heart, lungs, and brain, you can see how a simple tooth infection can turn life-threatening.

People tend to underestimate the seriousness of toothaches, which is why even in the twenty-first century we still have people who die from a tooth infection.

I’m not saying this to frighten you. I just want you to recognize, if the tooth starts to feel pain or if a pimple develops on your gums, both are signs of an infected tooth and you will need to be seen as soon as possible.

This blog is brought to you by Gilbert Dentist Dr. Matt Roper.

How Can I Get My Dentist to be More Gentle?

Hello,

I’ve been seeing my dentist for a few years now, and I’m happy with him, but he is the worst at giving shots. My last dentist gave me shots and they didn’t hurt this badly. I had to get numbed to get a cavity filled, and worked up the courage to ask him to be more gentle. He brushed off my concerns, saying that shots are supposed to hurt. The shots he gives are unbearable. I need another filling, and I’m dreading going back to this dentist. Is there anything I can do?

Jirard in Los Angeles

 

Hi Jirard,

The truth is, numbing a patient with minimal discomfort takes skill, time, and patience. If your dentist leaves the numbing gel on for some time, or delivers the injection slowly, this will lessen the discomfort. This gives your body time to adjust to the numbing agent. Injecting it quickly can cause the skin to stretch from too much liquid, and can increase pain.

Your dentist is placing the numbing agent as close to the affected area as possible, but trying to avoid the nerve. Everyone’s bodies are different, so it’s possible he came too close to your nerve, or even hit it. Hitting a nerve sends a shockwave of pain through your mouth.

You did the right thing by speaking up. However, your dentist not only dismissed your concerns, he refused to try. This is a major red flag, and shows he lacks in bedside manner.

There is something you can do to minimize pain. Make sure you are hydrated, as this can make getting numb easier. Also, feeling anxiety before numbing can cause a counter effect, where it’s harder to get numb. You can try relaxing techniques before going to the dentist, or ask for nitrous oxide to relax in place of the shot.

Since you are dreading going back to this particular dentist, it may be time to look for a sedation dentist in your area. Sedation dentists focus on gentle dentistry, which can reduce dental anxiety and pain. It may be worthwhile to find a dentist that listens to your needs.

This blog post is brought to you by Gilbert gentle dentist, Dr. Matthew Roper, of Vista Dorada Dental.

 

 

Why Won’t Novocain Make Me Numb?

Hi,

I need a root canal on two front teeth on my lower jaw. Despite an infection and nerve damage, my dentist cannot get these teeth numb enough for a root canal. He did over 5 injections in my gums and even used a numbing paste, but it still wasn’t enough! He didn’t charge me, but I’m tired of living off pain killers. I need this root canal, but can’t unless I get numb. What can I do?

Miranda, from Mexico

 

Hi Miranda,

Your problem sounds like it’s related to dental anxiety. Research has shown that each time the tooth fails to get numb, anxiety increases substantially. Anxiety counteracts novocain; the higher your anxiety, the more difficult it is to numb your mouth.

Unfortunately, your dentist did not understand the correlation between increased anxiety and the need for more novocain. The dentist needs to write you a script for anti-anxiety medication. You will be instructed to take the medication before your appointment, about 30 minutes to an hour before. No matter the medication, you will need someone to take you to and from the appointment.

Another option is to find a sedation dentist that offers nitrous oxide. The difference between taking anti-anxiety medication prior to your appointment or getting nitrous oxide is that nitrous oxide will wear off shortly after the appointment. Gentle dentists offer sedation dentistry, as they understand how anxiety-inducing going to the dentist can be.

If your dentist does not offer sedation dentistry, try to find one, and hopefully under their guidance, you can be numb enough to finally get your root canal.

This blog post is brought to you by Gilbert sedation dentist, Dr. Matthew Roper, of Vista Dorada Dental. Dr. Roper offers both nitrous oxide sedation or a prescription for Triazolam for dental anxiety.

 

Can You Get Sick from Dental Sedation?

Hi,

I started seeing a gentle dentist for my dental anxiety. Sedation is supposed to calm your nerves, but I’m worried about getting it at my upcoming dentist’s appointment. I’ve heard it causes nausea, and the painkillers you get afterwards can cause drowsiness. Those two side-effects mixed together is a recipe for disaster. I’ve never had any adverse reactions to medications before, but I’m still worried. Is choking on your own vomit a risk after dental sedation? Or am I overthinking this?

Samira, Sterling, Colorado

 

Hi there Samira,

There are different levels of sedation and medication a dentist can provide.

The first is nitrous oxide, Also known as laughing gas. This is the sedation of choice for gentle dentists, because it works fast and wears off quickly afterwards, before you even leave the office. You may experience some nausea afterwards, but not necessarily vomiting. Most procedures using nitrous are relatively short, but the longer you are under sedation, however, the amount of nausea you may experience increases. To reduce this risk, don’t eat before your appointment.

The second is oral conscious sedation (OCS): This method uses nitrous oxide and an oral medication (like a sedative, anti-anxiety medication, or anti-histamine) prescribed by your dentist. The type of medication prescribed will depend on your dentist’s personal preference and which one best suits your needs; for instance, at Dr. Roper’s office, he prescribes Triazolam, a safe method of oral sedation.

It’s also recommended you have someone take you to your appointment and check in with you for a few hours after the appointment. Again, to combat nausea, your dentist will schedule you for a morning appointment, and instruct you to not eat the night before or morning of your appointment. Even with this stronger sedation, no cases of asphyxiation during sleep have occurred, so please do not worry.

In summation, nausea is a common side-effect of sedation, but vomiting is not. Talk to your doctor about your fears, and they should be able to give you advice on how to minimize your experience with side-effects.

This blog post is brought to you by Gilbert sedation dentist, Dr. Matthew Roper.

Do i have to see an oral surgeon for my tooth extraction?

I have a strong apprehension to dentist offices. Therefore, I have not maintained a practice of attending regular dental check-ups. Then, a few years ago I lost a filling. I put off taking care of this and later that tooth broke. I prolonged having this looked at until the pain from the broken tooth became too much to bear.

When I finally saw the dentist, I learned that I needed a root canal. Following the root canal, the dentist did not follow up with me. However, because the pain had decreased for the most part, I did not follow-up either. I also did not have a cap put on the temporary filling. Therefore the temporary filling later fell out and an infection developed.

When I saw a different dentist about this, I learned the remaining part of the tooth needed extracted. In addition, because of the tooth’s poor condition, it was going to be quite invasive, involving the gums down to the bone. The dentist recommended I see an oral surgeon for the procedure and be under anesthesia. This is not something I can afford. Is an oral surgeon my only option, or can a general dentist conduct the procedure?

Thank you,
Jessica

Dear Jessica,

Your dilemma is an understandable one. First, it is important that you understand the reasons to see an oral surgeon for a procedure like this one. It would also be a good idea for you to develop questions to ask your dentist, to help you determine if an oral surgeon is the best route for you, even considering the cost.

Reasons to See an Oral Surgeon for Tooth Extraction

It could be that the dentist you say is not comfortable doing such an invasive extraction. He may be suggesting you seek out an oral surgeon to prevent himself from getting into trouble by taking on a procedure like this if it is outside his realm of experience.

Secondly, the procedure may be a traumatic experience for you, the patient. Therefore, he is suggesting seeing an oral surgeon in order for you to be under anesthesia, in order for the procedure to be easier on you.

Dental Anxiety Can Be Costly

As you are learning, the anxiety that sometimes accompanies dental visits and procedures can be quite expensive. If you had immediately replaced your filling after it fell out, there would not have been a need for the root canal you had. In addition, if the dental crown would have been placed quickly following the root canal, the tooth would not have needed extracted. And, if the tooth does get extracted, you may later need it replaced in order to keep your bite from collapsing.

Therefore, the idea of moving forward with the extraction procedure being done by an oral surgeon will prevent you from having a traumatic experience, which would just further amplify your dental anxiety and cause future dental issues for yourself.

Questions to Ask Dentist About Tooth Extraction

It is important to develop specific questions for your dentist, in order to help yourself better answer your question. Try asking how comfortable your dentist feels doing performing a procedure like this. Also consider asking if he has performed extractions like this before. It would be a good idea to find out if there is nitrous oxide available to help with your comfort level. Understanding if your roots are straight or tapered, or twisted with knobs on the end, would also be helpful.

From what you’re describing, it does sound like your dentist is sharing his fair and honest opinion with you, so place significant value in that while making your decision.

This blog post is sponsored by the office of Gilbert sedation dentist, Dr. Matthew Roper.

Dental numbing medications don’t work on me

I have found that numbing drugs do not work on me, like they typically would on patients. After several horrific experiences, it has been determined that I am extremely sensitive to the numbing drugs that dentists use and have learned that the only way for me to handle a dental procedure is to be unconscious. Do you have experience with patients like me?

Sincerely,
Richard


Richard,

There are many patients who have similar experiences with numbing drugs. For some, nitrous oxide will calm them enough for a drug like novocaine to work. However, others need to be completely sedated to become numb. If we are stressed or anxious enough, there is something in our body chemistry that prevents novocaine from working completely, or causes it to quickly wear off. It is typical for a patient to be hesitant to admit they have experienced something traumatic with a dental procedure. When this is the case, they would be given an injection of novocaine to numb the injection spot, allowing the dentist to know they are ready to proceed with the work. However, they begin to feel pain once the procedure has begun. This leads to nitrous oxide gas. However, if the dentist doesn’t wait long enough after administering the gas, the patient will still fill the pain. If a dentist waits until the patient is in a very relaxed state, then administers the novocaine again, they are typically fine. Sometimes, patients will need a stronger sedation and then for the novocaine to be administered again after they are fully sedated. This typically happens to patients who have had traumatic dental experiences.

It would be a good idea for you to look for a sedation dentist, or one with sleep dentistry experience. Conscious sedation is a more affordable dentistry option than general anesthesia. It is also safer and easier to administer. In fact, most patients are unable to recall the appointment. However, if this option doesn’t work for you, you may need to go the general anesthesia route.

This article was brought to you by Gilbert sedation dentist, Dr. Matt Roper.

 

 

 

 

 

 

 

 

Can I stay with my daughter during a sedation dentistry appointment?

My pre-school aged daughter has a significant-sized cavity on one of her back molars. Her dentist suggested using Nitrous oxide to sedate her, in order to place a filling. On the day of the appointment, I was told I could not go into the room with her for the procedure. She is three! Furthermore, in those three years, she has never been sedated. When I questioned this, I was told it was office policy and there was no way around it. Therefore, I canceled her appointment. Is this a common policy? It seems ludicrous for a parent not to be allowed to accompany a three-year-old for a dental procedure, especially one which involves sedation.

Thank you,
Mindi

Dear Mindi,
The presence of a parent during a dental procedure is really the choice of the provider. Oftentimes, the nervousness or fear that a parent is experiencing during a dental procedure is very obvious to the child, and, therefore, wears off on the child. Parents may say things like, “squeeze Mommy’s hand if you’re scared, or if it hurts, ” thus, letting the child know that being scared of feeling pain is an option, when they otherwise may not know this. Sometimes, it is easier for everyone if the only person the child has to focus on is the dentist. This also allows the dentist to give your child and the procedure he or she is performing their sole focus, as opposed to focusing on the procedure, the patient, and you. Sedation dentistry is not any different than a medical procedure. If you were to take your child into a hospital for a surgical procedure, you would not be allowed in the operating room with him or her. This seems to be a policy that many dental providers have also adopted. Though, I am sure you can find a provider who will allow you into the procedure room with your child if you look further.

This post was written by the office of Gilbert sedation dentist, Dr. Matt Roper.

Can I see a sedation dentist if I’m on medication?

I need to see a sedation dentist, but experience depression and anxiety, and am on several medications to manage them. Is this something that will prevent me from receiving sedation during my dental treatment?

Thank you,

Nikki

Dear Nikki,

There is not one specific medication used by all dentists. Each chooses his/her own sedation medications based on their dental experiences, philosophies, and the medical history of the patient. The only way to know which medication is used is to go directly to the sedation dentist who is treating you.

You will need to take a full list of your medications, including the amount and frequency, to your dentist. He or she will use this list to determine which medications are right for your dental treatment. If their typical treatment will conflict with your medication, the dentist should offer to find an alternative. If not, he or she should refer you to someone who can help.

If possible, you should also consider sending your medication list to the dental office in advance. The staff should be able to advise you if they are unable to treat you. Most likely, they will advise you to come in to discuss a treatment plan.

This article is brought to you by Gilbert sedation dentist, Dr. Matthew Roper.