on methadone / and no one wants to sedate me , and i am terrified of the dentist..help

[Scruffy]

on methadone / and no one wants to sedate me , and i am terrified of the dentist..help

hello. im a 33yo male. from jersey, i have a had dental phobia all my life. i have NEVER had work done...ever...nto even a cleaning... a molar broke 3 years and has gotten to the point of becoming a half of a tooth with a bit of the dead nerve exposed.... also i need wisdom teeth taken out... also a bunch of cavities....... my heart rate flys up just typing this.

I have severe anxiety and panic attacks...all my life.. and am on Klonopin 2mgs 2x a day. but also am in recovery with 8 years sober, but I take methadone for maintnence .......

so the problems is no dentists want the liability to put me under....i just keep getting bounced around.... on on top of that i have NJ state funded health care which is NJ family care threw Horizen ....so im limited....

ive been put under b4 for other surgerys but have been told those were "necessary " this isnt so thats why im being denied by dentists...

i cant wait much longer i went today to a new place that someone referred me to thinking it was all good.. but the oral surgeon saw me and just quickly said no sorry u need to be in a hospital.....

at at this point i am willing to do twilight sleep IV sedation..... they wont do that either........

has anybody here ever had or herd of someone getting dental sedation while on Methadone? and were they ok?

my dr has cleared me but its not up to him its up to the pratice i go to ......

if anyone on here happnes to be from North jersey essex county , bergen county area and knows any places that will do this or has any feed back PLEASEEE let me know

i wish so badly i could just walk into the place and sit there and just get it done ...but i have tried everything , my blood pressure goes so high and i shake , i feel like will pull the dentists hands out of my mouth...
and oral meds do nothing , since i take up to 5mgs of klonopin a day sometimes. usualy 4...and that barly keeps me calm.....


this really is a terrible sitituation to be in..... any thoughts or feed back would help ....

the only place i know of is UMDNJ university hospital in newark which is run by dental students . and i had a terrible consoltaion there, and do NOT trust kids learning with my life.......

thanks guys
-scruffy

 

[Enarete]

Re: on methadone / and no one wants to sedate me , and i am terrified of the dentist..help

Dear Scruffy,

I'm sitting here reading your post over and over again, trying to find words that wouldn't sound shallow. The fact is that I cannot even imagine what you have been through in your life, but I can see the hopelessness coming from the fact that you need a treatment but can't find a dentist that would sedate you. 8 years sober sounds like you have been fighting really hard and I can only applaud on your strength and bravery.

Sedation as the only way for you to receive treatment is obvious, but as it sounds like the biggest obstacle as well, I am wondering, if small pieces of psychological approach would be of use in your situation..
Would you mind to write a bit more about your specific triggers and fears when it comes to dental situation? Are you able to identify where the fear starts? Is it, for example possible for you to talk to a dentist? Or to get an exam? I got that you never had a treatment, but at the same time you seem to have seen a surgeon so I am trying to understand how your anxiety looks like and what triggers it. You said you tried everything so it seems like you have some experiences when it comes to seeing a dentist even if you wasn't able to receive treatment till now.
I am also wondering how much pain you are in currently and what treatment would be the most necessary at this point and also if you have a counsellor/therapist that would be willing to help you with that.

Sorry for the many questions and also if I am getting too far away from your actual topic. You are clearly interested in sedation trying to find a dentist who would do it and interested in information if sedation would work with your medication. As a non health-care-professional I sadly cannot answer any of this questions for you (hope you get a reply from one of the dentists here on the forum) but would like to offer you support and sympathy and also understand your triggers and fears a bit more. At the same time I am very aware that you have tried a lot of things and have a lot of experiences when it comes to dealing with anxiety.

All the best wishes, let us know your thoughts, sending you good vibes and again, a huge respect for your bravery and all those obstacles you have conquered till now. Hang on there, there must be a way for you to get your treatment and I keep my fingers crossed for it to show itself soon.

 

[Scruffy]

Re: on methadone / and no one wants to sedate me , and i am terrified of the dentist..help

Dear Scruffy,

All the best wishes, let us know your thoughts, sending you good vibes and again, a huge respect for your bravery and all those obstacles you have conquered till now. Hang on there, there must be a way for you to get your treatment and I keep my fingers crossed for it to show itself soon.

thank you for replying

well. in brief...the fact is my triggers for dental phobia are , the actual setting, the chair, the act of someone putting their hands in my mouth makes me feel helpless and my heart rate goes flying high.

the unknown, the stories people tell me. and as for how much pain i am in right now ...
honestly, im not in really pain.... its just discomfort because I have a hollowed out rotted molar with a huge hole... and if it gets hit it bleeds. and i can only chew on one side..so its more uncomfortableness.....and worry of infection......

ive been like this all my life, i really cant ID why....and yes ive tried everything as in going to like 10 dentists that do this type of work and due to my medication no one wants to take me on..... tho i have been put under for other surgeries and have been fine.....

and yes i have a counsellor , who helps with a lot but not so much with this... everyone just pushes me to "do it" .... and i wish i could , but i just am not able to. i wish i could just walk in and say pull them out.... also with my panic attacks i am nervous about taking maracain or lidocaine with epiniphrine ...... due to the raise in heart rate....... so I am thinking i need the one wiht out it.. which is less effective i have heard....

so being awake would be even more challenging ......im sorry if im all over the place....but yes I have had ex rays and an exam .. at one point University hospital in newark NJ was going to do it....but the dentist is a crack pot...... he kept saying and i quote "dont be suprised if u wake up with no teeth" " u do know that dental intubabtion knocks out most teeth right" ...and im like ummm i have been intubated many times i have never lost a tooth, i understand the risk of cracking or loosing one...but ... then he interupted me again and kept going on and saying " once we start drilling u never know how many extra teeth will come out..."

that scared me even more so i canceled the only approved appointment i had...mind this this was going to be done by dental students...so i was nervous about that to...and he wanted to do all 4 wisdom, like 3 extractions and like 8 cavities all at once...... he no longer works at the hospital now i checked....he was truely nuts


and it seems every place i go is not willing to calm me down at all more then here calm down have some water......


so thats baiscly it ...... and its been 4 years since this tooth broke and is just rotting...... amoungts the other stuff. so time is ticking.......if i missed anything lmk thank you for the response

 

[comfortdentist]

Re: on methadone / and no one wants to sedate me , and i am terrified of the dentist..help

you are best managed by a dentist with a G.A. permit. They could use ketamine and propofol on you assuminf you are otherwise healthy.
It is inappropriate to use an opioid on you.
Versed/valium won't work well due to klonopine use.

 

[Enarete]

Re: on methadone / and no one wants to sedate me , and i am terrified of the dentist..help

Ok, so it sounds that there are things you can cope with quite well and things that are too difficult. To me it sounds that you could really benefit from having a dentist that you like and trust and that would take enough time for you and go with you in very small steps. Once a dentist would manage to put you into control and give you as many breaks as you need to calm down if the stress gets too high, you might be able to cope with a treatment. This possibility takes much more time and effort on both sides and might be financially more challenging, but it would straighten your confidence immensely and make you able to cope with treatment long term. It's ok to get sedated for a urgent procedure that would be too stressful otherwise, but having a kind caring dentist you trust will help you long term.

I am shocked to read what that dentist told you!! I do not even know what dental intubation is, but I know what informed consent and a professional behavior of a health care professional is... a dentist with a valid licence should indeed know how many teeth will come out during his procedure.. so glad to hear you cancelled!

So far as an addition to comfortdentists reply, I'm simply a huge fan of desensitization and kind caring dentists who know how to build trust and put their patients in control.

All the best wishes and keep us posted

 

[Scruffy]

Re: on methadone / and no one wants to sedate me , and i am terrified of the dentist..help

I am shocked to read what that dentist told you!! I do not even know what dental intubation is, but I know what informed consent and a professional behavior of a health care professional is... a dentist with a valid licence should indeed know how many teeth will come out during his procedure.. so glad to hear you cancelled!

thank you i will... intubation is when they but the breething tube down ur throat/nose.. so u can breath while under sedation..

 

[Scruffy]

Re: on methadone / and no one wants to sedate me , and i am terrified of the dentist..help

you are best managed by a dentist with a G.A. permit. They could use ketamine and propofol on you assuminf you are otherwise healthy.
It is inappropriate to use an opioid on you.
Versed/valium won't work well due to klonopine use.

I FINALLY found a dentist who will do th work in an OR with an OR team and got a letter from my methadone clinic stating NO opiates givin at all during sedation.. so so no body messes up ... i took me since the months b4 making this post. but i go in tomorrow at 1pm ....
hoping things go well...

thank you for the heads up and about no other opiates . i knew so but i needed a reminder of how serious it is..

will repost with results ...

 

[Enarete]

Re: on methadone / and no one wants to sedate me , and i am terrified of the dentist..help

This is great news, Scruffy! All the best wishes for tomorrow, may it all go well and easy and do keep us posted!