Not allowed sedation again - plz help.

[Lizwhite28]

Hi all,

I need your help plz. I had 14 teeth removed under sedation 2 weeks ago. I reacted quite badly to the sedation (according to the anaesthetist*) and fought them. They said I was so anxious and tense that it didn't really work for me. I remember quite a lot of it and apparently wouldn't sit still and enable them to work very well, they done it but it took longer and they have said it was very stressful. My friend who was in the waiting room said i screamed at the start but i have no memory of this. That said I felt no pain at all, I was freaked out after but would do it again. I'm suppose to be having my next lot of treatment of 2 root canals and fillings under sedation but the anaesthetist*has said I can not have sedation next time. He said this to me and my friend when I was in recovery from last time.

Can anyone help me and tell me why this happened to me? I had a panic attack before I went in and was so scared when I went in.

I don't think I can go through anything awake/being aware and I'm getting so anxious again. Feels like I've had so much work done but my fears worse and still so far to go.

What are my other options? Also are there different types of IV sedation in the uk or just the one? Also would a pre med help? If I wasn't so anxious would it have helped?

Please don't let this freak you out if your due to have sedation as I would do it again in a heartbeat.

 

[comfortdentist]

some people loose all inhibitions when sedated and can be very difficult. in the past I have controlled this with narcotics or ketamine. I have since learned that often a better approach is one that I think Dr. Daniel might agree with where I lightly sedate someone and talk with them and verbally manage them with light drug use.

 

[vicki]

Your experience sounds similar to an experience of mine a few years ago.

I had an endoscopy at the local hospital to investigate ongoing acid reflux and I was booked in to have IV sedation for the procedure. I'm no stranger to hospitals as I have quite a complicated medical history, so I'm not really bothered by being in hospital and everything that goes on there. However, I do experience panic attacks in certain situations (such as going to the dentist ), so I was very anxious on the morning of the endoscopy. Although very tense, I was pretty much OK up to the point where they were trying to insert the IV cannula (I'm very used to this as well) and I started to panic. They injected the Midazolam but I didn't feel sedated at all so I started to freak out and was telling them to stop. I think they thought my behaviour was down to the drugs, so they just carried on with me struggling with them. At some point during proceedings, I think I might've passed out, but I actually remembered most of it, which is something that I should not have been able to do really, if I had been properly sedated.

A few hours later, I was sat in my mum's office (she worked at the hospital at the time) and began to feel extremely wiped out and exhausted. I slept for the rest of the day in her office.

At the follow up outpatients appointment, I asked what had happened and I was told that my panic had caused me to produce so much adrenaline that it had counteracted the sedation which is why I'd ended up half sedated and freaking out. Later on, when things had calmed down and my adrenaline levels had returned to normal, the remainder of the drugs in my system decided to kick in and that's why I slept for hours. If I had been calmer to begin with, who knows, the sedation may have worked better.

The main drug that's used in the UK for sedation tends to be Midazolam as it's quick to take effect, relatively quick to wear off and has a good safety profile. If you opted for sedation again (it's a bit odd that you were told you couldn't have sedation again - especially by an anaesthetist because they're the experts in sedation and know how to manage these things very well), it's likely to be the same drugs and procedure again. One thing that some people have found to help them if they're anxious beforehand, is to take an oral sedative the night before and maybe a few hours before the appointment (something like Diazepam or similar - your dentist should be able to prescribe it for you). That way, you'd be a bit more relaxed going in for the appointment.

Having said all of that, comfortdentist does have a point. Ultimately, the thing that will enable you to overcome your fears, is learning to trust your dentist and allowing them to show you that they can be trusted to take things at your pace and put you in control. Although it can be great for helping you to get through treatment, deep levels of sedation don't really enable this learning process to take place.

You mentioned that you've got some fillings and a couple of root canals to come. Maybe breaking it down into smaller to manage steps would be easier for you... 14 extractions in one go sounds like an awful lot - even with sedation. Perhaps if you tried maybe having a filling or two first (with or without sedation) and then build up to having the root canals, that might help? I was terrified when I was told that I had to have a root canal last year - it's the thing that *everybody* fears isn't it? I didn't believe my dentist when he tried to convince me that it was "just like a filling, except that it takes a little bit longer and we go a bit deeper". I have to admit it though - he was right.

Maybe have a chat with your dentist and see what s/he suggests?

 

[45andAfraid]

Have to agree...

I've been sedated for 3 appointments. Oral sedation (Ativan - 2.5mg each) topped off with some Nitrous to relax me.

My first appt I had to take 1 dose an hour before and then another one when I got there. It relaxed me quite a bit to be able to sit in the chair (for the first time) and I do remember bits and pieces. It was for impressions and because I'm a severe gagger (and yes I did still gag), it wasn't all that traumatizing because it's just a foggy memory for me now. Granted, I did, react to the gagging at that moment in time but because I was sedated, I didn't really panic and foot it out the door.

Second appt. Bottom Teeth - I understood sedation and also I was to stack the meds (2 when I got at the office). In about 20 mins I was more sedated than my first appt and I remember only tiny bits and pieces of the appt. I think I actually slept through most of it. I had 4 teeth pulled, massive deep cleaning and a temp bridge put in. I also had my top impressions RE-done because the first go didn't work out too well. all I remember with that is opening my mouth to take the tray and then the wiggling to get it out.

Third appt. I was to have top teeth done but was more nervous because it was a different scenario with bone grafting involved, 5 extractions and a temp. bridge (front teeth). I didn't stack the sedatives, I had 1 15 mins. prior and then another in the chair. some nitrous but it didn't seem like the same affect as second appt. I dunno what happened. I remember almost everything except for the bone grafting as that was quiet, and I was numb (prolly fell asleep then). But I do remember the teeth pulling quite well and I also gagged quite severly. They gave me another half dose of Ativan and I asked for more Nitrous.

So I like the stacking with Nitrous the best. It works the best but I think the key thing to remember is to try as best as you can to relax and let the meds do what they are suppose to do and go with it.

I would really talk to your dentist again and let him know you've been "coached" a bit about sedation and would like to try again.

 

[brit]

That particular practice may not be willing to sedate you again. This does not mean that someone else would take the same view.
However you are in good hands it seems and really would encourage you to do the rest with local and TLC. That way you will beat the fear more easily. The worst is behind you - multiple extractions is never fun.

 

[Lizwhite28]

Hi all,

Thanks for the reply's. Well I went today and the bad news is all my top teeth at the front need crowns at £450 a tooth which will mean x 8 = £3600 which I simply can not afford at once. The good news is I didn't freak out, I was absolutely fine. Had more X-rays, a stitch removed that was missed last time and another examination and i was fine It probably helped that I fell over on the ice on the way in and ripped all my tights and made my leg bleed, really made me laugh and helped keep me calm as I wasn't thinking of all the things that could go wrong just that I looked like a right wally lol.

I've decided to have 2 crowns done first and the dentist is goin to fill the rest until I can afford the rest. They have decided to IV sedate me again as im having a root canal, 2 crowns and 6 fillings at
once. I'm having all this done Thursday as they have a cancellation. I feel happy and excited to finally fix the front uppers and not at all nervous....... Yet. Hopefully it stays this way as I'm getting
so use to goin. My dentist said he thinks I'll be ok this time with the sedation, fingers crossed. He said they will give me more this time.

Hope my nerves hold out and I finally get a nice smile.

 

[brit]

Hi all,

Thanks for the reply's. Well I went today and the bad news is all my top teeth at the front need crowns at £450 a tooth which will mean x 8 = £3600 which I simply can not afford at once.

I've decided to have 2 crowns done first and the dentist is goin to fill the rest until I can afford the rest.

I am always very suspicious when people are told they need 8 crowns at the front. 8 might be the way to get a perfect Hollywood smile (remember crowns remove an awful lot of tooth structure and should not be done lightly) but a crowned smile also needs maintenance - they don't last forever.
If the teeth will hold out with just fillings, then just do that. The 2 at the front may make sense though based on what you've said before.
I think what I am trying to say is that the fact you can only afford to do two may be a good thing . A filling lets you keep much more of your tooth structure.
How come all these crowns weren't mentioned originally as well?

I'm sure the sedation will go better if you go in feeling more relaxed in the first place. Great you feel more confident now.

 

[Dave48]

Iam waiting to have an endoscopy I have acid reflux I have been diagnosed today with asthma Iam wondering why I keep breathing quickly at the dentist.

Dave.

 

[Lizwhite28]

Thanks Brit. Will see what the teeth look like with just the fillings before i decide on having more. The plan originally was to get rid of the bad nasty teeth and now it's to fix the fronts. He did ask me what I wanted and I said nice healthy teeth and a nice smile.

Well tomorrow's the big day. I'm a tiny bit nervous but very excited.

One question though - is it safe to be sedated for longer than an hour as my dentist said that they only like to sedate for a max of 45 mins so he needed to get the anaesthetist permission first. Will they give me extra? Last time it was just the initial shot and that was it, I was aware/awake after about 30 mins and they didn't give me anymore. Hope they do this time.