Fear of being unable to swallow with dental dam

[CHF]

Strangely, my greatest anxiety stems from the inability to actually swallow once the mouth bridge is placed in my mouth to keep it open.
One of those was used when I had to get a crown on a jaw tooth ( the same tooth that is the problem now)
and I couldn’t swallow. I had to move the bridge out of the way to swallow.
If I can’t move the bridge and I can’t swallow, I feel myself begin to panic!
I don’t know how normal or abnormal this reaction is but I’m very concerned about what’s going to happen.
I have a consultation scheduled with the endodontist. I’ve been told they don’t have nitrous oxide (laughing gas) but do use oral sedation if I am a candidate for it. I was told it makes one feel somewhat ‘loopy’, relaxed, sleepy, and may even possibly have somewhat of a amnesia affect.

Any thoughts or information on my plight?

 

[letsconnect]

Hi @CHF

I think it's a normal reaction which many people get to a certain extent. Your rational mind probably agrees that not swallowing during dental treatment won't cause any ill effects, but the feeling still sends you into a panic. Perhaps it's a very basic instinct for humans to want to protect themselves against the possibility of drowning, and the ability to swallow is essential to that. Or sometimes, past experiences can contribute to a fear of not being able to swallow.

Sedation can certainly help in lots of different scenarios by making you more relaxed and less panicky.

Do you get the feeling of panic only if water is pooling in your throat, or do you get it regardless? We do have some info on this page that might be useful:

Fear of Choking or Drowning

Are you scared of choking, swallowing gauze, or drowning in your own saliva during dental treatment? Find out how to avoid choking at the dentist's here!

www.dentalfearcentral.org

The most important thing is that you share your fear with your dental team (and especially the endodontist themselves), and together come up with a solution that works for you ?. The consultation is an ideal opportunity to see if they are understanding and open to accommodating your needs.

 

[CHF]

@letsconnect I haven’t actually felt the sensation of not being able to swallow due to any liquid/saliva/water pooling in my throat.
It seems to be the actual extreme need yet inability to swallow due to the bridge holding my mouth open. It causes me to suddenly feel panicked.

 

[letsconnect]

I've heard some people recommend learning to swallow with your mouth open (personally, I find that quite difficult, although it's a bit easier when your mouth/throat isn't dry). When you're referring to an extreme need to swallow, do you mean a psychological need or a physiological need? If it's the latter, what does the swallowing accomplish?

I would imagine that some sort of sedation would probably work quite nicely for this problem, whatever the cause ?

 

[CHF]

I feel like it’s more psychological but could be a little physiological.
I’m hoping the endodontist can shed more light on this issue and give me some hope about being sedated.

 

[CHF]

Thank you for talking to me about this issue. It helps.

 

[letsconnect]

I wish I could be of more help ?. Hope this is ok, but I've renamed the title of the thread, so others with personal experience of this issue are more likely to read it and chime in!

 

[Fontanella]

Hi there. Joining this conversation as I believe I have a similar issue and hoping to find some support. I went through the "Fear of Chocking or Drowning" Thread in the link, but it isn't altogether clear to me whether swallowing with one's mouth open is considered a problem or not. I have had dental anxiety (without even knowing it had a name) for most of my life and always felt I had to endure that sinking feeling. I am so tired of the anxiety. I have recently found a great team of dentists and hygenists that are very accommodating and have changed the overall experience for me. However, I will need to have a tooth extraction soon and an implant in the following months. I hoped to establish a good rapport with my dental surgeon, but unfortunately I was left a bit deflated by my initial impression. I am sure he is a good professional, but doesn't seem to be very understanding to my specific fears. For instance, I specifically and kindly asked whether he could assure me he would use a mouth prop/bite block during surgery so that I can rest assured my involuntary swallowing will not interfere with the procedure. To this, he told me I wouldn't even notice whether I have one on or not because I'll be having IV sedation... I mean, that's hardly reassurance. I'm now trying to make an appointment with my anaesthetist so that I can at least get him on board with the mouth prop thing, but due to Covid, nobody's taking appointments. I feel that I'm trying to raise an issue here so that we can avoid complications, but nobody's listening. I'm just being reassured that IV sedation will magically solve every issue. I know, rationally, that sedation will relax me and my damn anxiety (hence, less swallow reflex?), but just wish they could reassure me by actually putting a damn bite block in my mouth. Sorry for the long story, guys, but this issue has been draining the life out of me for the last couple of months. So, if anyone has any advice on whether swallowing with my mouth open IS NOT a problem, that would be great.

 

[MountainMama]

When I had a root canal on my back upper molar, I had the dental dam for the first time. I did have nitrous oxide, but it was a fairly low dose.

I remember the endodontist kept telling me to swallow because it would help them not have to suction as much, and I was thinking “how?” at the time. I did manage to do it once or twice but it was difficult. I do understand your panic with it, though. Luckily I had nitrous so I was very relaxed but not being able to do something you can usually do is very disconcerting.

On a separate note, I have had the oral sedative as well. It really just chills you out. At the time, I didn’t think it was working, because I didn’t “feel” different like I do with nitrous, but once the appointment started, I was aware that I wasn’t as nervous, and afterwards I really didn’t remember much, even though I was aware of it at the time. It kind of puts you in a zone, like when you are sleepy and your body relaxes. My husband drove me there and back and said I was talking like normal but he could tell I wasn’t as anxious.

 

[Fontanella]

Thanks for sharing and for your reassurance MountainMama!
My specific fear is this: since I cannot seem to hold my saliva and, at some point, I have the uncontrollable urge to swallow (with my mouth open) I am afraid that this will interfere with the procedure the dentist/surgeon is doing. With my usual hygienist I have an agreement (I raise my left hand for a swallow break, she pulls all the instruments out and that's it, no problem), but this new surgeon, being sedated (hence might not even be aware that I have to swallow) and not being able to signal my need I am afraid that I might swallow and cause an involuntary shift/trauma in my mouth/operation area... Very specific fear, I know. But if anyone can just tell me that's not a problem and that it's highly unlikely that would be an immense relief...

 

[MountainMama]

Thanks for sharing and for your reassurance MountainMama!
My specific fear is this: since I cannot seem to hold my saliva and, at some point, I have the uncontrollable urge to swallow (with my mouth open) I am afraid that this will interfere with the procedure the dentist/surgeon is doing. With my usual hygienist I have an agreement (I raise my left hand for a swallow break, she pulls all the instruments out and that's it, no problem), but this new surgeon, being sedated (hence might not even be aware that I have to swallow) and not being able to signal my need I am afraid that I might swallow and cause an involuntary shift/trauma in my mouth/operation area... Very specific fear, I know. But if anyone can just tell me that's not a problem and that it's highly unlikely that would be an immense relief...

Wouldn’t they be able to suction? That way you won’t have the excess saliva building up. When I had mine done, the assistant was suctioning the whole time. The endodontist just told me I could swallow if I needed to and that it would make it easier, but that they could suction if needed. I would definitely bring it up before your procedure so that they are aware of the issue.

 

[Fontanella]

I'm sure they use the suction instrument, but I noticed in my case that I had that uncontrollable swallow reflex even if my mouth is dry. I am sure that it's mostly due to stress and overthinking/being aware of it, but can't help it. I brought up this issue with this new surgeon, but he seems to be very reassured by the effects of IV sedation. His reasoning is that being relaxed will lead to 0 swallowing it seems... I'm just not sure that this is a likely scenario. Would love to hear some opinions/experiences on this. Would be of great help.

 

[krlovesherkids777]

CHF

Just want to say I so get your anxiety of the dental dam and it restricting swallowing, it really is a hard sensation. Its a really weird feeling not being able to swallow when you need to. I know for me I REALLY consciously worked on my breathing and focus and though at times that is hard to control being anxious there were times I could and it worked and I found I could swallow bits when I needed to. I also asked my dental team to give me a suction when I raised my hand , which worked nicely to work out a sign ahead of time you need help with this. Also just to know they will respect when you need rest , or if you need to exit due to any panic. I know for me , knowing my dentists wouldn't ignore my pleas to stop or get help was a huge relief in and of itself. Will you get to talk to the endodontist before your treatment again? and could you email them or ask for a call to discuss your fears on this. I know everytime I've laid down my anxieties and concerns my dental teams recenty have been very good at listening and caring especially if they know what I'm dealing with as in anxities. When do you go in again?