nhs dentists and oral seditives

[KTP]

Does anyone here have an NHS dentist who is willing to prescribe an oral seditive? I'm wondering because my NHS dentist has refused to do this but I've heard it's possible? If so, how did you find them? Any recommendations for Oxford?

 

[tazey]

If your talking something like diazapam your better off going to your doctor.

 

[comfortdentist]

If your talking something like diazapam your better off going to your doctor.

Would you explain why to this USA dentist?

 

[tazey]

Would you explain why to this USA dentist?

my dentist/consultant wouldn't prescribe it (don't think any in the uk would) if its coz of anxiety then it would be your doctor who deals with it,if you need to mention it to the dentist then sure but unless your having an actual procedure done then why would you?

 

[comfortdentist]

It's more the opposite here. If you need premedication I as your dentist would prescribe it. Actually I would be uncomfortable if your physician prescribed it without my input on which drug and dosage. It might be fine but might be inadequate. Just my take on the topic.

 

[tazey]

Guess that's just the way it works over here,if my doctor gives me 1 or 2 diazapam its a very small amount (it only just keeps me sitting still) in fact I'm not sure that will be enough at my next appointment if he's doing what he says so don't know what I'm going to do.

 

[Judythecat]

I have never had these medicines prescribed, but when my dad suddenly died aged 52, the doctor would only prescribe my mum five diazepam at one time. I think the NHS is very wary of addiction potential - which I realise is absolutely not an issue for short-term dental work.

As a child I used to get “gas” before extractions for orthodontic work, which I imagine is what is discussed as “nitrous” here, but I haven’t heard of even children having it in a long time. That may just be the children I know though. My friend’s 11-year-old is on the waiting list to have a tooth out under general because he is too scared to have it done with local.

 

[brit]

As a child I used to get “gas” before extractions for orthodontic work, which I imagine is what is discussed as “nitrous” here

I also had 'gas' as a child and I now understand it was a form of GA for which parents signed a full GA consent and which is now deemed unsafe outside a hospital environment. I understand it is not quite the same as 'nitrous' as inhalation sedation. I think inhalation sedation is more like 'gas and air' such as you might use during childbirth but it might even be slightly different to that re the mix of nitrous and air etc. It needs to be titrated to the individual.
I may be wrong but I always got the impression that with 'Gas' as a child they knocked you unconscious then worked very quickly in your mouth (often with just the dentist and no anaethetist present), whereas with inhalation sedation you are breathing it constantly while the treatment is happening. As I was usually unconscious (one time I remember and saw stuff) I don't know for sure though.
https://www.dentalfearcentral.org/help/sedation-dentistry/laughing-gas/

 

[letsconnect]

Would you explain why to this USA dentist?

Lincoln has explained it here: https://www.dentalfearcentral.org/forum/threads/sedation-options-in-uk.27113/#post-201344

 

[Enarete]

It's more the opposite here. If you need premedication I as your dentist would prescribe it. Actually I would be uncomfortable if your physician prescribed it without my input on which drug and dosage. It might be fine but might be inadequate. Just my take on the topic.

I think this is the whole problem with NHS, as Lincoln explained. If you, as a patient do not have a choice of dentists and can't go private and your NHS dentist won't prescribe you any oral sedation, but you have to get the treatment somehow, then I can see going to GP as the only hope. It's a circle. I don't think GPs prescribing any meds for dental treatment is right.

In the country I live in we do not have any possibility to go private, the whole country works on a NHS-similar system. This leads to phobics and dentists using GA as the general solution because no dentist anywhere has the time to even talk to the people about their fears.. leads to plenty of people who got everything done in one go on GA and then stop going for years again. Even doing tell-show-do for every treatment would take too much time as well so in the best case the dentists manage to got at least tell-do while treating. Coming back to the original topic, if the system is not set right to offer support for phobics, then counter productive things start to happen.

 

[KTP]

I've now made an appointment with my GP to see if they will prescribe diazepam or similar. If not then I guess I have to wait for the sedation clinic, which is disappointing because the tooth hurts.

Thanks for the interesting discussion. I believe that the inhalation sedation offered in Us dental offices is nitrous oxide and air. The patient breathes this throughout the treatment. It wears off quickly and is only mildly disorienting. I think similar to what is offered in childbirth here, as someone said above. I prefer it because I can drive home afterwards and be alert to care for my son.

 

[ruru]

Ahead of my extraction I was offered a chance to go to somewhere to be 'sedated' but they never explained what it was - just that I'd need someone to take me there and then home again (not an option). It sounded like I'd be out of it.

I'm not sure if my dentist was going to prescribe diazepam or not. She wanted me to take some, but I already had some for travel anxiety (for a journey I never went on). I managed to get it quite easily for that (and was given a lot more than I needed) so hopefully your GP will be the same and you can have relief from the pain sooner rather than later. I'm not sure if you're taken it before, but diazepam tends to make me sleepy enough that driving isn't an option (luckily my dentist is a five minute walk away), so my admittedly limited advice would be to be aware of that if you're not familiar with its effects.

 

[KTP]

Thanks, I hope the GP will help me! I've been diagnosed with generalised anxiety and was on daily clonazepam for a while but stopped before having my son. So yes, I agree, driving probably not a good idea, but the dentist is walking distance so that should be OK...

 

[tazey]

I think this is the whole problem with NHS, as Lincoln explained. If you, as a patient do not have a choice of dentists and can't go private and your NHS dentist won't prescribe you any oral sedation, but you have to get the treatment somehow, then I can see going to GP as the only hope. It's a circle. I don't think GPs prescribing any meds for dental treatment is right.

In the country I live in we do not have any possibility to go private, the whole country works on a NHS-similar system. This leads to phobics and dentists using GA as the general solution because no dentist anywhere has the time to even talk to the people about their fears.. leads to plenty of people who got everything done in one go on GA and then stop going for years again. Even doing tell-show-do for every treatment would take too much time as well so in the best case the dentists manage to got at least tell-do while treating. Coming back to the original topic, if the system is not set right to offer support for phobics, then counter productive things start to happen.

but a doctor is prescribing it for anxiety so you can get there+sit through treatment not for the procedure itself.

 

[Judythecat]

I also had 'gas' as a child and I now understand it was a form of GA for which parents signed a full GA consent and which is now deemed unsafe outside a hospital environment. I understand it is not quite the same as 'nitrous' as inhalation sedation. I think inhalation sedation is more like 'gas and air' such as you might use during childbirth but it might even be slightly different to that re the mix of nitrous and air etc. It needs to be titrated to the individual.
I may be wrong but I always got the impression that with 'Gas' as a child they knocked you unconscious then worked very quickly in your mouth (often with just the dentist and no anaethetist present), whereas with inhalation sedation you are breathing it constantly while the treatment is happening. As I was usually unconscious (one time I remember and saw stuff) I don't know for sure though.
https://www.dentalfearcentral.org/help/sedation-dentistry/laughing-gas/

That makes so much sense. I can remember the “gas” being really unpleasant - I had ten baby teeth removed, then four pre-molars, (all for orthodontic reasons) and having never had even a filling before, it was pretty scary. I’ve always been surprised to read about people being keen to have what I thought was the same thing!

 

[brit]

I can remember the “gas” being really unpleasant - I had ten baby teeth removed, then four pre-molars, (all for orthodontic reasons) and having never had even a filling before, it was pretty scary. I’ve always been surprised to read about people being keen to have what I thought was the same thing!

I concur it was really unpleasant. Even the last time when I went under calmly for orthodontic reasons at age 12/13?, I came round in tears and feeling sick. A hospital GA is far less traumatic.