Anxious about IV sedation

[RustyRebecca]

My journey to have my teeth restored has been far from easy. I was meant to see an NHS oral surgeon (as mentioned before) and she worried me with her talk of bruising, bleeding and pain after the oral surgery but also that as she didn't do IV sedation and I would be in the chair for at least 40 minutes, I cancelled with her and managed to return to a private dentist that was originally referred to me. I figured I would rather get into debt than be emotionally traumatised ;-) I saw this dentist yesterday and as soon as I entered his room, I went into panic (that was without getting into his chair!). All because of the pungent clinical smell, it triggered my vomiting phobia and I was very anxious (wouldn't have been if the smell hadn't been so strong). I was okay (obviously nothing happened, as usual), just very very anxious. He noticed and said that as I had asked for IV sedation to do the procedure next week, it would be right for me.
But it is a bit odd, he hardly talked of the extraction whereas the oral surgeon did ( a lot). It was almost as if he wasn't concerned about any difficulties (unlike her who was going on about the sinus and having to put a flap in the area, possibility of liquid coming out of my nostrils when I drink). In fact, my record with him just says 'difficult extraction' and not 'oral surgery'. Is he being optimistic?
And then there is the IV sedation. I have never had it before and have opted for it because of my panic attacks that make every visit to the dentist intolerable. But a dentist before (have mentioned this also) told me that as I have control issues (want to be in control) IV sedation wouldn't be right, I would fight against it, and I had to trust him (I did, but anxiety was still through the roof!). This dentist said that I didn't need to worry about this and all would be fine. They would look after me. But unlike the oral surgeon, he said the procedure would take about an hour.
But just reading about IV sedation here on the website (so that I am fully aware) makes me anxious (ironically). I am worried about how I will feel and if I will feel light headed (another fear; losing control). I am anxious about the whole thing. Having the sedation (once it is in, I can't escape), the procedure (injection, how much numbing will occur, top right 6 tooth) Just everything

 

[MountainMama]

I think the oral surgeon was just telling you all the "possible" complications, which was scary. I had told you in the other thread that I had two oral surgeries that involved the sinus being perforated and neither the endodontist nor the oral surgeon made it out to be a big deal. I was given a paper that went over all the possible complications, but it wasn't discussed.

I have never had IV sedation, but have had nitrous, where you are also aware but relaxed. I also have control issues, but once the nitrous hits, I relax.

 

[Gordon]

IV doesn't make you light headed. You are still able to talk and withdraw your consent even after the IV line is in, although I've never known anyone ask me to do that. The IV suppresses nausea very effectively, if that was an issue for you. I've never met anyone who could "fight off" IV with the power of their mind

Removing a curved root is pretty easy, even if it results in a sinus connection, it's a quick job to fix it. I kind of agree with the second dentist's approach, because it sounds like how I would do it
Numbing should be 2 injections, same as for any other extraction in the top, but you won't remember getting them.

 

[drhirst]

I would echo Gordon's words. Yes, you will be awake during the sedation, but the drug removes the feeling of fear. I did a long procedure under iv sedation yesterday, and the patient was commenting of how she could not believe that she was aware, but simply not bothered, or worried by what was happening. As I have become more experienced, I have found that a lighter sedation combined with good rapport with the patient makes the whole experience much better for everyone.
With regard to the talk of complications, my guess is that both dentists assessed the procedure would be the same level risk and difficulty. However, one was more concerned with covering his backside legally and the other was more concerned with making you feel at ease. Sadly, with the increase in legal action against dentists our insurers insist that we tell you every possible complication. The young dentists and maybe those who work in highly regulated hospitals do this to the letter. Some of us less politically correct old timers say to hell with the bullshit the says I must make sure every patient is terrified with exaggerated tales of impending doom.

 

[RustyRebecca]

The appointment is drawing closer (ie; tomorrow at 3pm UK time) and my worries/anxiety are increasing.
The dentist has said that it is fine for me to take 5mg diazepam beforehand. Will that effect the IV sedation at all?
Even though I know I will be under IV sedation, I still can't work out how to feel more in control (I am hoping I won't be worried at the time about that, but this in advance helps my cognitive processes and I am definitely governed by my thoughts. If i get them right, I can feel reassured). I can't exactly raise my hand and stop him as the procedure has to be done to completion (I would imagine, not escaping mid procedure). Can't half remove a curved root. So any tips on feeling in control would be appreciated.
I have only seen this dentist briefly once so there has been no chance to build up a relationship.
Is it a long wait for the IV sedation to take effect? Do they leave you in the chair twiddling your thumbs waiting for hopeful tranquility to descend to lessen your fears?
The dentist always seems to put you back so far in the chair so that your feet are dangling in the air (I hate this so much). So I do worry that by the time I am upright again, that I will feel light headed.
I have a fear of feeling spaced out and I don't know if IV sedation does that to you?
And then afterwards, do you feel drowsy and spacey or relaxed and nice?
I have a fear of numbness (loss of control again) but I suppose that will take time to wear off?
And worried about the aftermath of pain and discomfort, bleeding and stuff.
I am just worried and thinking too much

 

[RustyRebecca]

I would echo Gordon's words. Yes, you will be awake during the sedation, but the drug removes the feeling of fear. I did a long procedure under iv sedation yesterday, and the patient was commenting of how she could not believe that she was aware, but simply not bothered, or worried by what was happening. As I have become more experienced, I have found that a lighter sedation combined with good rapport with the patient makes the whole experience much better for everyone.
With regard to the talk of complications, my guess is that both dentists assessed the procedure would be the same level risk and difficulty. However, one was more concerned with covering his backside legally and the other was more concerned with making you feel at ease. Sadly, with the increase in legal action against dentists our insurers insist that we tell you every possible complication. The young dentists and maybe those who work in highly regulated hospitals do this to the letter. Some of us less politically correct old timers say to hell with the bullshit the says I must make sure every patient is terrified with exaggerated tales of impending doom.

drhirst...wish you were my dentist!

 

[Gordon]

The appointment is drawing closer (ie; tomorrow at 3pm UK time) and my worries/anxiety are increasing.
The dentist has said that it is fine for me to take 5mg diazepam beforehand. Will that effect the IV sedation at all?
Even though I know I will be under IV sedation, I still can't work out how to feel more in control (I am hoping I won't be worried at the time about that, but this in advance helps my cognitive processes and I am definitely governed by my thoughts. If i get them right, I can feel reassured). I can't exactly raise my hand and stop him as the procedure has to be done to completion (I would imagine, not escaping mid procedure). Can't half remove a curved root. So any tips on feeling in control would be appreciated.
I have only seen this dentist briefly once so there has been no chance to build up a relationship.
Is it a long wait for the IV sedation to take effect? Do they leave you in the chair twiddling your thumbs waiting for hopeful tranquility to descend to lessen your fears?
The dentist always seems to put you back so far in the chair so that your feet are dangling in the air (I hate this so much). So I do worry that by the time I am upright again, that I will feel light headed.
I have a fear of feeling spaced out and I don't know if IV sedation does that to you?
And then afterwards, do you feel drowsy and spacey or relaxed and nice?
I have a fear of numbness (loss of control again) but I suppose that will take time to wear off?
And worried about the aftermath of pain and discomfort, bleeding and stuff.
I am just worried and thinking too much

Try to answer as many as I can, sorry if I miss some:
1) Not really. It might reduce the amount of IV drug required but there's no way to tell in advance and it doesn't matter anyway.
2) You can absolutely work out a "stop" signal in advance, you won't be paralysed and can still talk. There are some points where stopping wouldn't be a great idea but knowing you can stop things helps most people.
3) It varies form 3-5 minutes for most people. The IV drugs are administered a little bit at a time, so you on't be left all alone.
4) Won't happen, as you recover from the IV the chair is normally gradually raised.
5) Not really. I think it's best described as a sort of mellowed out feeling, but you won't actually remember what it felt like. Weird I know.
6) Usually by the time the IV has worn off so has the numb feeling

Good luck!

 

[TalkGirl]

I hope my message does not find you too late but I thought I would come at the tread from a different angle, the one in the chair. For the past few years I have been lucky to be getting all my dental work done under sedation. I for one think it’s the best thing since slice bread and if anything has helped me more with my phobia than anything else. Before I would wind myself up in knots and really struggle to get through the door. If not for my mum being my rock I don’t think I would have had any of the work done. For me sedation has helped me to create positive experiences with the dentist, the team at guys have been excellent. Personally, I would be happy to get any procedure done if it was under sedation! Now I’ve said my bit, on to your questions.
1) unfortunately I cannot speak of using diazepam as my troubles have never been around getting in the chair more when the work is being done.
2) for me it takes hold less than a minute and no they have never left my side but instead talked to me about various life things.
3) the best way I can describe my experiences is sedation is positive. I go into the chair in a horrible state and I come out at the end happy (probably why I like it so much). Yes there is a period of time I cannot account for, but I am okay with that as I honestly don’t want to know what is going on...just that the job is done well. Apparently I am a little goofy in the early few minutes of coming round but after that you slowly return to normal, just a little hazy, a bit slow but happy and relaxed. I also tend to find I’m quite tired but I expect that is my system relaxing after being so heightened at the start.

It is easy to overthink the unknown, so I hope my account helps to maybe shed some light on the experience. I honestly can’t recommend sedation enough and just wish it was a routine option available. If you did have any other questions then give me a shout...fingers crossed you read this in time ?

 

[RustyRebecca]

Thank you Gordon. That was so supportive and reassuring.
TalkGirl, in time, thank you so much. I will be at the dentist in about seven hours time. All you said has really helped, I so appreciate it.
I will be so glad when this is finally over. And if it does go well, I will have all my treatment (which is quite a bit ahead) done this way.
I am trying to relax and not be anxious (quite hard!) and already feel really tired through not sleeping enough. I just think too much about the sedation and the procedure and then afterwards, pain and discomfort. But all you have said so helps.
I will return here when it is all over with hopefully happy news!
Thank you again.

 

[TalkGirl]

I totally understand RustyRebecca, I was the same! I think the uncertainty of what will happen and how it will effect you is what makes it worse.

I look forward to hearing how it went, fingers crossed it all goes swimmingly and you find a love for sedation...if there is such a thing ?

 

[krlovesherkids777]

Hope it goes well for you! let us know!!

 

[RustyRebecca]

Oh dear, that so didn't go at all according to plan.
I spent the whole day worrying myself sick about having the IV sedation and the procedure, that in the end, I just couldn't go.
I realised in the end that the main problem was still the IV sedation and it is because of trauma from when I was a kid and being brought up in a controlled environment. It is so complicated, but I am not like regular people with anxiety and control issues. I worked myself into a frenzy as I knew that once the needle was in, there was no turning back and I couldn't stand the thought of that loss of control, if somehow I really didn't like the effect of the sedation. I thought of asking for just a little bit but I knew I was out of my depth. I knew once I went in there, I would probably do it to appease people despite what I might go through.
I took 10mg of diazepam (once, not today) was so spaced out that I was super anxious. I have reacted badly to other medication. The thought of having to endure that really worried me a lot.
It really doesn't help that I don't know the dentist at all, there has been no time to build a relationship (this is just a referral) and I am quite complex with my fears because of previous trauma. I can call it dental phobia but it is more so a massive fear of losing control and feeling terrible sensations of panic or other feelings associated with drugs.
I think the dentist still wants me to return (I paid a hefty deposit, though there is a cancellation charge) but I don't think I want to return. I have had so many dentists say different things that I seemed to have lost trust in all who I have seen. The last dentist who did refer me to this one actually chipped one of my teeth and chose to ignore that he had. I think I have to find a dentist who will take me through everything and one that I can build up gradually with, not like this. This just freaked me out and even though I didn't have it done, I feel horrible and wiped out.

 

[krlovesherkids777]

RustyRebecca,

I hope you can get a little rest and relaxation and time to just process this . You have done more now than you give yourself credit for . Coming here and talking about it processing. Being willing to step into the unknown and try it even though you were scared, respecting your emotional health and knowing what you could handle and when. I hope you recognize all the things you did right after the stress goes down a bit from trying.. It was a huge step of faith

I'm deathly afraid of swimming and at swim classes they would make me walk down to the end of the plank.. well I did it.. how many times I said forget it , I'm not jumping. and walked backwards off the plank and down the stairs and somehow did it many times just testing the water. I hope you will get a peace in the right time and some great dental staff to help you through that.. You did alot of brave things just taking steps for today.

 

[RustyRebecca]

Thank you krlovesherkids777. Just as an update, today I have felt totally wiped out, and that is without the procedure and iv sedation . But I have been researching other dentists and beginning the process all over again. There are several who want to build up a relationship with a patient and reduce the anxiety as much as possible. So am in the midst of contacting them. Though it can be expensive. I am in the UK, but I paid a deposit of £150 towards the procedure (all together it was going to cost me £400) and the dentist decided to keep my deposit for not going to the appointment. All of it. I fully appreciate a cancellation charge due to what happened but that seems excessive.