Tag Archives: dental anxiety

Sedation Dentistry and Type-2 Diabetes

If I have type-2 diabetes can I still use sedation dentistry? I have to get my wisdom teeth out and I’m a huge baby when it comes to the dentist. He told me not to worry because I can be sedated. It wasn’t until a few minutes ago that I realized my diabetes might be a problem. I haven’t found anything online, but did come across your blog. I have a glucose monitor that keeps my blood sugar steady, but I do need to eat regularly. I just read the pamphlet that said not to eat the morning of the procedure. That will be a problem for me. Will any of this mess up my sedation?

Cassie

Dear Cassie,

woman asleep in the dental chair from dental sedation

I am so sorry you are having to deal with this. Diabetes brings so many worries into a person’s life. The good news is having sedation dentistry done, will not have to be one of them.

It sounds like your diabetes is being well controlled with your glucose monitor and you stay on top of things. That is wonderful and will be very important because of the impact diabetes has on your ability to heal.

My recommendation for you will be oral conscious sedation. This is sometimes called sleep dentistry because you are so relaxed you sleep through your appointment. Unlike general anesthesia, you will be okay to eat before the procedure with this type of sedation. It is administered by a pill. You will need someone to drive you to and from your appointment, as well as to stay with you for several hours after your procedure. Whoever you choose as your caregiver will need to make sure you are completely lucid and steady on your feet before leaving you on your own.

When you arrive at the office, all of your vitals will be recorded. Make sure to let them know your most recent HbA1c levels.

You probably already know this but diabetes can be hard on teeth and gums, so make sure you keep up with your regular check ups and appointments. You mentioned being a baby about the dentist. Don’t feel too bad about that. Dental anxiety is quite common. You could ask for some nitrous oxide for your regular, simple appointments. This is a gas that will relax you and take the edge of the appointment. It’s not as demanding as oral conscious sedation and you will be fine to drive yourself home afterward.

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

Can a Toothache Cause Chestpain?

My mother is in her 80s and absolutely hates going to the doctor and dentist. The other day when I went by to see her, she was chewing weirdly. When I asked her about it she said her tooth has been hurting. She said the pain comes and goes and that it makes her chest hurt sometimes. I went into a mild panic and she got snippy and told me to stop worrying that her chest hurts every time her tooth hurts and it is nothing. Ignoring the fact that I need to get her to see a dentist for her tooth, is chest pain a normal side effect of a toothache?

Selena

Dear Selena,

elderly woman smiling

Both Toothaches and Chest Pain Can Indicate a Heart Attack

I would like you to take your mother to the doctor right away. Chest pain should always be investigated. Although tooth pain is not one of the more common signs of a heart attack, it does occur in about 10% of cases. Rather than localized, this type of tooth pain seems to be more across the entirety of the jaw, though it often starts in the lower left.

Some additional signs of a heart attack are:

  • A squeezing feeling in your chest and/or arms
  • Nausea, heartburn, stomach pains
  • Shortness of breath
  • Dizziness and Lightheadedness
  • Cold sweats

Dental Health and Cardiovascular Health are Linked

Your mother implied that she has had several toothaches, which makes me wonder about her oral health. When you take her to the dentist, have him look at her gum health. People with periodontal disease are more likely to suffer a heart attack or diabetes. Getting her heart checked is priority one. Then, if that is clear, then I’d like you to schedule a dental appointment for her as soon as possible. You should be able to get an emergency dental appointment.

If Dental Anxiety Keeps Her Away

You mentioned that your mother does not like doctors and dentists. It is possible that she, like many people, suffers from dental anxiety. If that is the case, then having her see a sedation dentist will make her much more likely to agree to regular treatments. It will enable her to have pain-free/anxiety-free dental appointments.

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

Are All Dentists Sadists?

I am just going to be blunt. I have never had a pleasant dental experience. Here is the pattern. I go in. I get tortured and even have blood all over my dental bib. Not even numbing medication helps. I am too disgusted to go back again for a while and put it off. Then, I start feeling guilty for missing appointments and go in, this time to a different dentist. I get tortured… ad nauseum.

Here is my question. I need a bunch of work but don’t want to go to more appointments than is necessary. How much work can I get in during just one appointment? I figure I can just bring a flask of whiskey with me or something to steady my nerves and just grin and bear it.

Louis

Dear Louis,

Gilbert dental anxiety
Dental work can be intimidating…but there is a solution.

I’m sorry you have spent a lifetime having this trouble with dentists. Believe it or not, most dentists went into their field because they wanted to help people, not because they enjoy causing pain. My guess is there is a three-fold problem that is causing this cycle. We can go into that in a moment. First, I want you to know that there is a solution, so as I am going through this cycle, know there is hope.

First, early trauma. There is likely some point in your childhood where you had a frightening or painful dental appointment.

Second, anxiety. That early trauma set up a pattern of dental anxiety. This is a big deal because when a patient is anxious, it is actually harder for the numbing medication to work. The higher the anxiety, the faster the medication burns off.

Third, avoidance. The trauma and anxiety you’ve experienced keep you away from the dentist, which in turn allows for more buildup and problems with your teeth. This can lead to gum disease, which is painful to deal with and will bleed during your appointments, as well as large deposits that are harder to remove.

The solution is to get you relaxed enough for the numbing medication to effectively do its job. My recommendation, because of the severity of the experiences you’ve had, is to look for a dentist who offers dental sedation. You can do an internet search for one of the following terms to locate them:

In your case, I am going to recommend you find someone who specifically uses oral conscious sedation (OCS). Oral Conscious Sedation is administered by a pill. Don’t let that fool you, though. This pill is so strong that you will need someone to drive you to and from your appointment, as well as, stay with you for a few hours while you get lucid and steady on your feet again. Because you are so comfortable and relaxed, you are most likely to sleep through your entire appointment. This works in your favor when you need a lot of work done because it allows you to get more work done in each appointment than you would normally be able to. This will help you catch up faster with oral health care.

I think you’ll find this simple step will completely change your experience with dentists.
This blog is brought to you by Gilbert, AZ Dentist Dr. Matt Roper.

Dentist Cut My Tongue; Shouldn’t I Get a Discount?

I had to have some dental work done. Three crowns in all. It was a horrible experience. He did give me nitrous oxide, but that did not really help. At some point, the dentist splashed some type of chemical in my eye, which burned like crazy. Then, his drill slipped and cut my tongue. Both he and the assistant gasped when it happened. And, I yelled because, obviously, that hurt a LOT. It’s been a couple of days and my tongue still hurts. I called to ask for a discount because of all the accidents he had. He just acted like none of it ever happened and said I probably bit my tongue because patients do that when they’re numb. Don’t I deserve an apology and a discount?

Steph

Dear Steph,

toothache

While you certainly deserve an apology and recognition of what happened, it appears your dentist is in defensive mode and is pretending what you said did not happen. That means you won’t get the apology or the discount unless you push it. There is not enough damage to warrant a lawsuit, but you could tell him you are going to write a negative review if he does not own up and take responsibility. That does have an impact on his business. Short of that, your only other option is to move on and find a different dentist.

If you do go with another dentist, I am going to suggest you find someone who offers dental sedation. You mentioned that the nitrous oxide didn’t help. Plus, with the number of accidents you had, I wonder if you weren’t wiggly. That’s not excusing what happened but would explain some of it. Both of those things together tell me that you have some dental anxiety. Plus, given this latest experience, you’ll have greater anxiety next time.

A dentist who offers sedation will have oral conscious sedation. This is a pill that you will take before your appointment. It is much stronger than nitrous oxide. In fact, you’ll probably find that you sleep through your entire appointment.

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

Should an Oral Surgeon Do This Extraction?

I had a tooth that I neglected years ago because of a phobia I have with dentists. When the pain became too much to bear I went to see somoene who did a root canal treatment. As expected, the appointment was a nightmare. I did not follow through with the dental crown and neither did the dentist. At the time, I considered that a blessing. Now, the tooth is so far gone that it broke. I went to see a different dentist and he said it is infected and needs to be extracted. He gave me two options because of the state of the tooth. I could do it with him using a local or with an oral surgeon using anesthesia. I was tempted to go with the anesthesia because at least it would be pain free. But, the cost is way more than I can do and the oral surgeon wants payment up front. Here is my question. Am I putting myself at risk by doing this with the dentist? If so, I guess I could try to get a loan to use the oral surgeon.

Dennis

Dear Dennis,

woman asleep in the dental chair from dental sedation

There should not be a reason that a dentist could not do this extraction for you in complete safety. However, that does not mean the dentist you saw is qualified or comfortable doing it. The fact that he suggested an oral surgeon tells me he is not. Plus, given your dental anxiety I do not think a local alone will be enough.

My suggestion is that you see a sedation dentist. They can provide you with oral conscious sedation. This is administered by a pill but strong enough where you can sleep through the entire procedure pain-free. Be aware that you will need someone to drive you to and from your appointment.

The really great news is people in your situation, with anxiety of the dentist, have found that using dental sedation has changed their lives. They’re not only able to get the help they need without fear, but are able to stay on top of their dental care from then forward.

I hope this gives you some confidence.
This blog is brought to you by Gilbert Dentist Dr. Matt Roper.

Luster Premium At-Home Teeth Whitening

I don’t really feel comfortable with dentists but want to whiten my teeth. I saw an advertisement for a DIY kit call Luster Premium At-Home Teeth Whitening. It seems to have one of those light things that dentists use with teeth whitening. Do you know if it is safe? There are some good reviews, but these days it is hard to tell if they are legitimate.

Kristen

Dear Kristen,

teeth whitening trays
Professional teeth whitening trays

Looking at this particular whitening kit, I am glad you wrote before purchasing it. It won’t harm you, but you won’t be getting the whitening you think you are. True teeth whitening kits use a special peroxide gel to get your pearly whites looking youthful and bright again. Many over-the-counter kits have a legitimate ingredient, such as Crest Whitestrips. Though, by law, they are significantly weaker than what you would get with a dentist’s office.

Unfortunately, this kit doesn’t use a legitimate whitening ingredient. The whitening effect they achieve appears to be from a pigment in the zinc oxide. The pigment will stick to your teeth and make them look whiter, but only temporarily. The pigment will only last a few days. My suspicion is many of these positive reviews were written before the pigment wore off.

The light is another issue altogether. It is too weak to be of any effect even if they had a valid teeth whitening ingredient. It appears to be there for psychological effect. So, you essentially have a company using a bogus lamp that is supposed to aid the whitening, with an ingredient that merely colors your teeth.

If you are absolutely committed to doing this without a dentist, I suggest you use Crest Whitestrips. At least their product will work. It will cost you more in the long run to get the same results you would with a dentist, but it will work.

Dealing with Dental Anxiety

You mentioned being uncomfortable with the dentist. I wanted to make sure you knew dental anxiety is a pretty common thing and there are dentists equipped to help. Most dentists who enjoy working with and helping anxious patients will have a way to locate them on the internet by doing a search for a sedation dentist.

There are medicines available that will relax you in the dental chair and give you an anxiety-free and pain-free experience. I’ve found this has changed the lives of patients who were afraid to go to the dentist. Now they are able to get regular dental care and get the work done they’ve been avoiding for years.

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

She Should Not Trust This Dentist

I need some advice. I went to the dentist because of a toothache. It was actually hard for me to go because I have a lot of dental anxiety. When I got there he said that there is an infection in a tooth that already had a filling. He said the tooth is too far gone to save and it needs to be extracted then replaced with a dental implant. He gave me some antibiotics and scheduled me to come back in less than a week for the extraction. I’m having serious doubts about this, but it may just be because I don’t like dentists. Should I just move forward with this or are there other options?

Mandy

Dear Mandy,

A woman grabbing her jaw in need of an emergency dentist

I am very glad you wrote. I think you need to get a second opinion before moving forward with this. If the tooth were as far gone as the dentist indicated, he would not have needed an x-ray to see that. Your filling would literally be falling in on the decay. Plus, you would have been having severe pain for a while and that isn’t something you mentioned. You seemed to indicate the pain was fairly new. Have another dentist look at this just to make sure this is what your tooth really needs. It’s better to be safe in cases like this.

It showed real courage and wisdom to go to the dentist when you had a toothache, even with your dental anxiety. Tooth infections are considered dental emergencies and you did the right thing even if I am not sure you should trust this dentist.

I want to address something that can help with your anxiety. When you get your second opinion, try to find a dentist who offers dental sedation options. Doing it that way will enable you to get an anxiety-free and pain-free appointment. Patients with anxiety find dental sedation can change their lives and enable them to finally get all the dental work they’ve been avoiding for years done.

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

My 5 Year Old’s Teeth are Rotting

I have a difficult 5-year-old. I do brush her teeth, but she is a nightmare when I do it. Actually, she’s a bit of a Tasmanian devil. This is especially true in the dental chair where she refuses to cooperate any time they try to do work on her. She now has one molar with a cavity, two that the dentist is saying need to come out, and decay on several other teeth. What is your recommendation for something like this? I don’t know how to get the work done for her.

Patty

Dear Patty,

Young girl in a dental chair smiling

I can tell you are worried and want the best for your daughter. I do have a way for your daughter to get the dental care she needs with minimal fuss, but I am also going to suggest some tough love to help in the long run with her oral health care. The extensive amount of decay you are describing at her age is almost always a result of constant snacking and drinking.

Our saliva is a big help in the fight against decay. It contains minerals that help fight bacteria between meals. But, when we are snacking or drinking (with the exception of water) too often, it doesn’t give our saliva time to do its job. This leads to extensive decay, even when we have good oral hygiene.

I’m going to strongly recommend you don’t let your daughter eat between meals for a while. She won’t starve and it will help her be hungry for the nutritious meals you make rather than snack throughout the day and not get the value out of the healthy food you make. Juice and soda should also be limited because of the citric acid and sugar contained in both of them.

When you have a child who will not cooperate with their pediatric dentist but there is important work that needs to be done, you may have to use dental sedation. This is sometimes called sleep dentistry because even adults are so relaxed when they use this aid that they can sleep through their entire procedure.

What you don’t want to do is put off this treatment at all. Tooth infections are considered dental emergencies. This is because our jaws are close to our hearts, lungs, and brains. A dental infection can turn life-threatening quickly.

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

CEREC Crown Disaster

I was told getting a CEREC crown would be a snap and fit better than other crowns. Not only was I in the chair for over three hours, but the crown didn’t fit properly. She said it was because my tooth was in really bad shape so she had to take a general model from the database. It doesn’t fit at all like my normal teeth or even my other crowns. In fact, she had to grind it down because it didn’t fit in properly. Now it hurts. What do I do?

Carol

Dear Carol,

porcelain block for CEREC crowns

Something is wrong here. Let’s start with your dentist’s statement that she had to use a general model from the database. Her reasoning that the tooth was in too bad of shape doesn’t make much sense to me. Of course the tooth was in bad shape. That is the whole point of needing a dental crown! Why would you put a crown on a healthy intact tooth?

CEREC crowns should fit better than other crowns because they are designed and milled using precision software. However, computer software is only as good as the person programming it. Though, this software is pretty user friendly. For instance, let’s say you were missing your lower left molar. Your dentist would program that in and the software would give her a basic shape to use for that type of tooth to start the design. From there, images of your surrounding and opposing teeth give her the remainder of the information she needs to input into the software. Then it designs the crown.

Your crown is uncomfortable and she had to do grinding on the tooth, so clearly this didn’t happen properly. There are so many things that can go wrong with a dental crown. Here are just three:

  • Open margins. If the crown does not fit the tooth perfectly around the complete circumference of the tooth, then you will have a gap where bacteria can get in leading to decay under your crown.
  • Bite Design. When a bite isn’t designed properly, it throws off occlusion and you will end up with painful TMJ Disorder issues.
  • Poor Contouring. If the tooth is not contoured properly, you will have gum inflammation, which will lead to gum disease.

What this boils down to is you need to have this tooth looked at by another dentist. If they can tell you what is wrong with it, you can get either ask her to re-do the crown or ask for a refund and have it redone by another dentist.

This blog is brought to you by Gilbert Dentist Dr. Matt Roper.
We help patients with dental anxiety.

Dental Care for Addication Recovery Patients

I am on methadone treatments while I am in addiction recovery. I have a lot of dental needs as a result of neglect during my years of addiction. I’m in a lot of pain, but the last time I went to a dentist he refused to give me any pain meds for after the treatment. It was excruciating. I don’t know if I can go through that again. Is there any dentist who will understand my situation? I am willing to allow them to talk to both my doctor and counselor. I’m hiding nothing. I just need to get my teeth tended to without having to face agony afterward.

Paul

Dear Paul,

Man in pain, grabbing his cheek in need of emergency dental care.

I am sorry for all that you are facing. You show remarkable courage for both your ability to face your addiction as well as your desire to get your oral health under control. One of the things you are facing is that many dentists are afraid of the Drug Enforcement Administration (DEA) which sometimes cracks down without considering the individual case.

What you need is a dentist who is willing to put his compassion above his fear. You may be better served looking for a sedation dentist. They are already compassionate and treat patients with dental anxiety. You may have to do some calling around, but I am convinced you will be able to find one who will be willing to work with you. Be upfront before scheduling and ask to talk to the dentist directly, explaining you have a unique situation.

One other suggestion. With a sedation dentist, you should have the option of using oral conscious sedation(OCS). This will allow you to get more work done in each sitting than would otherwise be possible, enabling you to catch up on your work much sooner. Plus, it is strong enough that if you wanted to, you’d be able to sleep through your dental appointment.

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