Refuse to open mouth under IV sedation

[LondonGirl1984]

Hi,
I'm a very nervous patient with a severe gag reflex so the poor dentist cant even put a mirror in my mouth, let alone all the tools needed for treatment. This is all due to having generalised anxiety and a few bad experiences with dentists. IV sedation has worked great for me in the past and have managed to have wisdom teeth removed this way.
The last 2 attempts at IV sedation have been very unsuccessful and I really need treatment.
The sedation works great to relax my body and I don't remember anything however, it seems that it doesn't relax my mind. Dentists have told me that when I am sedated, I refuse to open my mouth so they end up not being able to carry out treatment. I don't have any recollection of this afterwards.
I'm at a loss on how I am ever going to have simple dental treatment. Its taken me such a long time to even be able to sit in a dental chair and now knowing that sedation wont help, its really sent be backwards.
Is there anything I can do to help the sedation work? I do meditation and loads of deep breathing before appointments. I don't have high anxiety before going under so I don't understand what the issue is.
Thanks for your help!

 

[Gordon]

To be honest, this is something your dentist should be managing for you, there are a few different ways to tackle this, but it's not something I can tell them via you.

 

[letsconnect]

Welcome, @LondonGirl1984

Great to hear that you've had good success with meditation and deep breathing to calm down before appointments (not the easiest thing in the world to do!).

So I don't really know the answer to your question (unlike @Gordon who has left us in suspense ), but I was wondering if there might also be other ways around this problem. For example, maybe a combination of CBT and desensitisation for the gag reflex, perhaps combined with a lighter form of sedation (nitrous oxide or premedication/oral sedation). I'm talking through my arse here... just wondering if that's something that might be worth considering?

The alternative might be changing to a dentist who knows some of the secret tricks that Gordon is alluding to ...

 

[letsconnect]

OK so Gordon did put me out of my misery, and the answer was rather mundane (basically, just advanced IV sedation techniques in terms of timing/dosing etc.). And there I was on the edge of my seat expecting some Derren-Brown-style-hypnotic-voice-control type answer!

So one option, if you want to go with IV sedation, would be to find someone with a high level of clinical experience and advanced training in this field. I'm not quite sure how to best go about this, maybe you could contact the Dental Sedation Teachers Group or the SAAD.

Or as I mentioned, another avenue could be the psychology route (either ask your GP to refer you or you can of course see a clinical psychologist privately).

 

[LondonGirl1984]

Thank you both for your answers. I am undergoing Dental Psychology with a teaching hospital but its a long process. I do have some urgent treatment and that is what I attempted to get done a few days ago under IV sedation. It was an odd situation as I had the numbing injection and some x-rays done whilst sedated and that was fine but once they went to start the treatment, I apparently refuse to open my mouth whilst sedated. Perhaps when the sedation gets very deep, my mind just gets confused and thinks there is a danger? I guess Ill never know! I will attempt to have a conversation with the dentist and see where I can go from here.

 

[Gordon]

Perhaps when the sedation gets very deep, my mind just gets confused and thinks there is a danger?

The opposite, the sedation is wearing off by the time they've finished with all the other stuff...