Dentists love iv sedation too much

[FinnishGirl]

I was surfing on some Finnish dentist websites, and I noticed something I don't like at all. Big dentist stations (private places with a dozen of dentists) with fancy websites usually have some information for dental phobics. And what did I find behind the link "Fearful patients"? Singing the praises of iv sedation. Downright advertisemens, I would say. First maybe two sentences about nitrous and/or Valium, then "but it isn't always enough" and then the ad begins.

I don't like this, because...
1)Not everyone needs iv sedation. Usually they say something about "severe fear", but every dental phobic considers himself/herself to be the worst coward ever. You don't dare to choose something that the dentist says isn't always enough, because you think you are the worst phobic ever. Only here at this forum I realised lots of people are more scared than I've ever been.
2)Some phobics have that kind of fears that they think any kind of sedation is a very very bad idea. And they should't think they can't be treated!
3)Big hype of something very expensive sounds easily like they want to get a lot of money out from desperate people.
4)It looks like they aren't so keen on treating anxious patients without sedating them. That doesn't have to be true, but if they hype sedation on their website they will probably offer it to all phobics.
5)People may choose sedation for the wrong reasons after reading the ad.

I understand iv sedation has been the solution for many people. It's good that it's available and the website also says so. The big problem is the one-eyedness of the information. Who would add to his/her "fearful patients" section that he/she won't judge or lecture, will let the patient be in control if he/she wants to, had the best injection technique ever and understands everyone's feelings? And put that first, then mention drugs, nitrous and finally iv sedation.

And the website should promise they always use LA for fillings, as Finland is one of those notorious countries where it isn't obvious - at least for about ten years ago my mum had a dentist who gave LA every time and mum considered it odd, now it's more routine but I'd like to read that from the website.

Comments, anyone? Is this iv hype a Finnish phenomenon or does it happen somewhere else as well? It's probably pretty new in Finland, because it doesn't seem to have an established word in Finnish, so that may explain, but I think this happens all over the world. What do you think about this?

I would have loved to put a link to one of these horrible websites as an example, but Google Translation Tool Finnish to English translation was ununderstandable, full of Finnish words and lousy translations. And I'm not a good translator enough to do it on my own, so no example this time.

 

[brit]

Interesting...I suppose it could just be that these places are the only ones advertising on the web in Finland because they know their niche market 'the very fearful patient' will only access them remotely i.e. from the web.

In some countries Ireland and France for instance dentists don't seem to be allowed to advertise on the web at all which is certainly a downside for patients looking for a sympathetic up to date painfree dentist.

Just in the couple of years I have been looking at dental websites I have noticed major improvements in formats...and a move towards relaxing colours and away from close up pictures of dental instruments...I have seen some truly hilarious (scary!) ones which would definitely not appeal to phobics.

I have some concerns about Sleep Dentistry in the USA as it would be a shame if all nervous patients thought that was the only option open to them but most practices offering it seem to strike a balance.

Marketing can exert a negative influence since as you knock your competitor you undermine patient confidence...even Healozone dentists ( a friendly bunch on the whole) can be guilty of playing up fear of injections and the drill even though they themselves probably are capable of giving the patient a comfortable experience whichever option is appropriate for a particular tooth.

I think your concern about people being pushed into i/v sedation is a valid one but the worst example of a dodgy approach to dental phobia which I have seen so far is the German based Gentle Dental Group who advocate GA as a cure for dental phobia and quite a few other strange things as well, in addition to costing an absolute fortune.

Feel free to post a link in Finnish if it has interesting photos/visuals?

On the LA for fillings thing other countries I get the impression have had a bit of a (historic) tendency to skimp on the anaesthesia for fillings are: Germany, The Netherlands, New Zealand (School Dental Therapists only) and South Africa. There are no doubt many more.

 

[FinnishGirl]

I wasn't talking about places that only treat phobics. It just tends to be so that where there are many private dentists working in the same place, they get all kinds of special stuff, including sedation. And they have a website. When just one or two dentists have a practice, they don't have a website or anything else than basic things to offer, their only advertisements are Yellow Pages and the grapevine. And here we also have a dental counterpart to chain stores! There are some big companies which have dentists in all bigger towns in Finland, and also at least one which is a branch of a private hospital business... These have fancy websites and they offer absolutely everything.

I hope these "advertisers" also find a balance in to who they recommend iv sedation. I went to the biggest dentist station in town for my wisdom teeth because they offer GA, but the dentist I saw said she thinks I seem brave enough to do with just LA. I insisted on Valium, and everything was fine. I'm glad she pushed me a bit to make me forget about GA.

All right, I'll put a link to the place where I was. Their website is really good, just as good as the place really is. [broken link removed]You won't of course understand a thing, so I'll explain a bit. The five links on light blue background are: Main page, Services (what they do in addition to basic treatment), Staff, Home treatment equipment (what they sell) and Contact us. The red link is to book an appointment online. There you write your personal info, whether you want check-up, first aid or other, is a.m. or p.m. a better time and whether they contact about the appointment by email or phone. In Services, 3rd from bottom is gas sedation and under that is GA. The others explain different procedures.

Someone has written something here about the Gentle Dental group and I agree they are very odd... sounds like they just want money.

 

[Nattis]

I'm from Sweden, and I can actually find a lot of clinics that do Sleeping Dentistry or what you want to call it. But there is also a lot of information about dentophobia and it clearly says in all home pages I've visited that putting you to sleep can be a good start if you have much that needs to be done, but it is never considered a cure for your anxiety.

On the other hand. The dentist I spoke to three months ago, when I bravely enough e-mailed her telling her about my anxiety, proposed that I should go to a hospital with medical dental treatment and get an iv sedation. But she was just an example of the kind of dentist that makes life hard for us. I do do do hope that this is not common among dentists that doesn't know how to help ppl with dontophobia... She scared the shit out of me to be frank with you.

 

[FinnishGirl]

Nattis, I've been reading your journal but haven't commented it... Your experience seems pretty awful to me. You obviously would have wanted to do it without iv sedation, why someone who hasn't even seen you says you need it? I don't understand. Someone else might have believed him/her (don't remember which one) and gone for unnecessary sedation and missed the possibility to unlearn the fear.

 

[Nattis]

My opinion is that dentist are either ignorant or just stupid... I know I'm wrong, and I hope to find one who is nice. But every dentist I've met this far has just proven what I feel. So has this last person also. But she don't know shit about scared patients, since she called instead of e-mailing me back. How the hell could she think that I would be calm and being able to listen to her when she says "Hello! I'm a dentist!" and then takes a break to wait for my reaction... There were not a word about sedation when I met my pshycologist at least. A good start.

 

[Snowball]

FinnishGirl, thing is - why do you automatically assume that a dentist who uses IV isn't helping patient's 'unlearn the fear'? IV in skilled hands can do just that - my own dentist used it extremely skillfully so that for many of my procedures, it was reduced down to the point I was pretty well as conscious and aware as possible and realised *Hang on, none of this is hurting me or even feeling mildly uncomfortable*.... You seem to assume IV is some huge chemical kosh that knocks people out - but used well, it's a brilliant tool. I now feel I don't want or need IV but I also feel happy to know it's there if I change my mind... I have little or no memory of the first hour of my procedures but fully remember the second hour, all the conversation going on, and everything else: I know various procedures were happening and I knew what they were - but I realised 'You know what? This is fine. It isn't bothering me!' I'd consider my fear to be as 'unlearned' as your's - maybe more so as I had considerably more stuff done to me than you did and was fully conscious through most if not all of the second hour of treatment, where I was able to respond, open my eyes, listen and fully understand what was going on - it's clearly not what you think!

IV gets people into the chair, gets them treatment that can, in extreme cases, be life saving and definitely life changing..... and for very many, like myself, it is a fantastic tool for 'unlearning' the fear as it gets you to the point you can accept treatment and that's where the healing from phobia starts. Trust me, it's not what you seem to think at all - not everyone is knocked out and forgets the whole thing to the point they think they've been asleep. A good dentist (and mine did her own sedation so is extremely skilled) can calibrate it, respond to situations as they arise, and slowly reduce it to the point the patient realises - as I did - 'Hang on this isn't hurting!'

 

[FinnishGirl]

You know what, Poodleoo, what you told about your IV sedation was pretty different from what everyone else has told here! It sounded more like what I experienced with Valium. I also feel I won't need it next time. Some chemical help is very good, I couldn't have done without. But have you noticed that the knockout story is a lot more typical. People don't remember a thing and they want every time be like that. I don't like the memory loss part. In that case you can't unlearn the fear.

And did you notice I never said IV sedation is a bad thing? I remember saying it's the best way for some. What I don't like is how some dentists seem to think that "treating phobics"="knockout-type sedation". And the advertisements which hardly mention any other ways that might be better for some and a lot less expensive.

If IV sedation was always like your experience, I wouldn't have written my original post at all. You probably know very well your story is different from most here. And I wouldn't say my fear is less unlearned than yours because I didn't need as much work than you - and why wouldn't I survive any smaller procedure after the wizzie operation?

I re-read my original post and seriously, I don't think you've read it very well. I NEVER criticized IV sedation, only the big hype and thinking of it as The Solution For All Phobics. Your post wasn't really a response to me. I understand the life-savingness and all that. I just don't want people to be knocked out only because nobody tells them about other ways to treat them.

 

[scaredwomble]

This thread is interesting, I came across the Gentle Dental Office group website too. It looked pretty strange, have you read the testimonials? All of them seem to have been put to sleep and then had almost all their teeth removed. i think I'd be worried if I went to a GDO place to have a tooth out, and then woke up to find they had taken out all of my teeth to replace them with shiny new implants....!!!

I struggled with an extraction very recently. I was terrified and I have to say, my dentist didn't know how to "handle" me well so I was even more terrified when he said I didn't look "ready" to take it. I mean, I was as ready as I would EVER be!!! He suggested dental sedation and it really, really upset me. I have had teeth extracted before (admittedly not often).... but the thought of being put to sleep to have a tooth out frightened me awfully too. But he insisted it was probably the "best option" for me and it upset me terribly at the time. Now, in hindsight, and facing milder oral sedation, I must say that after the experience of trying (and then failing) to extract a tooth, I'm left even more terrified than ever, and probably won't be able to face anything except a sedated sort of treatment! It is terrible it has got this way, but I guess with us phobics, it doesn't take much to push us in this direction....

scared womble

 

[rubyshoes]

They're actually not allowed to do anything to you under sedation that's not been explained and agreed prior to sedation here in the UK unless it's an emergency situation (ie immediate risk to your health) so anyone taking teeth out as you describe womble would be in serious trouble I'm pretty sure.

Just had a discussion with a dentist last week and about me meeting the implant dentist so he could explain the procedure to me I actually said I didn't want to know he could do what he thought best and she told me dentists in the UK are not allowed to do anything a patient had not consented to so I'll have to listen

And the way she explained IV sedation to me is that it doesn't put me to "sleep" I'll be awake and responsive can ask and answer questions. It's just that I won't remember and so I will only "think" I've been asleep. IV sedation is offered by most private dentists I've found and I think it's a good thing and should be available to anyone who wants it as well as those like me who wouldn't get in the chair without it I'm not sure what would be a "wrong reason". IV costs seem to be miniscule in realtion to general dental treatment costs. 20 years ago I had IV sedation at £170 per hour now it's about £120 and £230 for 2 hours so the cost has come down.


ruby

 

[comfortdentist]

I am a dentist in Florida. I did a hospital residency where I learned all forms of sedation but in my practice I only use the level that the patient requires or asks for. I have always wanted to be known and have become the dentist to see in Miami if you are a dental phobic but I do agree that some dentists overly promote IV sedation. My website describes Iv but doesn't put emphasis on that technique.

 

[Tommyr]

I prefer IV sedation every time. Cost is no object. I can NOT tolerate needles in the gums. PERIOD. Just yesterday I paid $410 for a half hour of IV for a impacted wisdom tooth removal and a front lower tooth.

Here in the U.S. (in some areas) it's not easy finding a dentist that does IV sedation. So, I go to my oral surgeon. My bill was $1,400 and my insurance will pay for everything but the IV. No problem, I gladly pay it. Worth every penny IMHO.

 

[drummerswife]

Just wanted to add my two cents here. I lve in the US and I agree with Brit tha . there seems to be something of a balance between the use and non use of IV sedation. And I also agree with what was said about how it can quite valuable when used by skilled professionals who know what they are doing.
I have had IV sedation for both of my oral surgeries and, at least for me, it made all the difference. The oral surgeon said that he does not use IV sedatio on all of his patients. Its a case by case determination. He said some patiients do just fine without it. Others, like me, do much better with it. That said, I would hate to think that there are dental professionals out there be they dentists or oral surgeons that would use a one size fits all approach.
I will having IV sedation again tomoorrow for my 3rd oral sugery to remove an abcessed tooth with a fractured root
My chief concern with IV sedation is 2 things 1) its really expensive and 2) its nor covered by insurance.
This makes it hard for the folks like me who do really benefit from this.

 

[Audio.Amour]

I wont knock on sedation techniques.
In the eyes of a phobic, getting treatment is a success it dosent really matter that you were awake or asleep. You did what needed to be done. And that is success in any phobics eyes, you got the work done and if you were sedated it was like a dream, and if you were awake it probably wasent the most plesant thing, but you had it done.

I dont feel like dentists push sedation too much, and even if they did I have a hard time seeing the harm in that, they may push it but we are our own people and we have our own minds and we make our own decisions.

 

[GrahamDee]

I wont knock on sedation techniques.
In the eyes of a phobic, getting treatment is a success it dosent really matter that you were awake or asleep. You did what needed to be done. And that is success in any phobics eyes, you got the work done and if you were sedated it was like a dream, and if you were awake it probably wasent the most plesant thing, but you had it done.

I dont feel like dentists push sedation too much, and even if they did I have a hard time seeing the harm in that, they may push it but we are our own people and we have our own minds and we make our own decisions.

I am sure there are many arguements about not having sedation or GA's or anything else. I have read the arguement about "not dealing with the fear of extractions" and that its somehow an easy option. Personally, I need whatever drugs are going before anything gets pulled. I have a deep rooted fear of extractions, I HATE the crunching and twisting and everything else. I would rather be out of my tree than having to lay back and tolerate it. I would even walk around with toothache than go through with it. I know there are techniques, methods and maybe "I should be tackiling the problem" - and maybe they are right. But that doesn't help me. I don't have enough teeth in my head to get anywhere used to it and to be honest, I don't want the truma of trying to. As for GA, I understand the risks, but I would happily sign whatever waivers there are and take my chances, than lay back and cope with the sensation of someone trying to pull teeth and snapping bits off in the process (been there...had that... no thanks).

For me, the options of IV should be down to the individual and their circumstances. In my case, no one is coming near me without thier syringe full of "instant dentistry", and when I'm off with the fairies, they are free to do whatever needs doing, for as long as they like. Because thats what I want and the only acceptable way to do it.

 

[drummerswife]

I'm with you on that Graham Dee. There is no way the oral surgeon could have done what needed doing in my mouth without inviting my friends Versed and Fantanyl along for the ride.
As to the argument of "dealing with the fear" my dentist has said that it doesnt help heal the trauma most dental phobics have suffered by subjecting them to more trauma. Thats the beauty of IV sedation. No fear, no awareness, no stress, no trauma.

 

[Tommyr]

I'm with you on that Graham Dee. There is no way the oral surgeon could have done what needed doing in my mouth without inviting my friends Versed and Fantanyl along for the ride.
As to the argument of "dealing with the fear" my dentist has said that it doesnt help heal the trauma most dental phobics have suffered by subjecting them to more trauma. Thats the beauty of IV sedation. No fear, no awareness, no stress, no trauma.

A-freaking-men! Whoever invented those drugs should win every prize available. For healthy people they are safe and worth every single penny.

 

[drummerswife]

'I'll second that. However, it shou;ld be said that these drugs can only work their magic when they are used safely by trained professionals who know what they are doing.

 

[Beccaposie]

I would love for IV sedation to be avalible to me,they dont do it here where I live in Eastern Canada ,the only thing you can do is take a pill,that calms you down.

 

[kittenpink]

What do you guys think of hypnosis and EFT for relaxation purposes prior to treatment?