My story so far...

[symmit]

I last saw a dentist 25 years ago, and since then for various reasons have developed a terrific fear of needles, just type that is making my head spin.

In January I started with bad toothache, my usual course of hitting the painkillers didn't work and I've suffered through until July... I found this site then and yet the fear had stopped me even posting, though I read and read...

So I finally found that our local community dental service does nitrous. After a quick check over (which was 20 mins before I could actually get in the chair, then 10 mins of non-contact and a quick temporary filling) we agreed on a course of treatment.

Two weeks ago went for an X ray, today for a short intro nitrous session.

WHY don't all dentists offer nitrous?! All the prodding and poking he wanted to do he could do but I really didn't care. Still took me a while to get into the chair and I was conscious and aware enough to be apprehensive but although I found the overall experience unpleasant I'm now more confident I can carry on. The next visit will be the big one for me mentally, as that's when the needles will start...

 

[Dr. Daniel]

Hey

You asked why not all dentists use nitrous.
In general, I do agree with you that every dental clinic should have at least the option for a nitrous. However, there are several reasons that it is not so commonly used: To begin with, not all people react well to nitrous, some don't react at all, some get dizzy (roller-coster feeling) and there are some medical limitations to the patient and to the staff. In addition, nitrous does not solve the anxiety just decreases it.

Can you tell us more about your fear of the needle? Any related information can be useful .

 

[symmit]

My fear of needles set in quite late in my younger life, after have a lot of unnecessary medical tests, and if anything it's made me quite nervous of medical staff too (but not so much now). I'll often pass out watching someone else receiving an injection or blood draw in the same room, and the thought of it sends me into panic.

 

[Dr. Daniel]

These medical tests you had to go through, would you point out on some of them (or a specific one) as a trauma?
Let's make the question even clearer: would you say that before having those tests you do not remember having this fear from needles and since a specific "unneeded" blood test you developed this fear?

 

[brit]

I would add was it a blood test (which can be pretty atraumatic like a dental injection if correct technique used) which caused it; or some other invasive (unnecessary) needle procedure?

 

[symmit]

Hi - sorry for the delay in responding - just had another appointment (two extractions and two root canals...) - nitrous is working for me, eyes shut and no sign of needles and I was OK - mental torture for the hour up to the appointment, and very little pain afterwards.

Even though it's an anonymous site, I'm not going into detail about my past, which should say enough for those that have "past" experiences. Daily blood tests make you realise one thing though - some doctors and nurses are better with needles than others....


Back to the dentistry, I got through today, the dentist thanked me and I thanked him, it was a good day even though I nealy passed out when I sat up at the end and saw the empty syringe.

 

[brit]

Daily blood tests make you realise one thing though - some doctors and nurses are better with needles than others....

I'm sure this is true. I have always found the plebotamists working in hospitals are usually really really good at it though. It's the nurse at the local doctor's surgery who may not be so experienced.
When I was having a baby, a nurse in a hospital said , 'have you got good veins?' 'Probably not', I said. 'Then you best go up to Pathology to get the blood sample as they are much better at it than me.'
Useful honesty there. I am not needle phobic but prefer needles not to hurt at all or to be 'just a little scratch'.

 

[Amoreyna]

I can understand your statement that some are better with needles then others. I've had times where a nurse poked me twice, admitted she was having problems and went and got a medic to put in the IV since he was better then her. I appreciate that, she didn't want to cause me pain and honesty does a lot to develop trust in your healthcare worker. My neighbor has a very rare disease, haemochromatosis, and basically has to be 'bleed' every month. She could definitely tell some horror stories about people and needles.

I also understand not wanting to talk about what's wrong or what you're diagnosed with. It took me years to talk about my medical problems, and it's still difficult.

I agree that all dentists should offer laughing gas. While not all people respond well to it, a lot of people do, and for someone like me it's the safest thing I can have. I don't understand why it's not used in the UK more instead of sedation or oral sedation.

I'm glad you found a dentist that understands your fear of needles (which isn't uncommon) and is willing to help you work around it. Some traumas can be overcome, and I encourage you to find someone to talk to. Even going to a therapist can be helpful and they can give you techniques to manage your fear better.

 

[brit]

I don't understand why it's not used in the UK more instead of sedation or oral sedation.

I have an idea why. Historically 'in-chair gas GA' was available and routinely used on kids for extractions at virtually every dental practice in the country.
I experienced it myself more than once. The smell and suffocation feeling you got going under, plus waking up bleeding (because they didn't use local as it was a quick GA, you bleed more without the benefit if the epi in the local) meant most people regarded it as negative experience.

Gradually as local anaesthetics and injection techniques improved, topical anaesthesia etc , more and more people opted to have treatment with local instead.
Then when in-chair GA was banned for safety reasons, I expect those still using it, simply got rid of all their equipment.
The similarity between the old gas GA mask and nitrous oxide as conscious sedation has I think meant it has taken a long time for nitrous oxide to become acceptable again.

It is gradually appearing more and more especially for kids - nitrous pus comfortable local anesthetic technique, in place of safe GA in hospital or instead of just local aneasthetic.

I personally think it is better for kids to have treatment with local delivered comfortably if at all possible. I think making people think they always need nitrous is doing them a disservice especially if extra is charged for it.

I have never personally tried the modern nitrous at thedentist - I think I would likely dislike it a lot because of my negative chldhood experiences. I have used it in childbirth though but I hold it myself then.
I'm making this up as I go along but that is what it looked like happened to me. Gradually UK went from one extreme to the other, Gas nitrous GA to no nitrous available whatsoever.

Then there's all the reasons DrDaniel mentioned as well but I think people/dentists in UK just associate nitrous oxide with negative past experiences.

 

[Amoreyna]

It's rather sad to me that people hold past negative experiences up to something that is completely different. While a lot of people who are older didn't have great experiences growing up, it's a shame that something that is safe and can be helpful isn't used because of this.

I agree that just offering nitrous at every appointment as though it's always needed is wrong, it won't help with the long term comfort with the dentist or to help those get over their fear or could even place people in a position that they always need it for dental appointments. Personally I feel nitrous is a better solution then oral sedation every time one goes to the dentist though, as the effects from it are pretty much gone after a couple of minutes and you are awake during the whole thing, just calmer.

I can get the roller coaster feeling on it if it's too high, I just ask for it to be turned down a little. I personally hope it makes a come back in the UK because to me it seems to be the middle ground between IV sedation and just having LA

 

[symmit]

I can understand your statement that some are better with needles then others. I've had times where a nurse poked me twice, admitted she was having problems and went and got a medic to put in the IV since he was better then her. I appreciate that, she didn't want to cause me pain and honesty does a lot to develop trust in your healthcare worker. My neighbor has a very rare disease, haemochromatosis, and basically has to be 'bleed' every month. She could definitely tell some horror stories about people and needles.

Indeed, for a while I was absolutely fine, I can't really recall when the turning point was that made me properly phobic (for those that understand, vaso-vagal reaction to the sight of a syringe with needle attached, in fact just typing this is making my heart pound) of needles but it refuses to go away for now. I actually feel daft about the whole thing, I know it doesn't hurt much or for long, no more than being attacked by a playful cat (and I have five of them, and regularly provide them blood samples) and yet for some reason the sight of the equipment makes me over-react, and the uncapping of the needle will make me either panic or faint.

I also understand not wanting to talk about what's wrong or what you're diagnosed with. It took me years to talk about my medical problems, and it's still difficult.

Thankfully I have no medical problems, but went through years as the victim someone elses pychological disorder.

I agree that all dentists should offer laughing gas. While not all people respond well to it, a lot of people do, and for someone like me it's the safest thing I can have. I don't understand why it's not used in the UK more instead of sedation or oral sedation.

I'm glad you found a dentist that understands your fear of needles (which isn't uncommon) and is willing to help you work around it. Some traumas can be overcome, and I encourage you to find someone to talk to. Even going to a therapist can be helpful and they can give you techniques to manage your fear better.

Nitrous is safe, quick and either works or doesn't for someone, which is why I think it should be a more available option. I can't imagine it's particularly expensive either - certainly my dentist is covering it under NHS treatment (although it's the local salaried dental service I'm using) and seems happy to treat using it.

For me, a few minutes on the gas and with topical gel in place, I kept my eyes closed, I could definitely feel the injections (which made me squirm somewhat as I knew what was happening but didn't panic) but not really have a clue when the needles went in. I was conscious enough throughout to be able to give a thumbs up for OK or a hand up for "pause..." but relaxed enough to get through it.

I'm finding it good to open up a little here, there is a good friend helping me through it too.

 

[symmit]

Just as way of an update, just had my fifth visit to the dentist. He's taking it slowly with my and completed a root canal today.

We've built up a trust with the aid of some nitrous and taking it slowly, to the point today he kept the nitrous to hand in case we needed it but asked if as there'd be no injections in this session if I'd be happy to try without.

Suffice to say, it was a big step for me, but I'm happy to report that it was sucessful. I'm still irrationally afraid of injections but I can put up with a bit of drilling and scraping.

Next appointment is next week - which is work on the root canals of a wisdom tooth, so I'm not sure what to expect!