Anxiety attack when dam inserted and i can't swallow

[harmonyherb]

This has been a problem with me for along time. If I can swallow a dentist can work on me all day, no problem. I had root canal last month on a frontal tooth so the dam was not inserted all the way into my mouth. I set up ahead of time with the dentist that I will grunt so he should stop and let me swallow. Everything went well with no anxiety, no problems. Last Monday I went back this time for a root canal on tooth #15 upper left rear. I reminded the dentist about my problem and he said he would stop to give me a chance to swallow but he said this tooth was in the rear so the dam has to be put deeper into my mouth which my limit my ability to swallow. He installed the dam and in about 30 seconds I went into an anxiety attach because I could not swallow. It took me an hour to calm down. My clothes were soaked with sweat I went home and had to take a shower and change my clothes. I cancelled the procedure and will have the tooth extracted next week, then in the spring I will get an implant. This anxiety attack was one of the worst I have had in years, I was shaking like I was in a frigid zone. Does anyone else have this type of problem of panicing when you cannot swallow?

 

[kitkat]

I've never experienced a dental dam personally but you should be able to swallow with it in place. The swallow comes from the base of tongue and throat and the dam does not obstruct or inhibit these structures from moving so it is more likely just an overwhelming feeling of not being able to swallow. Also it is physically more challenging to swallow with your mouth partially or fully open. Some people have required sedation to tolerate the dam and even then find it challenging others can tolerate it for hours with no problems.

 

[harmonyherb]

Hi Kitkat,
Thanks for the shout back. Yes the Dam when placed deep into the mouth does, for me anyway, prevent me from swallowing. My dentist does not give you anything to calm you down only novacain. Some dentist give you an iv which puts you at ease, I had that with an implant and it was amazing. A dental dam is a necessary tool but when a rear tooth is worked on for me it is panic time.

 

[comfortdentist]

Most people accept the rubber dam without a problem but there are a significant number that panic even though the rubber dam protects your airway.

 

[BostonBelle03]

Harmony,

I am like you and cannot sit through a procedure with a dental dam. I have major panic attacks from not being able to breath and swallow and feel like I am being suffocated. I also don't like the smell and the feeling when the dam is jammed up against my nostrils. Makes me gag just thinking about it! Luckily, I found a dentist who is competent enough to do simple fillings without a dam, through other means of sterilization and isolation. She won't do root canals without one, but if I ever need that procedure, I will likely opt for extraction and an implant. Just know that you aren't alone, dental dams are one of my biggest fears!

xo,
Belle

 

[griffinej5]

I've had some stuff at the back of my mouth that had to be done without a dam because the attempts to get it in had me gagging so hard I was going to vomit. I have had it in though in other spots. I felt it helpful when the dentist physically cut it down a bit around my nose, as opposed to just bunching it down. I don't know if this would help you, but I felt better about it since I knew it wasn't going to block my nose.

 

[Shazawazza1969]

@harmonyherb

Hi harmonherb i had dental surgery with a rubber dam on,on Friday 8th April. I was fine as this dentist of mine is amazing . He explains everything and keeps me calm. The last time I got unwell through having an extraction and I think I have put off going to my original dentist which made me loose my place with them. Due to a right top front molar break I had a temporary filling put in at an emergency dentist, but with covid all appointments were cancelled to replace the tooth with a proper filling.
Due to that I have had 3 emergency temp fillings done and on the last one it took out alot off my tooth. As this dentist was amazing I asked if I was able to join the team there as they were taking on NHS . I was very lucky . So I have a few appointments set up to get this tooth done as a root canal.
Well on Friday I explained to my dentist that my chest was tight (asthmatic)and if it was ok to take my ventolin pump prior to the procedure. All good .
He explained that I'd have 2 deep injections to freeze the site and put on the rubber dam. I was able to breathe fine . I was in the seat for about 50mins when I noticed a little smoke and a smell of something surgical that didn't bother me, but the same thing happened again a little later and the smell caught at the back of my throat it made me cough. With that he said sorry but I realized that I had a thick feeling in my throat which I couldn't swallow away and as I tried to breathe I couldn't catch my breadth. I panicked and tried to get up and pull the rubber dam away off my face to get some air in. I have never been so frightened. They were so calm and quick but as the rubber dam had only been pulled to one side I was struggling to breathe still and they realised I needed it off completely. It took ages for me to get my breathing under control and with that the tears started. I eventually calmed down to speak and then could feel my body start to shake uncontrollably and that made me so embarrassed as I started shivering feeling cold and my head hurt. By the time I settled it must have been 40mins and I ended up with a migraine couldn't see out of my eye and couldn't put a sentence together. Tried ringing my Dr when I got in my car but just couldn't make sense of why no-one was answering and had to cancel 2 calls to them. Tried doing the e-consult and trying to read that information was no good. Eventually got to drive home got over a bridge and had to pull into a layby as I needed to speak with my partner as I felt so embarrassed and emotional. As I'm speaking to him my right hand and fingers start going numb. By that time I knew I had to get home and eat and get into bed or I'd be stuck in the car.
Don't ask how I made it home but I was aware of everything going on . I have slept since I got home after food. And all day Saturday until 4pm before I was able to face anyone to talk to because of the pain in my head.
Been advised to get medication off Dr to take prior to any appointments that concerns procedures. Cant believe that this happened and don't know how to proceed now with this root canal.
It just seems anything now over my mouth is making me panic if I can't take a breadth.
I know I'm going to have to speak with my asthma nurse too as I think I need an X-ray because I've been out of puff for quite some time. Each time I try to wear any of the masks during COVID I have felt like someone is trying to suffocate me . I'm just so embarrassed for myself just as for the medical profession treating me. As their time is just so precious.
This is my second panic attack, first was having a hysteroscopy and that was in march gone. I do suffer from anxiety but this now is getting bad.

I hope that you have completed your procedure and all has gone well.

 

[PlatypusBear]

@Shazawazza1969 My dental anxiety is strongest around needles but I have had several panic attacks at the dentist so I empathize with you deeply. If you have anxiety, they may happen to you sometimes and that's okay. Not every dentist will have experience with it and they don't always know how to react or what to do to help and that can leave you feeling foolish, but trust me: you aren't! Loads of us have trouble with this.

I believe you should be able to find a dentist who can work with you to help the root canal happen, even if you have to find a different one. If you are in pain, get a friend to help you call around and find someone who is experienced at working with anxious patients. DFC has a really good page with red flags and signs you need a different dentist, as well as one on how to find a new one.

It may help a lot just to let your dentist know that you may panic, what typically causes it, and tell them how they can best help you if it happens (for me, it's just sitting up the chair and being left alone for a few minutes). That way there is a plan in place, and you don't have to worry about trying to explain yourself in the moment.

You can also let them know what things cause your anxiety to spike in general to help them decide which accommodations to make. One option might be just having an assistant ensure adequate suction from your throat so you don't feel the need to swallow. You should also be able to control the suction tube yourself and position it where you need to to clear the saliva (I did this during mine on several occasions since they just left it hanging in the corner of my mouth, it just may be a bit tricky to maneuver around the dam). I actually had a root canal on #14 on Thursday without a dental dam. Granted, I live in the US and my experience here has been very different to others on this forum. I've never actually seen one used since I was a kid and I've had fillings at four different dentists since then.

When you are able, one thing which has helped me a lot was to learn about panic attacks and how to get through them. My therapist recommended this book, but admittedly I have not read it yet - "Badass Ways to End Anxiety & Stop Panic Attacks! by Geert Verschaeve". My preferred technique currently is a combination of acceptance, controlled breathing and meditation. I've also tried getting up from the chair and jogging in place (yep, I got weird looks but it was worth a try) and the full body clench and release - both of these are supposed to help relieve the fight-or-flight response you are experiencing. With luck, you can dramatically shorten the duration of panic attacks and lessen their impact on you. Then even if they happen, you may find yourself able to resume the procedure while you are still there.

Whatever you choose to do, please don't beat yourself up about being anxious. You are perfectly normal and not alone! Wishing you all the best.

 

[Shazawazza1969]

@PlatypusBear Thank you so much for replying. It's good to know that there are others out there that have had same or similar experiences.

I have been very fortunate in my new dentist and they were the ones who suggested speaking with my Dr as the panic attack is the first I've had in a dentist chair.
They were amazing during the procedure and the assistant was checking on me throughout with "are u ok " every so often when the dentist was away from my mouth and touching my left arm on her side which was reassuring.

My problem is that I breathe through my mouth and I do think that as I suffer from post natal drip that that was what the lump I could feel when I tasted the smoke and coughed. Because I couldn't move that lump by trying to swallow I panicked because it felt like it was obstructing me from breathing.

I have found it very difficult wearing masks during covid because of not being able to take a proper mouthful of air in.

I saw a Dr today and he has prescribed some diazepam to take 1hr prior to the appointment and another if I'm not calm when I get there.
Worse part now is that I now have to ask someone to drive me to and forth from all procedures . I feel like my independence is being taken from me bit by bit.

I love my brother in law to bits but I just think he has better things to do than spend ½ hr driving me back and forth and having to wait an hr for my appointment elsewhere in the car because he isn't able to come in due to the COVID rules and there is nowhere really for him to go but park & wait outside a CK shop about 5mins away when I could really do with him in the room with me.

Only other option I was then told by my Dr was that I get knocked out by gas and they complete the procedure that way without adding any stress to me.

I'm considering having the tooth removed and an implant by being put under as I really don't want to go through another panic attack.

I'm also looking at using an antihistamine to see if that will dry the post natal drip prior to the appointment.

I will look at the links you have put above . Thank you for sharing them .?

 

[ChickenLittle028]

@harmonyherb I just have to tell you that the same thing just happened to me on Monday! They put the damnin and then a wedge to force my mouth open and laid me all the way back where my head was lower than my body. Sure felt like I couldn't breathe!!! Had a panic attack!!

 

[KMac]

I went in for a root canal on a molar yesterday. First, there was no explanation about what to expect, how long it would take or what was happening next. I was laid back and the endo told me to bite down on this thing that was just huge. It was so uncomfortable, so she gave me a smaller one. They laid me back and stretched a piece of latex over what felt like most of my mouth. She started drilling and I could not swallow! The more I couldn’t swallow, the more I panicked. Pretty soon I was in what I believe was my first panic attack. I was gasping for air. My heart was pounding, and my upper arms felt like someone was squeezing them really hard. I did everything I could to keep myself from tearing everything from my mouth and bolting for the door. Finally, they let me sit up and the dental asst squirted a few drops of water into the back of my mouth. As long as I was sitting up, I could swallow but as soon as I was down, it would happen again. I felt so helpless. I had to stop her several times. Why didn’t she offer me a sedative beforehand? I wish I had watched YouTube about what to expect and had taken some Xanax or something. I didn’t like my consult some time back and I didn’t want to return but she’s the only one in my network. The worst thing? While I’m in full-blown anxiety hell, the assistant was talking about her personal life like they were working on a person under anesthesia, not a patient feeling like they weren’t going to live through this procedure. I could have slapped her. Parting shot? “You did well after you calmed down.”

 

[ChickenLittle028]

@KMac I'm sorry to hear about your experience. The same exact thing happened to me. They had a dental dam in and a wedge and put my head lower than my feet. I couldn't swallow either and went into panic mode as well. It would be nice if they coached you along and walked you through the procedure like my dentist does.