Tag Archives: oral conscious sedation

I Want to Get ALL My Dental Work Done

I have avoided the dentist for years, but my mouth has been hurting so much that I went in. I need a LOT of work done. A LOT. I know it is my own fault, but I’ve never had a pleasant dental appointment in my entire life. I’ve decided it is time to man up. I want to get as much of this done at once as possible. So, give it to me straight. How much can I get done in one day?

Troy


Dear Troy,

woman asleep in the dental chair from dental sedation

You are not alone in your dental anxiety. Many of those anxieties start because they had a horrible experience at the dentist when they were children. This often happens because parents don’t think very young children need a dentist and wait until there is a problem before they bring them to the pediatric dentist. Then, their first experience in the dental chair is a painful and frightening one. That’s enough to keep anyone away!

I have a couple of pieces of good news for you. One, there is a way for you to have an anxiety-free/pain-free dental appointment. Two, there is a way for you to get more work done than would normally be possible in one appointment. Even better, they both have the same solution.

The best thing for you to do is to see a sedation dentist. They can prescribe you a medication that will completely relax you. I recommend that you find a dentist who offers oral conscious sedation. With this medication you will be able to sleep through your appointment if that is what you choose to do. It is so strong. The only real downside is that it’s strength means you will need someone to drive you to and from your appointment, as well as stay with you for a few hours after your appointment.

Dentists who offer sedation are more compassionate with their patients who have dental anxiety than most other dentists. Plus, because you are so relaxed, or even asleep, you are able to tolerate more work done in each sitting. Though, you need to know up front that dentists vary in the amount of work they are willing to do in each appointment.

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

Should I Wait to Extract an Impacted Wisdom Tooth If It Isn’t Bothering Me?

I have four wisdom teeth. Two are impacted. The one on the top right is bothering me. The one on the bottom left does not. I’m having the one on the top right extracted. My dentist asked if I wanted to extract the other impacted tooth, but warned me the root went past the nerve. He said we could leave the root and that way there’d be less chance of a problem. I can’t decide what to do. That bottom tooth does not bother me so I wonder if I am borrowing trouble by removing it. Is there a standard for this situation?

Miles


Dear Miles,

An illustration with four examples of impacted wisdom teeth.

The most important rule of thumb is to take an impacted wisdom tooth out when you are young. When you are in your late teens to twenties, everything is relatively pliable. The older you get, the greater the risk of complications. By the time you are thirty years old, your risk of complications doubles. Then it doubles again every few years after that.

An impacted tooth almost always becomes a problem at some point. What you don’t want is to wait until there is a dental emergency to have to deal with it. You will have far less control over the circumstances at that point. Leaving the tooth root is not a bad idea. However, I am not in favor of leaving the entire root. I would suggest you just have him leave the root tip that is near the nerve. You’ll reduce the chances of having trouble with it if the root tip is small.

For dental procedures such as yours, where the patient can feel very anxious, I recommend using oral conscious sedation. This will allow you to get the needed work done in an anxiety free/pain free way. In fact, you will be so relaxed that you could sleep through the entire procedure if you wanted to.

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

Novocaine or Sedation for Porcelain Veneers?

I am on the cusp of getting porcelain veneers. I am a bit concerned about the procedure. I have a sensitivity to Novocaine as well as any drugs which can make your heart race. A friend of mine recently had the porcelain veneers procedure done and said that the green topical agent they put on her teeth made her very shaky and nervous. This went on for almost fifteen minutes. Do you know if there is epinephrine in the medication used in the procedure? If so, would I be better off having this done with dental sedation?

Sally


Dear Sally,

An image of a porcelain veneer being held up to a tooth.

Epinephrine’s function in a Novocaine injection is to restrict the blood flow and keep the medication more effective. However, any epinephrine in a body would have very little effect on the symptoms your friend experienced. It is more likely that she was dealing with anxiety. That would be a much higher amount of epinephrine than what would be in the medication given to you.

My advice would be to use a mild relaxant along with the Novocaine, such as nitrous oxide. This will keep the epinephrine in your body from getting too high and causing the issues you are concerned about. As I mentioned earlier, any epinephrine in the medication would be miniscule compared to a body’s reaction to anxiety.

I do not recommend you use a stronger dental sedation such as oral conscious sedation. Though stronger, you will not be lucid. Your dentist should place your porcelain veneers on with a temporary try-in paste. This is so that you can get a good look at the veneers and approve of them before they are permanently bonded on.

If you are practically asleep, as you would be from oral conscious sedation, then you would have no way to approve or disapprove the smile makeover. That is important.

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

Dentist or Oral Surgeon for Denture Surgery

I have always had a fear of the dentist. This really kept me from getting my teeth taken care of. I generally only ended up going in when there was a dental emergency. I know that wasn’t the best way to handle things, but what is done is done. I am now to the point that I need dentures. Most of my teeth are either missing, broken, or decayed. In that case, should I go to an oral surgeon or a dentist to have the remainder of my teeth extracted?

Bruce

Dear Bruce,

Image of dentures

I would go to a dentist who can do both the tooth extractions and the dentures. Most general dentists do pre-denture surgery. It is not a difficult thing to do. I would call to several offices and ask them what the dentist’s normal procedure is. Do not hint to them what you are looking for, just ask about their denture procedure.

Because you struggle with dental anxiety, I am going to suggest that you see a dentist who offers oral conscious sedation. This is sometimes called sleep dentistry because most patients are so relaxed they just sleep through the entire procedure. This will ensure you do not have to have any fear or pain during your procedure.

The reason for using a dentist instead of oral surgeon is to get the best fit possible for your denture. An oral surgeon won’t be as familiar with designing and fitting dentures, as a result they don’t know the things that can be done during the extractions to make this work better.

You should be aware that even the best fitting dentures will reduce your chewing capacity by 50%. There are also long-term consequences, including shrinking of the jawbone. Dental implants can help with both of these issues and I recommend discussing this with your dentist before making any final decisions on your treatment plan.

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

Emergency Dentist Caused Massive Problems

I had a problem where my tooth number 19 became sensitive to cold. I didn’t have a regular dentist because I have a bit of a dental anxiety. Generally, my teeth stay healthy, but this time I could tell something was wrong. I looked online and there was a dentist who called himself an emergency dentist which meant he would see patients who didn’t have a regular dentist. I went in and he did a quick examine and some x-rays. He told me that one of my wisdom teeth is impacted and should probably be extracted, but if I wanted him to do a filling instead, that could fix it as well. I went ahead to have him do the filling. It was just a few days after that when everything blew up. I was in tremendous pain. I went back to the dentist and he adjusted the filling and told me to take over-the-counter pain meds. I mentioned the pain felt deeper and closer to tooth 19, but he said the only other option was to extract the tooth. I asked for a referral to an oral surgeon and went to have the tooth extracted. That seemed to help things and I was relieved. However, when the prescribed antibiotics and pain meds wore off, the pain returned. I could not understand that because there was not tooth left. Eventually, I ended up at the ER in so much pain I didn’t know what to do. They told me that I had an abscess on the tooth which I’d been telling the dentist all along was the problem. I called him and he just told me to give it time. Instead, I went back to the oral surgeon because I didn’t trust the dentist any longer. He said that he didn’t do root canals and I need an endodontist. So, I found an endodontist. I’m out a ton of money and time, not to mention all the pain I’ve been in. To be honest, I’m more likely to avoid the dentist than ever before because of this. Is there any way I can get at least some of this money back from my dentist for all these unnecessary procedures?

Dennis

Dear Dennis,

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

What a horror story! I am so sorry this happened to you. I would consider this gross malpractice. Here is why:

1. The sensitivity to cold should have told your dentist right away that a root canal treatment was likely needed. If he didn’t like doing root canals, he could have simply refered you elsewhere.
2. The pain didn’t go away with the filling and he is just adjusting your bite? That was another symptom of the need for a root canal treatment.
3. You have an extraction and that doesn’t help the problem, should have told him he had the wrong tooth. Instead he tells you to “give it time.” Time for what? To develop a bigger infection and leave you with a dental emergency?

My suggestion is that you go to the dentist and ask him politely to pay for all the extra, unnecessary procedures. If you end up losing the tooth, he should pay for its replacement as well. If he refuses, you have a good malpractice case.

Help for Your Dental Anxiety

I want to make sure you are aware of dental sedation. This can allow you to get your dental work done without anxiety and without pain. There are different levels of sedation. My suggestion for you would be to use oral conscious sedation until you are comfortable at the dentist again. It is administered by a pill. However, it is so strong you will need someone to stay with you a ride to and from the dentist as well as stay with you for a few hours after your procedure until you are steady on your feet and lucid again.

Patients who use this say it changes their life. In fact, they are so relaxed that most people just sleep through their entire procedure. Give this a try, with a different dentist than the one who was such an incompetent disaster.

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

High tolerance for Novocain

I have always had a high tolerance for Novocain, which has made all of my dental appointments a living nightmare. I’ve been avoiding the dentist for quite a few years as a result. I am in a position now where I cannot put it off any longer. I feel certain at least two of my teeth will need to be extracted. I just need to grab the bull by the horns. Do you have any recommendations for how to do this with the least amount of pain possible? Also, I’ve been reading up on tooth replacement options. Are dental implants as good as they are advertised to be?

Carla

Dear Carla,

woman smiling in the dental chair with her dentist standing nearby

I can actually help you on both counts here. Your dentist may not have been aware that when a person has a high resistance to Novocain, it is usually a sign that they have dental anxiety. The higher the anxiety, the greater the resistance to the numbing medication. This is because your metabolism kicks in and burns the medication off.

What you need for the numbing medication to actually work is a way to deal with the anxiety. Most people can’t just turn it on and off at will. Instead, you need a dentist who offers dental sedation options. I recommend oral conscious sedation for you. It is sometimes called sleep dentistry because it is so strong that you can sleep through the procedure. You will need someone to drive you to and from your appointment as well as stay with you for a few hours after your appontment until you are lucid and steady on your feet. You will have an anxiety-free/pain-free dental appointment.

As for dental implants, yes, they are the top tooth replacement available. Once completed, it will be like having healthy, natural teeth in your mouth again. Just make sure you see an experienced implant dentist. It is an advanced procedure. Ask them how many dental implant procedures they have done as well as what their success rate is. Don’t settle for anyting under 95%.

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

What is the Fastest Way to Get Caught Up On My Son’s Dental Care?

My son has never been to the dentist even though he is nine years old. We’ve been broke for so many years. Now my husband has been offered a great job and it even has dental insurance. I am certain my son will need a TON of dental work (as will my husband and myself). What is the easiest and fastest way to catch him up on his needed care without traumatizing him. I remember hating the dentist as a child.

Patricia

Dear Patricia,

Happy girl in pediatric dental chair

I am glad you wrote and I can tell you care about your son! It’s always hard when their first experience with the pediatric dentist is to deal with decay, etc.. Ideally, their first visit is in their toddler years before there is a time for any problems to develop. That way they associate the dentist with fun. However, we realize the ideal is not always possible. You were in that situation, but are still trying to do the best you can for your son.

The good news is he may not need as much work as you think. If his genetics are working in his favor and he’s done a good job keeping up with his oral health care at home, you may just get lucky. I once had a woman who wasn’t ever able to go to the dentist growing up. Her first dental visit was when she married. She came in at twenty five years of age very nervous about what she’d find. Would you believe that woman didn’t have even one cavity! The entire office was amazed. It was a combination of superior oral care at home along with fantastic genetics when it came to her teeth.

The first thing I would recommend, because you do not know what type of shape your son’s teeth are in, is that you go to a pediatric dentist that also offers dental sedation. For his first appointment, you may want to have them use nitrous oxide so that he is relaxed. This is very mild sedation. He can be awake the whole time. Let’s say, however, that at your son’s first check up, they find a bunch of things that need to be worked on. Don’t panic. There is a way to do that without him feeling any pain whatsoever.

There is another type of sedation you can use for his treatment appointments called oral conscious sedation. This will make him very sleepy. In fact, he’ll sleep through the entire appointment which will allow dentists to get more work done during each appointment. This is the fastest way to get him caught up.

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

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 Diabetic Use Dental Sedation?

I have type-2 diabetes and am about to have my wisdom teeth out. I understand that there is dental sedation available for this procedure. Will my being diabetic be a problem? I have a glucose monitor and my levels have been staying in a healthy range. One of the things I worry about is the ability to eat before a procedure because that affects my levels significantly. Am I a candidate for dental sedation or will I have to tough this thing out the hard way?

Karen

Dear Karen,

woman asleep in the dental chair from dental sedation

I am glad you wrote. Diabetes sure does make life more complicated, doesn’t it? The good news is this should not keep you from having dental sedation. Your levels are staying steady and it sounds like you keep up with your care. My suggestion is you ask for oral conscious sedation. This is administered by a pill but is quite strong. Not only will you be able to eat before your procedure, it will be important for you to do so. Also, don’t skip your insulin dose, though I doubt you would. If you didn’t have a monitor, we’d ask you to bring a glucometer, but your meter will make monitoring your levels during the procedure simple.

With oral conscious sedation, you will need a driver to get you to and from your appointment as well as to stay with you for a few hours afterward until you are lucid and steady on your feet. You may want to pick that person well in advance and make sure to train them in your diabetic care so they are prepared for any eventualities.

Other than that, you will want to keep a close eye on your healing and surgical site. It is harder for diabetics to heal, so stay on top of all your post-operative care.

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.