Introduction, and a couple of questions

[Mands]

I stumbled across this forum a couple of days ago. I never knew there were so many people who share the same fears as me. I know nobody enjoys going to the dentist, but I don't know anybody personally who seems as scared as me. Seems from the few posts I've read here that there are many of us! I'm a pretty level-headed person most of the time, I have no fear of medical procedures or needles, but put me within sight of a dental surgery and I start shaking.I have had treatment on and off over the years, but only when absolutely desperate. I found a dentist several years ago who does IV sedation, and I had a wisdom tooth removed. I loved the sedation. Unfortunately when the way that NHS dentists are funded was changed, I got a letter to say they could no longer treat NHS patients. I can't afford to go privately, so I just didn't go any more.Fast forward to about 6 months ago. A crown I've had for years at the front of my mouth fell out. All the fear came flooding back, so I stuck it back in with superglue. Yes, I know, stupid. It doesn't taste very nice either, but was better than seeing a dentist. Anyway, the crown held, till last week, when it came out again. This time however, I couldn't get it back in. The thought of showing up at work missing a front tooth was pretty horrifying, so I rang the dentist I used before they went private. I was shaking like a leaf, but got through it. It was difficult to get back in, she had to remove a lot of dried glue from the post on the crown, and there was quite a lot more inside the hole in my gum. She told me however that the root needs to come out, and I need to be fitted with a single denture. So here we go again, I have to face it all over again next Tuesday. I will be having IV sedation again, though I have to see a different dentist in the practice, because the one I saw last week can only do gas and air. I have used this in the past for fillings, but no way could I get through an extraction with just gas and air. The good news is, they now treat NHS patients again, so it's not going to cost me anything, not even for the sedation.

This brings me to a couple of questions I hope someone can help me with. I know I can't drive after the procedure, but everyone I know who would take me is working. My son is going to try to get a half day holiday to take me, but if he's turned down, I want to know if I would be allowed to come home in a taxi after the appointment, or is it essential to have an escort, and someone with you afterwards at home?

Second question, I can't remember if I had to fast before the IV sedation last time, and I don't think anything was mentioned about it when I was there last week (I could be wrong about that, I was in a bit of a state and I can't remember half the stuff she said to me)
Thanks to anyone who takes the trouble to read this longer than intended post!

 

[chickenjen]

Hi, Mands,
I know exactly how you feel!!
I'm the same way.............not scared of medical procedures or surgeries (I've had many), but dental stuff, YIKES!!!!!!!!
As to actually needing a person there to take to home as opposed to going home by yourself in a taxi, it would be best to call your dental practice and ask them what they require. I know when I had my extractions done with IV sedation, I HAD to HAVE someone physically in the office with me and that person HAD to drive me home. They made that clear BEFORE I actually scheduled the procedure, so I was able to work around my husband's schedule.
Yes, you will probably have to fast the night before your procedure (no food or drink after a certain time the night before), but again, it would be wise to check with your dentist as to exactly when you need to start fasting.
Good luck and keep us posted!!!!
Many 's,
Jen

 

[Sparkles]

Hi Mands,

That's great that your old practice is able to see you as an NHS patient again, and well done for going and seeing them.

I had IV sedation for getting my wisdom teeth out and was so glad I did, it made it far easier. I did have to have someone to take me home. I asked whether they could just put me in a taxi but unfortunately not, and was told they could not go ahead with sedation unless I had someone there to take me home. So I would imagine you will have to have a person responsible for you.

As for fasting. I think the type of drugs used for IV sedation in the US are different from here so that's why chickenjen may have had to fast the night before. However, I did not have to fast. I was told to eat something light in the morning and then nothing for about an hour before the appointment. I had toast and jam with a cup of tea a couple of hours before it and that was fine.

Would be worth ringing the practice or emailing them to check how they like to do things that way you will know for sure. Hope everything goes really well for you.

 

[Mands]

Thank you both, your responses are much appreciated. I knew I should call, but to be honest even the thought of ringing them makes me feel sick. I did it though, just made the call. I felt a fool because the dentist probably told me all I needed to know last week, but after telling me it had to come out, I don't think I took in anything else she said. Anyway, the receptionist was lovely, told me I have to fast for just 2 hours before the appointment, and it's essential to have an escort. Fingers are crossed now that my son can get the time off to take me, or I will have to reschedule.

 

[Mands]

One more thing is niggling me. Though I'm not scared of needles, I have vivid memories of when the crown was done first time round (years ago, no sedation), that the injection at the front of my mouth was extremely painful. It felt like it went right up my face and was piercing my eyeball. I'm dreading feeling that again. Will I still feel it under the sedation? Will I feel it and just not care? I dread the thought of crying or making a fool of myself.

 

[Kim]

Hello from me Mands and welcome

I was feeling all your fears when you said about your crown coming out I've had that happen a couple of times, but didn't put it back myself, tho' wasn't totally surprised that you used superglue, as when you get a shock like that, I think you tend to do drastic things.

I am glad that you are able to get your treatment now, and just wanted to say about the IV I've only had it once but it was the best thing for me, as like you, I certainly couldn't have had my treatment without it. I was the same a Sparkles, and told to eat something light a few hours before (I am guessing this is because you wont want to eat much after) but am possibly wrong.

You should not feel any pain relief being given as you will be given the IV prior to that, and with sedation there is part of the concoction that makes you forget, so you will be all good.

I truly hope that your son is able to get his time off to go with you, because if you are anything like me, when I had it and after I got home, all I did was sleep for hours, so you need someone to be with you to take you home, and look after you a while after.

I hope your fears and worries ease for you.

Take care.

Kim x

 

[Sparkles]

I'm glad you rang them, at least now you know what you need to do. I told my dentist not to tell me anything important at an appointment as I will not remember afterwards. He usually emails me with any important instructions or gives me a leaflet.

So, I would recommend you either get whoever is escorting you for the appointment to listen to the after care instructions or ask for them to be written down and given to you.

I used to be absolutely terrified of needles and had EMLA cream (which numbs the skin) on before the IV was inserted so I didn't feel that. I got that from my GP though. After he had given me some of the IV stuff I don't remember feeling any of the injections in my mouth, in fact I don't even remember him doing anything.

Dental techniques have improved so much there is no excuse for painful injections anymore. I would let the dentist know you are worried about it, at least that way they can reassure you. My dentist still used the numbing gel on my gums before the injections in my mouth and still used the slow injection technique to make sure it was not painful.

I know it's a weird idea the whole IV sedation thing. You are still awake and can respond to the dentist, swallow, breathe normally and keep your mouth open. The thing about midazolam (the drug they use) is that it makes you so relaxed you don't really care what they are doing, and then it has a weird side effect. It makes you forget. So you don't even remember being awake! Then it just wears off and you feel a bit sleepy and dopey (why you need to have someone with you). I went home and slept it off and felt fine.

The dentist monitors your pulse and blood pressure so that if they increase they know you are distressed or feeling discomfort, so they can top up the sedation or give you more local anaesthetic in your mouth.

Don't worry you will be fine. I wasn't convinced until after it was over but would happily use it again if needed. Amazing stuff!

 

[Mands]

Thanks again everyone for your reassuring words. The good news (I think) is that my son has been given the day off work so the appointment can go ahead. I had the IV sedation before for a wisdom tooth extraction, and that went fine, don't remember a thing. But the injection for that was obviously at the back of my mouth, which I've never found painful anyway. I know it is possible to feel pain with Midazolam, since I underwent a surgical procedure in hospital using it (endometrial ablation). The surgeon was keen for me to do it this way, said I should be fine since I had tolerated an earlier (different) procedure without it. The anaesthetist wasn't so keen though. When the Midazolam was injected, I did initially go "out of it", but soon woke to excruciating pain, and the anaesthetist then gave me a general anaesthetic, for which I will be eternally grateful. I'm not soft (apart from at the dentists!), but I have never experienced pain like that, and I still remember it. The level of pain from a gum injection, even at the front, will probably be a lot less than that though. I'm rambling, and I think I'm probably working myself up into a panic for nothing, now I know it's actually going ahead.thanks for all your support.

 

[chickenjen]

Thank you both, your responses are much appreciated. I knew I should call, but to be honest even the thought of ringing them makes me feel sick. I did it though, just made the call. I felt a fool because the dentist probably told me all I needed to know last week, but after telling me it had to come out, I don't think I took in anything else she said. Anyway, the receptionist was lovely, told me I have to fast for just 2 hours before the appointment, and it's essential to have an escort. Fingers are crossed now that my son can get the time off to take me, or I will have to reschedule.

I think that doctors and dentists are used to their patients not taking everything in the first go-around, so don't feel foolish, just human.
Glad you got your courage up to call the dentist to make sure what you needed for your sedation appointment......................otherwise, your dentist could have cancelled the appointment (especially if you didn't have your escort). Then you would have to go through all this again.
You'll do fine!!!!!!!!
's!!!!!

 

[Sparkles]

Don't worry Mands the injection at the front of your mouth should not be painful. I've had a few there and as long as your dentist uses a good technique and injects the LA really slowly then you shouldn't feel any pain.

You will do fine and it will be over with before you know it.

 

[Mands]

Thought I'd give you a quick update. For those who might not have seen my other thread, I still haven't had the extraction. I did make myself go back yesterday for an inspection, and yet again today for impressions. The top impression was a bit of an ordeal, and I did gag a bit and start to panic, but the dentist just gently reminded me to breathe through my nose, and reassured me that I wasn't choking!

I have one more appointment next Thursday to choose the shade, then it will be D day, the actual procedure. I'm so dreading that. The good news is, the dentist said none of my other teeth need treatment. I'm finding that difficult to believe because one of my lower teeth has some pain. Not excruciating, but it's very sensitive to cold, and it hurts when I put pressure on it. It's also turned a strange shade of grey. He said it could be a gum infection, but the gum itself is not inflamed. He will x-ray it and do a cleaning when I'm under the sedation, so it's wait and see on that one.

Would just like to add how grateful I am to have found this site, and to thank everyone who contributes. It's been a huge help to me over the last few days.

 

[Mands]

I went back today for final impressions and bite. The actual procedure is now booked for next Thursday I actually coped with today's visit a bit better I think. Up to now, this dentist has been a man of few words, although he has been reassuring, I wasn't quite sure if I liked/could trust him. Today, I've decided that the quietness is just his personality, he's very calm. After the nasty impression stuff was over and done with, he talked me through the procedure with the iv, and answered all my questions patiently. He reassured me that it shouldn't be difficult to get numb, and that I would be able to tell him if I needed more anaesthetic, and he would give it no problem. I can also request more sedation through the iv if I need it, he said they will titrate the dose a little at a time till I'm happy. He also gave me a very early appointment, 8.15am so I would be first in and not have to wait around. In order to do that, he is rearranging someone else's appointment (his neighbour apparently, he said she wouldn't mind), otherwise I would have to wait several weeks.

I am so relieved to feel better about him, and I really appreciate the trouble he's taken to reassure me. I think I can actually do this, though no doubt as the time draws closer I might be a quivering wreck again. Thanks so much to everyone on here, your support is much appreciated. I hope to be able to pay it back eventually

 

[Mands]

I did it!! After an awful night worrying, stomach churning, feeling sick, trying to think up excuses to back out, I went through with it yesterday morning . To be honest, I think the only reason I did was because it had taken a lot of arranging, my boss let me have a last minute holiday for today, and a colleague agreed to work a shift tomorrow for me (in case I had trouble adjusting to the partial denture), and a friend (actually my ex lol,) offered to drive me in and bring me home afterwards. I couldn't arrange all that and then let everybody down.

Of course it was the same old story, the build-up is so much worse than the event. The dentist and his nurse were brilliant. I will probably write about the experience in another thread, but I just wanted to thank everyone here for their help, and try to encourage anyone else who is about to face any procedure they are dreading. Go for it, you will feel so glad that you did, and it won't be as bad as you're expecting if you are comfortable you've got an understanding dentist

 

[Mands]

Well, just when I thought the worst was over, I developed an infection Friday morning, just over 24 hours after the extraction, I noticed a vile taste and nasty smell coming from the front of my gum (there was actually a wound in the front of the gum, not just the socket). I called the dental surgery Friday afternoon, and spoke to a nurse. She agreed that it sounded like an infection, but because the pain was controllable with Ibuprofen, suggested I just continued rinsing 4 times a day with warm salt water (I had started this Friday morning), and call back on Monday if it was no better. Big mistake I think, and looking back, I should have been more insistent on being seen Friday. I have diabetes, and it's not a good idea to let infection take hold.

By Saturday morning, pain was worse, hadn't got much sleep, and I spent all morning trying to get through to an emergency dental line (my practice closes for the weekend). Eventually managed to get an appointment. I was terrified of going to someone different, all the fear came back, but I thought he would just write a prescription. He was very young (about 12 I think!), and that didn't fill me with confidence, but he really was lovely. I got more than I bargained for though, he said the gum tissue was breaking down, and he had to cut away bits of dead tissue, and pack it with a dressing He prescribed Metrodizanole for 3 days, and told me to contact my own dentist on Monday, in case it needs another dressing. Within half an hour of the dressing being put in, the pain was much better thankfully. He did say there was some element of local anaesthetic in the dressing, so I guess that helped.

Sorry for such a long post, I just needed to get this off my chest. I feel very bad that I developed an infection. I have been very careful to keep it all clean, have cleaned the plate and my teeth every time I ate something. The dentist said it was because of the diabetes, it makes you more prone to infection. I already knew that, but my diabetes is extremely well controlled, and my blood glucose levels are very rarely above the normal range (I test my blood regularly). A friend asked me last night "How come it got infected?". I'm probably being over-sensitive, but that comment made me feel very guilty, as if I should have prevented it. I couldn't have done more than I did, to keep it clean, so why do I feel guilty? If you got to the end, thanks for listening. I do feel much better pain-wise this morning

 

[carole]

I missed all this before, I have just read through the whole thread and I hope you are feeling better now. It has nothing to do with you being dirty or anything we are prone to infection as soon as a procedure is done be it in the mouth or any other part of your body. It is how it is. You were just unlucky, but lucky for you, you were able to get it attended to.

I think you have done really well

 

[Mands]

Thanks Carole. Things have only just started improving yesterday. After seeing the emergency dentist last Saturday, I had to see my own dentist again on Tuesday, the infection was spreading, pain was getting worse, and I had only one antibiotic tablet left to take. he prescribed another 5 days of Metronidazole, and added Amoxicillin as well. I was beginning to get very scared to be honest, I thought it was never going to clear up.

Anyway, yesterday morning when I woke up, the first thing on my mind was coffee, not painkillers lol, for the first time in 10 days . It seems to be steadily improving since then, though the gum still looks a mess at the front (the front of my gum under my lip was damaged during the extraction, and all that tissue seems to be broken down, going straight through to the socket). Luckily nobody can see that, only me . I have only needed to take Ibuprofen once today, and I am about to take the last of my antibiotics, so hopefully it will all be good from here.

It's been a bit of a rough ride this last week, but I'm happy to say I'm feeling much better now. I hope you are well Carole, and thanks so much for all your kind words and support

 

[chickenjen]

Sorry, I also missed this.
I'm sorry that you got an infection afterwards. I've been lucky that after my extractions that I never had any problems, although I won't say the same about a root canal I've had back in May .
Glad you're feeling better!!
Congrats for getting through the appointment!!!