Dental arrangements disappointing

I found a sedation dentist here in L.A. and on my initial visit although we were unable to get xrays he assured me that with IV sedation he could get all the work done including a crown, replacement fillings, new fillings and root planing.

I decided to break the work into at least two visits because he was talking about a very long stay in the chair under sedation and that made me anxious.

Yesterday I went in to make the final arrangement and pay my deposit. Now he was saying that the root planing (three hours worth and not the one hour he'd originally mentioned) would not be done under sedation because he didn't want to sit there and "watch me" for three hours while someone else worked on me. He dismissed my concern that due to my horrible gagging problem the root planing would be an expensive waste of time.

On top off that he gave me a worst case scenario if the crown turns into a root canal, and the filling replacement turns into a crown. It could add $3500 to what is already a very expensive visit.

I called this morning to have them drop the root planing and revise the financial form. My goal is to have a positive, successful visit. The three hours of sedation dentistry should be fine since I will be out of it while he works. The three hours of root planing will be a failure because right now I cannot tolerate someone working in my mouth without gagging. Why would I even schedule myself for three hours in one sitting if there would be no sedation? I would break it up into smaller visits to spare myself prolonged torture.

So I'm feeling a bit betrayed and unheard. This guy is supposed to be a specialist in difficult patients but after 20+ years I think his patience and attention are probably on the wane.

I left a message about the root planing and am awaiting a fax of the revised financial form. If everything goes well the visit (which is maybe 50% of the work I need done) will be $4000 dollars. If it is worst case (or if he performs procedures I don't need) it will be $7000. And then I'll still need three new fillings, two replacements and the damn root planing.

So my plan is to get through this appointment on 9/15 and see what happens. If he goes for the maximum charge I will not go back to him. I just won't be able to trust him. I have found only one other sedation dentist in Los Angeles and he doesn't return phone calls.

In the end I think I am about to be taught a very expensive lesson that I will regret. But I have no choice.

I can't understand this. Your gagging problem doesn't seem to be something that would go away with a nice dentist and taking breaks. When I was going to have my work done and did some Internet research on GA in dentistry (which I, by the way, didn't choose), I remember having read that one reason for GA would be a bad gagging problem. I know I should say "you can do it" because that's what people are supposed to say here, but in this case I don't think you can. You definitely should get the IV for all work done. Is the dentist the one who gives you the IV sedation? That never happens in Finland, here we have always an anesthetist (spelling?). So here IV sedation always means having one extra person watch someone else do the work, so to speak - that's what anesthetists do with surgeons in hospitals as well! If your dentist used an anesthetist, hygienist (or someone else, don't know who) working on you wouldn't be a problem.

This guy can't be the only sedation dentist in L.A., I've understood it's a big city and there are usually several sedation dentists in a lot smaller towns. But if you trust your current dentist and dn't want to or can't afford to try another one, talk to him, maybe he will understand.

You need to go elsewhere - trust has already broken down- he is not meeting your needs - if you couldn't manage x-rays then I agree you are not going to manage deep cleaning very easily. There are loads of dentists in LA and under i/v sedation you would not have gagging problems...have you tried the other tips for gagging:


Are you sure it was i/v sedation which was involved because in the USA it is common to advertise sleep dentistry and actually only mean that oral sedation (a pill) is given.

You can also do a Google search for 'Los Angeles anxious patient dentist'.

No other tricks work. Of that much I'm certain after 15+ years of struggling with this awful problem.

It's IV sedation for sure, and he administers it. He says he's had good success with IV sedation and gaggers in the past. If not this will be an extraordinarily expensive mistake.

I'm into him for a non-refundable $1500 deposit so I have to go through with it. If all goes well I'll try to explore other options. I'll be out of work soon and losing my insurance so there's no time now, that and I know I've needed the crown for a couple of years. I can't wait until I have a crisis.

I've found only one other sedation dentist in Los Angeles. They are probably uncommon because it's not covered by insurance so only desperate or rich people can use them. If I make it out of this procedure ok I hope I have other options.

I'm sorry to read your problems but I think Brit is completely right. This dentist certainly does not seem to be the right one for you, and believe me, there is always a dentist out there just for you. Finding that right dentist makes things so much easier and this one, apart from the problem over sedation, the amount of time etc does not seem to have any compassion at all. So I would say, start looking again, you will know when you find the right one, it will all sort of gel and fall into place and if you are comfortable with someone, trusting and can build up a rapport, then no matter how long you have to be in that chair or whatever needs doing, it can be done and much easier than you could ever believe.

Well I have to get through this visit first. If everything turns out ok and he doesn't run up the bill I will count myself lucky and then start searching again. I still have found only one other sedation dentist in Los Angeles. I'll check him out when this visit is behind me.

I don't know the American legal position but surely you still have cancellation rights up to so many hours beforehand - a time period in which he can schedule someone else. It's not like he's brought in another person to do the i/v even.
It's absolutely fine if you want to give him a go but if having already paid the deposit is the sole reason you are doing this, I would have thought so long as you remunerate him for the consultation time, x-rays, etc etc if you were to cancel with sufficient time, your deposit should be refundable since he is in no worse position???

I don't understand why he has moved the goalposts and you could check on the Dentistry Questions first but I was under the impression it is more usual to clean before restorative care - only treatment for pain relief should take priority over cleaning and getting the gums as the healthy foundation for the rest of the work.

The deposit is non-refundable. Even if that's somehow illegal it would probably cost as much to fight as the money I would get back.


The good news: He called back to talk about my wanting to skip the root planing due to lack of sedation. He said he should've been clearer and that he wants to stop the sedation at the end of his work and try the root planing while I'm groggy, but if I need to be put back under he will do it.

He also said that I shouldn't worry about the root planing without sedation being an expensive failure because he would not charge for an incomplete or unsuccessful procedure.

Unlike the financial form which is black and white this part requires trust and he did ask me to trust that he would not take advantage of me. Although I'm not really a trusting person under the circumstances I decided to go for it because he took the time to explain himself without being a jerk about it.

Yes, he seems casual about my worries but after 20+ years that might be his weak point, that he does not come across particularly sensitive. So I'm going to go for the root planing and... we'll see. It's not impossible that it will all go well without any complexities or cost overruns. I would love to look back on this first big round of work with relief and have some hope for finishing my problems next year when I have insurance again.

Thanks for reading my posts and offering feedback. I really appreciate it and it helps keep me thinking clearly.

Well that certainly sounds much better...just a communication breakdown I suppose. I know some people do get jaded after 20 odd years but if you are going out to appeal to the 'anxious' market, you have to deliver really or risk losing all credibility.

The appointment is on 9/15. I'll return with my feedback. I hope to put it in the "Success" forum although I'll still have at least one more big visit to do fillings.

Thanks again for the support.

rbanzai said:

The appointment is on 9/15. I'll return with my feedback. I hope to put it in the "Success" forum although I'll still have at least one more big visit to do fillings.

Thanks again for the support.

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Im a gagger too, I'm also a kicker. I sometimes have violent outbursts if PTS kicks in so I make sure I'm drugged.