IV sedation - absolutely terrified

[essella]

This is my first post, thanks for adding me to this group. It's good to know I'm not alone in having such an extreme fear of dental treatment.

This is my dilemma...I have an appointment in a few days for an extraction (possibly two, one of which is surgical and not likely to be straightforward) and I'm absolutely terrified, as in I feel like I'm going to the gallows (not joking, already going over death scenarios in my head and multiple what-ifs ). I can't do it without sedation...am booked in for IV ... but am absolutely terrified of that as well. I do have a needle phobia but am going to use emla cream and close my eyes...but the bit I am most scared of is the room spinning and feeling out of control. I have a medication phobia and struggle to take anything that makes me feel as if I no longer have control of what happens to my body.

I've mulled over other options....am terrified of dying under general... so that's out, plus am agoraphobic and couldn't travel the thirty five miles to the only hospital near here that does it ...I don't know if oral sedation will zonk me out enough and I'm terrified of what if it doesn't and I have a panic attack in the chair ... I absolutely have to have the work done though as it's avoiding the dentist that has lead to the two extractions ...

...of all options I would probably prefer oral sedation but just don't know if it'll be enough and if the surgical extraction is really difficult or takes longer than they think I don't want to have a panic attack...

Sorry I know this is extreme dental phobia but I'd really welcome any comments that may be helpful on any of the above ....thankyou so much.

 

[Enarete]

Hi essella ,

it's lovely to have you here and I think you're super brave for having scheduled that appointment! And it seems to me that your mind is doing what an anxious mind is supposed to be doing before an appointment: give you all the things that may go wrong so that you have more fear! But that's just what minds do when it comes to anxiety. The good thing is it doesn't matter which method of sedation you chose, you would have fears anyway, because that's what anxiety is about. It's therefore not about finding something you're not afraid of (because there is not such a thing) but to make yourself go despite the fear. Also, your fear is not a prediction in the future. Your being afraid of something doesn't make it more likely to happen. The fear of room spinning sounds very special - is this something ever happened to you in the past?

When it comes to IV sedation, if you take a look around here, you'll find massively positive experience from the most phobic members. The story goes always like this: before it started it was over and they don't remember a thing. So while I do think your anxiety may be massive beforehand, you'll be surely fine afterwards Is your dental team nice?

All the best wishes

 

[essella]

Hi,

thanks for replying, it's really appreciated. The dental team I've met so far have been absolutely lovely and really understanding. I went to this practice because I'd heard they were very good with anxious patients, and also offer IV sedation, which no one else does locally. I haven't met the dental surgeon doing the extraction yet. I've got an assessment appointment tomorrow with the nurse. Then the iv sedation & extraction a few days after that with the dental surgeon when he's back in.

The room spinning ...tbh that's something I've read can happen when the iv sedation first kicks in ... and that's the point at which I'm worrying I'll panic I suppose. Maybe that goes back to my ill-spent youth when I remember unfortunately overdoing the booze on one or two occasions and it feeling horrible and room-spinny. Don't fancy that again.

I'll have a look at the posts on here around positive experiences with IV. The more of those I can read at the moment the better!

 

[Dg6300]

Hi! Welcome.

I’m glad you posted here, and got it all out. We are only as sick as our secrets.

I’m not sure I can add more than the excellent post by Enarete, other than an offer of encouragement.

In general, many anxieties are rational: it is scary to not be in control of oneself. That anxiety is rational.

Happily, you will be in a controlled environment, filled with trained professionals who abide by ethical and moral standards that are very clear.

Lastly, by all means speak up at any, and I do mean any, as decided by you, discomfort with what is happening. You have every right to ask what is happening and why. You can pause or end the treatment at any time.

I am confident that this will go well. In the meantime, post here as much as you like.

 

[letsconnect]

Hi @essella, I’ve been following this forum for the last 18 years and honestly can’t remember a single person describing the room spinning when the IV sedation first kicks in… maybe the reports you read were about nitrous oxide (happy air) sedation? This can occasionally be accompanied by a short and passing feeling of lightheadedness right at the start. With IV sedation, very occasionally people report feeling very slightly woozy at the start (nothing like the room spinning or anything of that sort!), though more often than not, they feel no different at all.

You can read some personal experiences of IV sedation here:

IV Sedation Experiences

Read about IV sedation experiences which people have shared on Dental Fear Central over the years!

www.dentalfearcentral.org

As everyone has said, you’ll be fine afterwards!

 

[essella]

Hi! Welcome.

I’m glad you posted here, and got it all out. We are only as sick as our secrets.

I’m not sure I can add more than the excellent post by Enarete, other than an offer of encouragement.

In general, many anxieties are rational: it is scary to not be in control of oneself. That anxiety is rational.

Happily, you will be in a controlled environment, filled with trained professionals who abide by ethical and moral standards that are very clear.

Lastly, by all means speak up at any, and I do mean any, as decided by you, discomfort with what is happening. You have every right to ask what is happening and why. You can pause or end the treatment at any time.

I am confident that this will go well. In the meantime, post here as much as you like.

thankyou - I keep reminding myself I'll be in a controlled environment, filled with trained professionals...I need to trust them and stop letting my anxiety take over.

 

[essella]

Hi @essella, I’ve been following this forum for the last 18 years and honestly can’t remember a single person describing the room spinning when the IV sedation first kicks in… maybe the reports you read were about nitrous oxide (happy air) sedation? This can occasionally be accompanied by a short and passing feeling of lightheadedness right at the start. With IV sedation, very occasionally people report feeling very slightly woozy at the start (nothing like the room spinning or anything of that sort!), though more often than not, they feel no different at all.

You can read some personal experiences of IV sedation here:

IV Sedation Experiences

Read about IV sedation experiences which people have shared on Dental Fear Central over the years!

www.dentalfearcentral.org

As everyone has said, you’ll be fine afterwards!

Thanks for replying - your reply is really reassuring. I hadn't planned on having happy gas, is that essential?Ideally I'd just like to drift off withy the IV, and not have the woozyness which maybe i'm worrying about more than it warrants...

 

[letsconnect]

No, it would be unusual to use both nitrous oxide and iv sedation. Normally it's either/or, though you could use nitrous oxide as a way of relaxing before having the iv sedation started. It wouldn't be very common though. So no need to worry on that front .

(as an aside, the usual feeling people get with nitrous oxide is one of relaxation, with perhaps a bit of a floaty feeling - not a wildly spinning, out-of-control feeling! though I suppose if the person administering the nitrous oxide were to crank it up too high too rapidly, you could get unpleasant side effects. These days, they tend to be well-trained though!)

 

[MountainMama]

I have not had IV sedation (yet), but I have had nitrous oxide, and that one does give you a slight spinning feeling at first.
I will say that I also have the fear of not being in control of my body. I refuse to take opioid pain medication for that reason, and hate taking any medication that makes me feel even slightly off. I took oral sedation once, for an extraction and it was okay, but I didn’t like the zoned feeling.
With the nitrous, I was so scared of the procedure that it was the lesser of two evils and honestly it made it much easier. So I imagine IV sedation would be even better! I have never had the option available yet, but I think I would choose it!
Good luck!!!

 

[essella]

An update: it's 4.38am, and I'n sitting on the edge of my bed crying. The appointment is tomorrow morning at 11am. I am an absolute nervous wreck. I can't think about anything else, I can't sleep and I can't stop crying.

I went for the pre-surgery check up / appointment yesterday. The staff are lovely, and highly experienced. Yet the pre-assessment appointment has left me more terrified than ever. My blood pressure was through the roof. I can't put into words how terrified I am. I'm convinced i'm going to die and I honestly don't know how I am going to get myself to do this. I'm terrified of the the IV sedation, I'm terrified of general anaesthesia (which isn't what I'm having, but if I don't have the IV that's the only other option), I'm terrified of everything. At this point in time I would honestly rather die.

I asked if I could have oral sedation instead but the dentist won't do it because one of the extractions is a surgical one, which I understand. But I can't cope with the day before of going in without taking something to calm me down. Buy I can't take anything because you can't take anything before having IV sedation. I can't even take Rescue Remedy which is what I usually take when I am struggling.

I know this group is for people who struggle with dental phobia but mine feels beyond what his group is for. I'm convinced I won't be here in two days time. That something is going to go wrong with the IV sedation. And nothing is working to calm me down.

I don't know what to do and I'm not coping.

 

[letsconnect]

Hi, I’m not sure why you can’t take any premedication beforehand to calm you down, there’s a good thread about it here:

Can you take anti-anxiety medication before IV sedation?

Hello to all and thanks in advance for taking the time to read this. I am having the first of four extensive procedures done this Monday, at a new dental office. (Deep gum scaling and I'm not sure what else.) I will be given IV sedation as, like so many here, I am terrified of dental...

www.dentalfearcentral.org

Your fear is definitely not beyond what this group is for! Many of our members over the years have used premedication to make it to their IV sedation appointment.

Were you able to speak to the person who is administering the IV sedation at the pre-assessment appointment? I’m a bit puzzled as to why you wouldn’t be able to take rescue remedy.

If you have any concerns about the safety of IV sedation, you can find helpful info here:

IV Sedation

Find out all about IV dental sedation: what does it feel like, is it safe, and how do the sedation drugs midazolam and remimazolam differ?

www.dentalfearcentral.org

I hope you will make it to your appointment - you’ll feel so much better with this big burden off your shoulders . Let us know how you get on, regardless of what you decide to do. Best of luck

 

[essella]

Hi, I’m not sure why you can’t take any premedication beforehand to calm you down, there’s a good thread about it here:

Can you take anti-anxiety medication before IV sedation?

Hello to all and thanks in advance for taking the time to read this. I am having the first of four extensive procedures done this Monday, at a new dental office. (Deep gum scaling and I'm not sure what else.) I will be given IV sedation as, like so many here, I am terrified of dental...

www.dentalfearcentral.org

Your fear is definitely not beyond what this group is for! Many of our members over the years have used premedication to make it to their IV sedation appointment.

Were you able to speak to the person who is administering the IV sedation at the pre-assessment appointment? I’m a bit puzzled as to why you wouldn’t be able to take rescue remedy.

If you have any concerns about the safety of IV sedation, you can find helpful info here:

IV Sedation

Find out all about IV dental sedation: what does it feel like, is it safe, and how do the sedation drugs midazolam and remimazolam differ?

www.dentalfearcentral.org

I hope you will make it to your appointment - you’ll feel so much better with this big burden off your shoulders . Let us know how you get on, regardless of what you decide to do. Best of luck

Thanks so much for replying. I don't know why they won't let me take anything - I did ask, and they just said no - it was the dental nurse I saw for the pre-IV assessment. I think she said it was because if I take anything before (like valium) then it could interfere with the IV sedation? The sedation is midazolam - don't know if that's why? Am going to phone them up this morning and ask again if I can take anything to calm me down beforehand as I am so terrified I don't know how I'll cope to even get myself in the chair in this state, let alone go through with the treatment.

 

[letsconnect]

There shouldn’t be a problem with taking something like Valium (or temazepam) beforehand, could you maybe ask to speak to the person who is actually doing the sedation?

Best of luck with the phone call, hopefully this can be sorted out for you

 

[Enarete]

It's really strange they did not allow you to take pre-medication. From what I've read here on the forum and heard from other dentists it's not unusual to take something prior to the procedure, as @letsconnect said. I hope they will find a way to accommodate you. If they don't and you don't see yourself going through the procedure otherwise, then looking for someone who is willing to work at your terms may help. There are always options.

 

[essella]

Hi, thanks to everyone who replied, it's massively appreciated. I'm still finding my way around this forum so please bear with me with responses etc, am getting there.

Ok so an update ... I sent the practice an email (because I know they sometimes prefer that as they get really busy) and they phoned me back straight away. In the email I basically said how I'm not feeling sure about IV sedation and am struggling today without being able to take anything to calm me down inadvance of the treatment. The receptionist was lovely, she must have spoken with the dentist because she said best thing to do is to come in anyway tomorrow but not for the treatment and to talk with the dentist about options.

I feel much better about this because tbh I was struggling a bit with the fact that i hadn't actually met the dental surgeon doing the treatment and would have preferred to have met him yesterday at the pre-op assessment. But equally I know how busy they are there and he's a brilliant dental surgeon and I know I'm very fortunate to have him doing the work. I know there is going to come a point where I just have to stop talking about it and do it but I just wasn't feeling ok about the IV sedation or about the fact that I hadn't really met the dentist doing it.

I haven't been at this surgery long but they are fantastic there and I know it's the right surgery for me. They are known for being very good with anxious patients. The dentist I usually see there is brilliant, and I've been getting much better about going since seeing him. But that hasn't been for extractions, which still scare me silly. I'm ok with scaling and polishing now, reckon I could handle a filling, and am booked in for root canal on another tooth which I'm feeling a bit wobbly about but I reckon I can get through it. But the extractions are a different ball game for me unfortunately. One of them is a surgical extraction (the other is more straightforward) so my usual dentist can't do that, that's why I was seeing the dental surgeon at the practice for that one and the IV.

I've asked if I can get the root canal done first, and build up to the extractions. Because I'm thinking if I can handle the root canal then maybe I can handle the extraction that isn't problematic with local anaesthetic plus headphones and relaxation techniques, maybe some valium too, as I'd feel more in control then. Because I've realised that the thing I'm struggling with where the IV is concerned is the feeling out of control and the risks (I know these are small, but unfortunately my head is having a field day with them). I also struggle with the fact that it can depress respiration (I sometimes get this thing at night where I wake up suddenly panicking and it's as if I've forgotten to breathe if that makes sense?)and silly as this sounds I am scared of stopping breathing with the IV.

My ideal scenario would be to be able to do the extractions without IV sedative but with oral sedation and relaxation techniques/natural remedies. I will have to build up to it but I need to feel in control. I don't know why but oral sedation just doesn't freak me out as much. Not that I'd want to take loads, just enough to take the edge off my fear really. I wish gin and tonic was acceptable as sedation tbh as that's what I'd rather do, even though I barely drink - but know that definitely isn't an option! As for the surgical extraction, that's obviously way more problematic, and I don't think they'd do that without sedation. If I have to have sedation for that I'd prefer oral sedation to zonk me out a bit (but not too much). I'm not great at taking medication at all but my gp can prescribe small doses of valium to help me cope with my nerves and if I can do a trial run at home of taking that, so I know how it feels, I think that's help me a lot with taking oral sedation at the dentist, as I'd know what to expect, and that helps reduce my nerves. Again I guess that's a control thing. (I should add - I don't think I'm a control freak around trying to control other people etc - it's more that I have to feel like I have agency/personal control, and my control issues likely stem from childhood trauma and horrendous experiences at the dentist as a child)

I'll update again tomorrow after I've spoken with the dentist. Thankyou so so much to everyone who has taken the time to comment so far, your responses are really really helping me to navigate this as I'm determined to get this treatment done one way or another. Also, I hope my post isn't making anyone else feel more nervous, I'd hate for that to be the case.

 

[Enarete]

What you just posted shows that you arrived at a very different mindset after that call. I love the clarity in your post. You're taking the control and responsibility here - you are clear about what you can cope with, what you can't and what you are willing to try. Looking forward to reading how tomorrow went.
No worries about making anyone else nervous, we all here have our own fears already

 

[essella]

@Enarete Thankyou, the encouragement means a lot. Am so used to giving myself a hard time over this that I forget to congratulate myself for the small wins. But I guess those are important too.

 

[Dg6300]

Hi! I’m glad you’re posting. You are demonstrating courage left and right. You’ve come a long way.

I have to get back to work, so I can’t offer you the response your posts deserve, but you are not alone and you’re going to make it.

 

[LittleLynnie]

"I sometimes get this thing at night where I wake up suddenly panicking and it's as if I've forgotten to breathe if that makes sense?"

Glad to know that I'm not alone on that front. I wonder what causes that?

All the best tomorrow. I think that you have come to a great way to deal with the issue and it's so nice that you feel supported by your dental team.

 

[letsconnect]

Glad to know that I'm not alone on that front. I wonder what causes that?

Sometimes it can be a sign of sleep apnoea so especially if you experience daytime sleepiness, it’s worth discussing with a GP to rule it out…

@essella That’s great news and sounds like a much better plan . All the best for tomorrow, I’m sure that you and your dentist can work out a solution. Let us know how it went!