• Dental Phobia Support

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I bit the bullet and did it!! It was okay!!!!!

S

Sissybaby

Junior member
Joined
Jan 28, 2009
Messages
7
New here and desperate

Hi everyone.....

I'm sorry to come to a new board and start whining right off the bat, but I need to vent.....and need some support (please).

I have royally messed around and let dental phobia ruin my teeth. I am 54 yrs old and now am scurrying to save what teeth I have left. I have all of my front teeth but had most of my back teeth pulled rather than get root canals or even have them filled.

So, in the past, I found a dentist that did IV sedation and had 5 cavities filled. She moved so there is no one else on my insurance list of providers that does IV sedation. There is one that does conscious sedation, using Halcion.

I have been given Halcion by my Perdontist for deep cleanings (although it's a lost cause at this point.) He just gave me a script for one or two and I wasn't monitored (blood pressure) during the cleanings.

I am scheduled for 2 fillings and impressions for partials on Thursday. Today I went to the dentist for a sedation consult and sign consent papers. She said they would monitor my BP during the approx. 20 minutes of drilling and filling. Fine.

I get to check out and the receptionist tells me there is a monitoring fee for conscious sedation that my insurance won't pay. It's $500.00!!!! :o I was stunned. I don't have that much in addition to my part for the partials. It was a big deal just to talk myself into going under the drill with the Halcion, but I know that calms me.

So I decided to find some halcion on my own and reschedule the fillings in a couple of weeks. I thought I could find some online without a prescription but nope......couldn't find a reputable site. I feel so foolish for even trying to buy them online. I'm always getting spam about other kinds of drugs that I thought it was actually doable.

So, here it is, 2:30am, and I don't know what to do. Nitrous does not work for me. They can never numb me enough. Forget the xanax and Ipod. Won't work. I know the Halcion will work.

No other MD is going to give this to me....not for dental work and I can totally understand why they wouldn't. I'm just wondering if there is any other reason I could get some, like for fear of flying?

I know this is a dental phobia board and we're pretty much all in the same boat. I just needed to vent. I don't know what to do except start reading the forum for ideas.

Thanks and good luck to all of you dealing with the same fear.

Love,

Sissybaby
 
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Stress Doc

Former Member
Joined
Dec 10, 2008
Messages
768
Re: New here and desperate

Hello and Welcome:

I will try to answer you questions the best I can with the information you have provided.

You are very wise not to try to buy Halcion from "pharmacies" that do not require a prescription. This medication is a "triplicate" and prescriptions are carefully monitored. Almost every "no prescription" pharmacy dispenses non-regulated medications as to dose, type and purity. In short, they are dangerous.

Halcion needs to be monitored due to hypotension (low blood pressure) and numerous medication reactions and interactions. Oral sedation reactions and depth of sedation is difficult to predict as it is dependent on many factors such as weight, genetics, current medications and other factors. The medication can take 1-2 hours to become effective, so correct timing is required

Insurance will not pay for monitoring since in their eyes the use of halcion for dentisty is "off label" as this medication was made for insomnia. I know many dentists that do not use this medication because of the extra monitoring required. This is specially true in "stacked dosing" which is common with halcion use.

It is also unwise to go to a doctor and claim a condition you do not have in order to get a medication. This is called "drug seeking behavior" and is a quick way to get dismissed as a patient. Doctors are very sensitive to this with psych and pain medications. We have training in spotting this type of behavior.

In regards to solutions. Xanax is not a great drug for phobias. There is a medication called Ativan. This has a similar action to halcion and works great for short term anxiety.

Our office will prescribe this for anxiety. We never use halcion or Xanax for phobias, short term. Talk to you dentist about this medication, it works very well and has the added benefit of being a preanesthetic. I think this will calm your fear and most dentists would have no problem prescribing it. This medication does not usually require extra monitoring. I hope this helps.:D
 
S

Sissybaby

Junior member
Joined
Jan 28, 2009
Messages
7
Re: New here and desperate

Stress Doc,
Thank you so much for your advice and input. Now I understand why Halcion needs monitoring.
However, my Peridontist prescribes it for my deep cleanings. I take one the night before and one the morning of. He never monitored my blood pressure. He didn't act like it was a big deal at all. That's why I couldn't understand why it would cost $500.

I'm going to call a couple of dentists who does conscious sedation to see what they charge.

God bless,

Sissybaby
 
letsconnect

letsconnect

Administrator
Staff member
Joined
Jan 1, 2005
Messages
5,736
Re: New here and desperate

Good luck with the calls :)! A $500 "monitoring charge" does sound like a complete rip-off to me. It's sad to see some people taking advantage of other people's fear. Of course there need to be reasonable charges which cover costs like training, equipment, insurance etc., but $500 for oral conscious sedation seems totally over the top, compared to other prices I've seen quoted.
Let us know how you get on :grouphug:
 
S

Sissybaby

Junior member
Joined
Jan 28, 2009
Messages
7
Re: New here and desperate

Good luck with the calls :)! A $500 "monitoring charge" does sound like a complete rip-off to me. It's sad to see some people taking advantage of other people's fear. Of course there need to be reasonable charges which cover costs like training, equipment, insurance etc., but $500 for oral conscious sedation seems totally over the top, compared to other prices I've seen quoted.
Let us know how you get on :grouphug:

Thanks! I only found one dentist who uses halcion and he charges $195 for light sedation and $295 for moderate. My current dentist said from numbing to finish the two fillings should only take 30 minutes, max. I do feel people do take advantage of people's fear. But no one ever said life is fair.
I'm still looking and thinking. I'm also getting partials, top and bottom so I will get quotes on that too and see what the final figure and comfort zone I come up with.
Oh, my doctor recently gave me Soma for acute sciatica but after taking one, which made me drowsy all the next day, I didn't take anymore. I wonder if that would relax me enough to get through the drilling????

Thanks!

Sissybaby
 
S

Stress Doc

Former Member
Joined
Dec 10, 2008
Messages
768
Re: New here and desperate

Soma can be somewhat sedating. However, it is not an anti-anxiety medication. Anxiety produces profound change in brain and cardiac chemistry. Soma is a muscle relaxant and has a much different action than benzos. It would be very easy to overcome the effects of Soma due to the action of the medication which is not a primary central nervous system depressor.

Benzos like Valium, Ativan or Halcion bind with the GABA receptors in the brain. Soma works with muscles and does not interact with GABA receptors in the brain.

Here is a quick overview of the method of action of Benzos:

Your body produces many different brain chemicals. These natural chemicals (neurotransmitters) have either a "calming" or "arrousing" effect on the brain. These chemicals transmit these messages to the cells in the brain.



About 40% of the billions of brain cells respond to GABA. GABA is the brains "calming" or tranquillizing neurotransmitter. Benzodiazepine medications enhance the effect of GABA.
When one suffers from anxiety or panic attacks then the brain becomes "over-aroused" it needs the transmitters associated with the "calming" chemicals to come into action . These respond by sending messages to the brain cells to slow down or to stop and since a large portion of the brain’s cells are responsive to these transmitters there is a “calming” affect on the brain.
Benzodiazepines have similar chemicals to those produced by the body for "calming" effects and when these are added to those produced naturally by the body it means that there are a greater number of transmitters sending out messages to the brain cells resulting in an excessive slow down or shut down of these cells.
As a result of this increase in the numbers of cells being slowed down the brains output of "arousing" transmitters is reduced. However, these “arousing” transmitters are vital for normal alertness, memory, co-ordination, emotional responses, heart rate, and blood pressure.
The failure to produce enough excitatory transmitters affects the functioning of these systems and affects the bodies normal working.

I would stick with a benzo like Ativan which has a proven mechanism of action. I would also reccommend learning to use relaxation or biofeedback techniques to begin learning to calm the anxiety response.

In my experience, anxiety never stays confined to one area, it spreads. There are many proven methods to work with this condition before it becomes pervasive. These methods are the best way to improve quality of life. I hope this helps.


:D
 
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S

Sissybaby

Junior member
Joined
Jan 28, 2009
Messages
7
Re: New here and desperate

Doc Stress, thank you very much for the detailed explanation about the brain, anxiety and medications.

I decided to see a new dentist nearby, who has a good reputation. She's very gentle and calming. I mentioned halcion to her and she had never used it for sedation before. She said she would call my Peridontist and talk to him about it, and get his opinion.

Today, she called and said she would give me the Halcion, one the night before and the morning of. My appt is this coming Monday, Feb. 9th, first appt in the morning.

I'd like to get your opinion again. If I were to have a root canal in the future (I need one but so far it is just not doable (mentally) for me. If the Halcion were to help with the filling, I might consider the root canal (cringe...big cringe). The only pain meds I can take is demerol with phenergan. Would that affect my heart rate and/or be too dangerous to take with the Halcion (after the root canal, while halcion is still in my system)?

Thanks for your advice,

Sissybaby
 
S

Stress Doc

Former Member
Joined
Dec 10, 2008
Messages
768
Re: New here and desperate

The halcion would work well for a root canal. Since you appear to have a good response to the medication. A root canal is not any more difficult, from a discomfort perspective, than a filling.

Halcion effects are usually gone within 2-3 hours after taking the medication. Demerol would be overkill for most people after having a root canal. Demerol can raise the heart rate but if you have had it before this it is not a problem.
Taking demerol at the same time as halcion is not advisable. Dangerous sedation, dizziness, or drowsiness may occur if Halcion is taken at the same time as demerol. Once the halcion dissipates there is usually not a problem.

I do not think your dentist would give you demerol for pain. They usually only tell you to take over the counter pain meds as the pain post root canal is not usually very severe. They might give you Ultram(tramadol) is the pain is a little more intense. It is a non-narcotic pain reliever.

If you use relaxation techniques with the halcion this will greatly reduce any anxiety and make the experience easier to deal with.

I hope this helps. All the best :cheers:
 
S

Sissybaby

Junior member
Joined
Jan 28, 2009
Messages
7
Re: New here and desperate

Thanks Stress Doc. You are very thorough with your replies.

If Halcion effects are gone within 2-3 hours, I wonder why she is having me take one the night before and the morning of?

Also, is there a sticky or thread on relaxation techniques? I only have til Monday to gear up for this.:scared:

Thanks,

Sissybaby:scared:
 
S

Stress Doc

Former Member
Joined
Dec 10, 2008
Messages
768
Re: New here and desperate

They usually give you a halcion the night before to help you get a good nights sleep and to start breaking the anxiety cycle. It does not help you to spend the night before in fear.

If you PM me I will send you a link where you can download a technique I use with my patients. It is in mp3 format so you can put it on an mp3 player.

All the best :D
 
S

Sissybaby

Junior member
Joined
Jan 28, 2009
Messages
7
Re: New here and desperate

Thanks for all of your help, Doc! The relaxation techniques are awesome and I appreciate the PM and links.

I'll post my experience on Monday.

Best regards,

Sissybaby
 
S

Sissybaby

Junior member
Joined
Jan 28, 2009
Messages
7
I think my dental phobia is worse than anyone I've ever met. I'm 54 and have always had dental insurance so I should have beautiful teeth. I've had several pulled, mainly molars.
To make a very long story short, I found a dentist who gave me Halcion before the appointment. I've been twice in the last 2 weeks. The first visit, she was only going to fill one. I was so relaxed that I asked if she had time to do another one.

I went back this morning to have the 3rd one filled and again, no fear....no pain.

I took my walkman, put in classical music (per advice on this board......thank you!) and didn't have a care in the world.

Halcion rocks! I wish to God I could have had this years ago. I'd have a beautiful set of teeth.

I never, ever thought I could go under the drill without IV sedation. But I did. So there is hope for all of us. Good luck!!!!
 
brit

brit

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