Phobia of the dentist

[abailey]

Has anyone had experience with iv sedation for deep cleaning, tooth extractions and fillings? I am extremely nervous haven’t been to the dentist in years and need all the above doing under iv sedation. My questions are will it work? What will I feel during the procedure?

 

[borderer]

Hello and welcome here. I really feel for you as I know how hard this is. The good news is that you’ve probably already done the hardest part.

This is my first posting on this forum and I hope that I might be of some help. A couple of years ago I faced up to having fairly extensive work done having avoided the dentist for forty years as a result of the usual childhood traumas. After decades of misery it was truly the hardest thing I have ever done, but I came through and am almost comfortable with the (terrific) dentist now. As part of my treatment I had a couple of IV sessions in order to cope, so I reckon I can reassure you as to what it will be like.

The first thing to say is that the term ‘sedation’ is very misleading. Although from the objective viewpoint of the dentist and those around you you might appear sedated, from your own subjective point of view it is more like a general anaesthetic! You’re away with the fairies.

What will happen is that you will need a friend to take you to the surgery, as I’m sure you already know from the briefing notes the dentist will have given you. When the time comes you go into the surgery and sit down. The dentist will talk you through what is to happen, ask you if you have any questions and introduce you to the sedation nurse who will be present throughout to monitor your condition. They may connect you to a machine to monitor you blood pressure etc. When everyone is ready to go the dentist will probably insert a cannula into your forearm and then inject the sedative through it. Nothing will seem to happen for about thirty seconds, then you might then feel a little woozy. Probably the next thing you will know is being on the sofa at home! (Which is why you need a friend to take you home and stay with you for several hours).

In reality, once sedated you will be aware, though not self-aware (sounds strange but you’ll understand afterwards). You will able to obey instructions and interact with the dentist so that he can get the work done, but you will not know this is happening. Since the sedative is not an anaesthetic you will be given the usual anaesthetic injections, though you will have no memory of this. Afterwards the dentist may assist you down the stairs and sit you in the waiting room with your friend. You might all talk together for a while, though you will probably not remember this either. They will take you out to the car and belt you in and you will be driven home. You will talk back and forth in the car, though you will probably not remember this either – quite weird really. The thing is that a major effect of sedation is that it inhibits memory formation.

If you’re anything like me you will be so pleasantly surprised as to how easy it all turns out to be that it will set you up for life for visits to the dentist. Good luck and let us know how it went if you feel able...

Borderer

 

[Worried]

Hello and welcome here. I really feel for you as I know how hard this is. The good news is that you’ve probably already done the hardest part.

This is my first posting on this forum and I hope that I might be of some help. A couple of years ago I faced up to having fairly extensive work done having avoided the dentist for forty years as a result of the usual childhood traumas. After decades of misery it was truly the hardest thing I have ever done, but I came through and am almost comfortable with the (terrific) dentist now. As part of my treatment I had a couple of IV sessions in order to cope, so I reckon I can reassure you as to what it will be like.

The first thing to say is that the term ‘sedation’ is very misleading. Although from the objective viewpoint of the dentist and those around you you might appear sedated, from your own subjective point of view it is more like a general anaesthetic! You’re away with the fairies.

What will happen is that you will need a friend to take you to the surgery, as I’m sure you already know from the briefing notes the dentist will have given you. When the time comes you go into the surgery and sit down. The dentist will talk you through what is to happen, ask you if you have any questions and introduce you to the sedation nurse who will be present throughout to monitor your condition. They may connect you to a machine to monitor you blood pressure etc. When everyone is ready to go the dentist will probably insert a cannula into your forearm and then inject the sedative through it. Nothing will seem to happen for about thirty seconds, then you might then feel a little woozy. Probably the next thing you will know is being on the sofa at home! (Which is why you need a friend to take you home and stay with you for several hours).

In reality, once sedated you will be aware, though not self-aware (sounds strange but you’ll understand afterwards). You will able to obey instructions and interact with the dentist so that he can get the work done, but you will not know this is happening. Since the sedative is not an anaesthetic you will be given the usual anaesthetic injections, though you will have no memory of this. Afterwards the dentist may assist you down the stairs and sit you in the waiting room with your friend. You might all talk together for a while, though you will probably not remember this either. They will take you out to the car and belt you in and you will be driven home. You will talk back and forth in the car, though you will probably not remember this either – quite weird really. The thing is that a major effect of sedation is that it inhibits memory formation.

If you’re anything like me you will be so pleasantly surprised as to how easy it all turns out to be that it will set you up for life for visits to the dentist. Good luck and let us know how it went if you feel able...

Borderer

All this sounds great and could be just what I`m looking for but I have a few questions for patients and dentists who read here.
1. Use of this type of sedation sounds ideal for nervous patients who require a lot of work but would it be offered/recommended for less work eg 1 or 2 extractions? If not what do nervous patients do after 1 or 2 sessions with sedation with major work?
2. Does this type of sedation add a lot to price of teatment? Any ideas? I`m in Spain and I think I read a figure of 500€ per session somewhere.
3. it doesn`t seem to be available in many places. Are fully qualified anaesthetists required?
4. Are a lot of medical tests required before? Blood pressure etc.
5. For reasons like 3 and 4 above, is this type of sedation only available if planned several months in advance? Long waits just add to stress and fear.

 

[Enarete]

Hi Worried, my answers, based on what I have read here on the forum, what my practice and my favorite dentists say about this topic and also on my opinion:

1. There are several factors to be considered when it comes to sedation being ideal for nervous patients: the ability to cope with a treatment, the amount of work needed and the time available to get the work done. If you need a lot of work and cannot cope with a treatment because your anxiety is too big and if the work is urgent, then sedation is a good option. If you can allow to take things slowly, it would be better to find a dentist you trust and gradually go through the needed treatment in small steps spread during several visits, starting from the easiest treatment. You can also combine these two, but I wouldn't recommend you to get everything done under iv sedation. The reason for this is, that sedation doesn't cure your dental and you will likely have a hard time to come back to the dentist's office for regular checkups, until the next emergency comes. There are other options to manage anxiety such as laughing gas and oral sedation.

2. Yes, a treatment under iv sedation is more expensive than a treatment with just local anesthesia, nitrous or oral sedation. The exact price will vary depending on where you get treated, if you have an insurance or go private etc.

3. Again, I don't know how things work in Spain, but usually a dentist qualified for iv sedation can do iv sedation

4. An assessment is needed. I don't know what exactly it includes, but for sure there are experienced members who can tell you.

5. This might be depending on how things work in Spain, on the practice/hospital and their capacity and if you have an insurance or go private etc.

 

[Thephilsblogbar]

I have never had IV treatment at the dentist when needing a filling, cleaning etc. when I had my root canal redone in 2016 (I had it 10 years) she gave me a padded pillow as I was going to be in the chair for 90 minutes had she also gave me a duvet I could have a nap.

I hate going to the dentist myself but know it important to get any problems sorted out,

 

[Worried]

Hi Worried, my answers, based on what I have read here on the forum, what my practice and my favorite dentists say about this topic and also on my opinion:

1. There are several factors to be considered when it comes to sedation being ideal for nervous patients: the ability to cope with a treatment, the amount of work needed and the time available to get the work done. If you need a lot of work and cannot cope with a treatment because your anxiety is too big and if the work is urgent, then sedation is a good option. If you can allow to take things slowly, it would be better to find a dentist you trust and gradually go through the needed treatment in small steps spread during several visits, starting from the easiest treatment. You can also combine these two, but I wouldn't recommend you to get everything done under iv sedation. The reason for this is, that sedation doesn't cure your dental and you will likely have a hard time to come back to the dentist's office for regular checkups, until the next emergency comes. There are other options to manage anxiety such as laughing gas and oral sedation.

2. Yes, a treatment under iv sedation is more expensive than a treatment with just local anesthesia, nitrous or oral sedation. The exact price will vary depending on where you get treated, if you have an insurance or go private etc.

3. Again, I don't know how things work in Spain, but usually a dentist qualified for iv sedation can do iv sedation

4. An assessment is needed. I don't know what exactly it includes, but for sure there are experienced members who can tell you.

5. This might be depending on how things work in Spain, on the practice/hospital and their capacity and if you have an insurance or go private etc.

Thanks for reply. In Spain, dental treatment seems to be almost exclusively private (think state service offers extractions and preventative treatment for children) though nowhere near as expensive as in UK. As iv sedation is not common it may be expensive, hence my question.
hopefully one of the dentists who posts here will answer about pre iv sedation tests - I think I`d find it pretty devastating to finally get to a dentist to be told treatment with sedation wasn`t an option. As for point 4 above, is it not a question of clinics employing an anaesthetist who does iv sedation? Some dentists may not be happy with that.

 

[Enarete]

Worried,here is a thread to that topic. There is a pdf-documend (28 pages) attached to it and you will find very detailed information about the assessment there too:

Guidelines for treatment of adult patients under IV sedation

Published by Cambridgeshire PCT Dental Service, this document provides guidelines for treatment of adult patients under IV sedation. It explains what to expect both during the assessment visit and during the treatment visit, and lists indications and contraindications for IV sedation.

www.dentalfearcentral.org

 

[Worried]

Many thanks. I`ll have a look at it. Notice it`s from 2009. Almost a decade ago. 9 years is a long time in medicine not least in dentistry.

 

[geos]

I hope this can help:
1. It all depends on the dentists and/or anesthesiologist.
2. I'm in Canada and my dentist says it's in average 10% to 20% of the price
3. In Canada and the USA, and I would guess in most places, you need a specific training to administer the sedation. Dentistry by IV Sedation is usually less available then sedation by pill or by laughing gaz. However, it's more available than by general anesthesia.
4. In my case, they wanted to check blood pressure, weight, heart rate. This could be different with someone else.
5. It all depends on how often the service is available. If it's offered Monday to Friday from 7am to 4pm, you would probably have less waiting than if it's offered the 3rd Monday of every month.

 

[Worried]

I hope this can help:
1. It all depends on the dentists and/or anesthesiologist.
2. I'm in Canada and my dentist says it's in average 10% to 20% of the price
3. In Canada and the USA, and I would guess in most places, you need a specific training to administer the sedation. Dentistry by IV Sedation is usually less available then sedation by pill or by laughing gaz. However, it's more available than by general anesthesia.
4. In my case, they wanted to check blood pressure, weight, heart rate. This could be different with someone else.
5. It all depends on how often the service is available. If it's offered Monday to Friday from 7am to 4pm, you would probably have less waiting than if it's offered the 3rd Monday of every month.

Many thanks for the reply.

 

[abailey]

how do you know if the sedation is working? How will they know if it’s working? I’m petrified they’ll start doing things and il be able to feel everything and be completely aware and with it about what’s going on. Does it get less effective the more you have it? As I need it over 5/6 appointments. I have gone private and she has shown me the list of patients she’s treated with sedation successfully and there is well over 200 on the list. I hate the smells, the look of the tools. Just sitting at home thinking about going to the dentist petrifies me I know I need it doing but I’m petrified of the above

 

[Enarete]

Hi abailey, I understand you apprehension about iv sedation, maybe this link can answer some questions for you:
https://www.dentalfearcentral.org/help/sedation-dentistry/iv-sedation/
You are not asleep during iv sedation, you are just very relaxed and conscious - you can talk and follow easy instructions. The reason why it feels like you were asleep is, that the iv sedation produces memory loss so you won't remember the procedure.
Second important thing is, that the sedation makes you relaxed but they will still numb you up for the procedure so you won't feel any pain.

There are a lot of people who have been through iv sedation around in this forum and the short version of the story of all of them is always the same: 'It was great'