Tag Archives: oral conscious sedation

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.

Dental Sedation with Wisdom Tooth Extraction

My 20 year old has an impacted wisdom tooth. The dentist thinks they will have to remove some of the bone. He wants her to go under general anesthesia for the procedure. Is this necessary because of the bone? I’m uncomfortable with using anesthesia unnecessarily. There are so many risks and we have a relative with serious complications to anesthesia. What would your recommendation be?

Kelly

Dear Kelly,

Someone asleep from dental sedation

Bear in mind I haven’t examined your daughter. However, at her age I would be very surprised if general anesthesia was warranted. With a twenty year old, the bone is still very pliable because there is not really any cementum accumulation at the roots. She is in the ideal age range to have her wisdom teeth extracted. As she ages, that cementum builds up and makes the procedure more difficult with a greater risk of complications.

My recommendation would be oral conscious sedation. This is sometimes called sleep dentistry. However, don’t push your dentist into that. His suggestion signals to me he is not completely comfortable with the procedure. Your daughter would be much better served finding a dentist who is experienced and confident. To find that dentist, simply do an internet search for “Sedation Dentist”, find out if they do wisdom tooth extractions, then schedule a consult with them.

If they recommend general anesthesia as well, there may be some complicating issues the first dentist did not explain to you. My guess is your second dentist will think oral conscious sedation will be perfectly sufficient.

There are always additional risks with general anesthesia. With your family history, it seems like that risk is higher. I’m with you on this one and would not want to jump into that unless it were absolutely necessary.

This blog is brought to you by Gilbert Dentist Dr. Matt Roper.
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Traumatic Tooth Injury and Dental Anxiety

I took a pretty bad fall and now two of my teeth are starting to turn black. Is there something that can be done to help this? I have to tell you I haven’t been to the dentist in two years because I have horrible dental anxiety. The last time I went the teeth were healthy.

Brooke

Dear Brooke,

woman asleep in the dental chair from dental sedation

When a tooth turns black after an injury, it means the nerve inside the tissue of your teeth has died. The treatment for this will be a root canal treatment. Then a dental crown can be placed over the tooth to both protect the tooth and to improve its appearance.

I do understand that you are not comfortable at the dentist and have some dental anxiety you are dealing with. I want to make sure you know there are dentists who work with anxious patients. By seeing a sedation dentist, you can have a completely anxiety-free and pain-free dental experience.

Most dentists offer two levels of dental sedation: nitrous oxide and oral conscious sedation. Nitrous is sometimes called laughing gas. It doesn’t actually make you silly as it does give you a relaxed, floaty feeling. This is often enough for some patients to have an easier dental experience. It has the additional benefit of allowing you to get on with your day immediately following your appointment.

If your anxiety is stronger, and for some it is debilitating, then I would suggest oral conscious sedation. This is so strong that some call it sleep dentistry because you are so relaxed you can sleep through your appointment. The only real downside is that, 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 your appointment until you are lucid and steady on your feet.

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.

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.

Can a Tooth Infection Spread to My Brain?

I’m worried about this tooth infection I have. I went to the dentist and he provided me with an antibiotic but told me not to take it until two weeks before my procedure, which isn’t for another month. I read somewhere that a tooth infection can spread to my brain, but he is insisting there is nothing to worry about. What do I do?

Miranda

Dear Miranda,

toothache

While it is true that a tooth infection can spread to your brain, as well as your heart and lungs, there are some dental infections that are so small, you’d have time before you had to worry about that type of spread. Starting the antibiotic in two weeks, will help prevent it from spreading as well.

The danger often comes when there are patients who avoid the dentist out of fear. By the time they see a dentist, if they do at all, the infection has progressed so far that it is a dental emergency and they need treatment right away or they can put their lives in danger.

This doesn’t sound like you. However, I’m sure you know someone in your life who suffers from dental anxiety. For the benefit of those who do struggle getting to the dentist I want to post here that dental sedation can change their life. By using something like nitrous oxide or oral conscious sedation, which is even stronger, you can have an anxiety-free dental appointment.

Not only will that prevent them from waiting until they need a painful emergency procedure, but it will also allow them to get caught up on their dental care, giving them a healthy smile for the first time in a long time. In turn, this makes the remainder of their appointments easier.

When You May Have a Problem

Though I said this infection likely won’t be a problem, sometimes a dental infection will surprise us and take off suddenly. If your pain worsens or you develop a fever, call your dentist and have him move up your appointment.

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

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.