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My IV sedation experience for 4 fillings

  • Thread starter Thread starter Karenw
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Karenw

Well-known member
Joined
Dec 21, 2007
Messages
121
Location
Wales borders
I've never been a fan of visiting the dentist but coped with it as a child then things began to go wrong from my early teens.

Our old family dentist was detained at Her Majesty's pleasure following trading his cocaine supplies and his successor was a 'drill and fill' fanatic. Each appointment saw at least 2-3 new fillings until there were no teeth left unfilled whereupon he then replaced the previous appointment's fillings so that no filling ever lasted more than 6-12 months. On my last visit to him at the age of 15 I was told that three fillings needed to be replaced immediately and was asked to make an appointment for the following week. I was concerned at the amount of work he was doing and eventually, after much badgering, my parents allowed me to switch to another practice. This was more than 30 years ago and until three days ago, those same fillings remained in place.

After the experience of excessive drilling and filling my teeth began to break up - chunks would fall off the molars and they would be patched up but I DREADED any appointment, particularly those which might involve the dreaded drill and I had just the occasional check-up and needed no treatment at all in the intervening 25 years, until about 5-6 years ago when more chunks fell off and I knew it was time to finally have my teeth patched up.

I approached a new dentist in trepidation but this was a private dentist with more time and the appointment went well-ish. I found that as soon as I lay back on the chair, my old dental anxiety came to the fore and I sweated through appointments with palpitations, dizziness and feeling awful. Then came the time when I knew I had to face the +30 year old fillings being replaced.

I couldn't go through with it. I'd feel anxious from the moment I made the appointment then on the dreaded 'D-Day', the surgery would sway from the moment I set foot inside. The anxiety soared and the dentist admitted she couldn't treat me in that state. Eventually, although it took several years, I managed to obtain a referral to a dentist offering IV sedation and just 2 days ago, ie on Monday, I had the appointment.

I'd spent the weekend a complete wreck terrified at the thought of the pending appointment during which an upper left #6 and lower left #5, #6 and #7 would be replaced. Incredibly, I drove to the surgery feeling relatively calm - my husband called it 'acceptance' but I thought of it as 'denial', but as I approached the practice I was shaking and my teeth were actually chattering together noisily. My husband came in with me, holding my hand to try and calm me down. The plan was that he would leave once I was asleep but instead he sat through the entire appointment to try to provide some reassurance.

The dentist, having been forewarned that I wouldn't be easy, was calm in his approach. To get things over with as quickly, I'd written a note to him to confirm which teeth were to be filled and in which order - the most urgent were to be done first so that if I wasn't coping then the last two could be aborted and saved for another day - a day which would never arrive!

He took my blood pressure - 168/106 with a pulse of 129 reflecting how I was feeling (ie petrified!) and then I had to sit on the chair as the cannula was inserted into my right arm. Three times I was asked to lay back but each time I sprang back up again to ask any question I could think of as a delaying tactic and then checked that he was injecting Midazolam and no other drug. My left hand was gripping the nurse's hand tight, my right hand gripped my husband's and I gave into the drug as it was administered - or at least I thought I did.

Apparently, for the first 15 minutes I kept waking up so a further 3 doses were administered at which point I flopped, opened my mouth and began to snore - not gentle snores but loud, fog-horn snores which reverberated around the room, could be heard outside and in the reception directly below. Grins must have been stifled until my husband broke the silence saying he'd remind me of this next time I complained about his own snoring.

As for me, I was out of it. I heard nothing at all - not even the telephone call the dentist took or the the colourscheme discussion with the decorator who came into the room as I snored away. The four fillings were completed and when it was time to shape them, I was asked to bite on blue carbon paper - but I was too far gone so the dentist had to push my jaws together and guess whether the fillings were the correct height. Throughout it all, I didn't feel a thing and was dreaming I was at a fairground until being awoken. I felt that I'd come round quickly. The room was swaying for the first few seconds then I focussed on my husband who was still sitting by my feet and looking up at me. I looked at my watched, realised I'd been asleep for almost 2 hours, yet hadn't been aware of anything at all - absolutely nothing. The dentist asked if I was okay and I was asked to sit up.

I was very sleepy and just wanted to lay down and doze but I couldn't. Within less than 2 minutes of coming round I had to leave. It felt very hurried and I didn't feel at all ready to leave but another person had an appointment and I had to vacate the chair. I couldn't sit or stand so my husband had to scoop me up and carried me into the staff room where I flopped down across a row of chairs while he left to collect his car to drive me home. There was no 'recovery area' and I felt very much in the way.

I felt mentally alert and began shaking and feeling very anxious which surprised me because I thought I'd be 'happy'-dopey and not like this and couldn't recall anyone from the forum mentioning shaking or or anxiety on waking. I was alone now and started shivering - probably a reaction to the drugs. I'd been worried about feeling nauseous but was very relieved that I felt ok - and actually felt hungry. Incase there were any risks of nausea or vomiting, I'd dosed myself on precautionary metoclopramide before the appointment.

The nurse came back to check on me and asked me to sit up which I managed for a few seconds before flopping horizontal again. Then I managed to sit for a few moments. My husband returned, asked the nurse if I was ready to leave and took one arm while she took the second and, slumped against him, I was guided down the stairs. I remember glancing to the waiting room where there was one patient - if she had any dental anxiety then I'm sure the sight of me would have done nothing at all to ease it.

The cold wind hit me at the door and I was then guided along to the car. My husband asked if it was normal to be so sedated - the nurse said that a few people were like this, usually the smaller, thinner patients - I'm 1.76 metres and just 48kg (ie less than 8 stone in weight!). While being semi-carried along, again I felt I'd been discharged too soon. The dentist didn't check me before I left and this was unexpected.

The hour drive home felt more like about 15 minutes - I glanced up a few times but mostly dozed. Somehow my husband managed to get me upstairs and I flopped on the bed. He removed my shoes and glasses and left me to sleep, checking on me every hour or so but I slept solidly from 6.30pm until 4am.

On Tuesday, I slept on and off for most of the day and felt clumsy, unco-ordinated and a bit confused - just not really with it. I ate some light snacks and drank squash and Lucozade. I didn't have any pain at all and felt OK. Late at night I felt a bit groggy and woozy - the room was swaying which made me feel panicky which I'm guessing was caused by the drugs.

Yesterday, Wednesday, I felt more awake but still a bit doped and confused. I asked my husband more about my the drugs and he said I'd had either 8mg or 18mg of midazolam (he thought the dentist had said 18mg but this would be a very high dose) and, because I was very deeply sedated and not waking up, I'd also had 1mg of flumazenil, the antidote to reverse the sedation given in divided doses. I had no idea that I would also be given this (which would have worried me due to the possible side-effects of nausea/vomiting) but suspect this was probably the cause of my anxiety and shaking after waking.

It's now Thursday morning, 2.5 days following the IV sedation and I'm feeling much better. I'm more awake, less confused and my co-ordination is better.

I feel that I was over-sedated - I don't blame the dentist for this: I presented in a highly-anxious state and was probably a challenge to treat. The dentist wouldn't be aware that I am teetotal, have never previously taken medication other than a few half-doses of antibiotics and maybe just 4-5 paracetamol pills during my 45 years so my body just isn't used to medications.

I'm relieved that the appointment is now in the past and proud that got through it. I'd do it again but next time I'd like to agree with the dentist that I am sedated much more lightly and have some sort of hand signal to indicate that I'd like more.
 
Hi Karen - thanks for that thorough description and I trust you're feeling better by now.

I'm not sure if it's reassuring or not. It makes me feel like making sure from the outset that I'm not going to be over-sedated just to make things easy for the dentist. I like the sound of suggesting a 'hand signal' to indicate I want more sedation. I'm shorter than you, but heavier - I weigh more like 66kgs.

I didn't know anything about the antidote to make you come round from the sedation. I also assume the fact your husband was in the room when you were sedated was his and your choice? The sedation clinic have stressed that I must come with a "responsible adult" - but I think if my mum was in with me while I was sedated she'd pass out! She wouldn't be much support at that time - not through any fault of her own though. She's certainly not strong enough to support me in any way to take me to the car and the clinic I'm going to doesn't have any parking. We'll need to park a few mins walk away.

On the other hand after reading your experiences, it's very reassuring that you got through it - and are now OK.
 
I don't want to put anyone off by my experiences. I'm teetotal and just not used to drugs or medication of any sort so I possibly reacted more strongly than others would - and not helped by being significantly under-weight and very anxious.

The agreement was that my husband would hold my hand until I fell asleep then he would wander around the town until being called to come and collect me. However, once I was asleep and he was about to leave, the dentist said he was welcome to stay and that it might be reassuring for me. It wasn't planned but he was more than happy to do so and made mental notes of all that was happening and the drugs I was given. He didn't want me to be given too much of the reversal agent but, obviously the dentist was in charge.

However, it was probably good that he was there because the nurse and dentist wouldn't have managed to get me out of the surgery.

The over-sedation wasn't pleasant but it was probably better than the intense and severe anxiety I experience on the dentist's chair but I don't want to be so heavily sedated next time.
 
Hello Karenw, well done for getting through your treatment. Hope you are feeling better now. Hopefully you can continue your future appointments with your usual dentist. Keep in touch.
 
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