Sedation success for a panic disorder patient - got through double root canal!

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kat111

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Oct 26, 2011
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Sedation success for a panic disorder patient - got through double root canal!

I'd like to share my success story in case it is helpful for anyone else going through something similar.

I've suffered from anxiety disorders for all of my adult life. Last fall, I fell into a bad spell with panic disorder. At the same time, I needed a root canal and some additional work on a second tooth, and I pursued these through my regular dentistry team. I was having panic attacks pretty regularly, and it wasn't too surprising given the state I was in that the dental work started to trigger massive panic attacks. My dentist was too quick with the numbing shots and the quick "rush" from the shots would trigger hyperventilation, numbness, dizziness, racing heart, and shaking. I recognize all of these things as a panic attack so I don't think I'm dying or anything, but it's a huge battle to try to get under control. When I had the root canal done, I had sustained panic attacks for several hours and it was one of the hardest experiences of my life. It was also very hard on the dentist, and my initial dentist freaked out and wouldn't treat me anymore because she was worried I was in physical danger (yeah, that's about the worst thing to say to someone who is having panic attacks, and it's totally ignorant and false!).

After that root canal, I developed a horrible phobia about going back to the dentist because I was afraid I'd have a panic attack immediately. I needed the temporary filling on my root canal replaced, and I didn't want to go back to the same dentist who had responded poorly to my panic attacks. I tried a different dentist, and sure enough, I started having a panic attack the second I had to open my mouth, and I had to get up and leave. I've never been consciously afraid of anything in particular about the dentist, but when you've had panic attacks in certain situations, or when having one would be really embarrassing or difficult to deal with, it becomes a self-fulfilling prophecy.

At this point I was in a state of near paralysis about all dentistry, and I had also learned that I probably needed at least one if not two additional root canals, as shown by some of the additional x-rays. I couldn't even face getting a temporary filling replaced - a 5-minute, no-shots procedure - much less face going through more grueling procedures.

I spent a long time freaking out about this, reading this website, talking with my therapist, and trying out various meds for the anxiety.

All of those things helped, but two key discoveries made it possible for me to successfully get all of my dental work done (including a marathon double root canal!). First, I found a dentist who was willing to be extremely patient and open to my needs. I found the dentist through recommendations on this site, and on Yelp, and I wrote a "Dear Dentist" letter explaining my issues up front, with great success. Second, I discovered that sedation dentistry is a godsend for me.

I was really afraid of the sedation dentistry at first. For someone with an anxiety disorder, losing control is the worst thing you can imagine. But with a bit of help from my doctor and the new dentist, I was able to "build up" to the experience and it worked beautifully. The type of sedation that I tried was "oral conscious sedation" in which I took a dose of a benzo (halcion in this case) right before the dental work. To get comfortable with this idea, I first asked my doctor if I could try out a slightly higher-than-usual dose of Xanax (which I had previously taken in extremely small doses only a few times, for extreme panic emergencies). She authorized a trial of this kind, which I did on a regular weekend supervised by my partner. This helped me to get used to what it felt like to be a bit drugged up. Then, I arranged with my dentist to do a sedation "trial run" where we did the sedation procedure with a smaller dose than usual during a dental cleaning. This was a great thing to do, because I wasn't afraid of the dental cleaning and I knew I could bail at any point if it made me uncomfortable. But, at the same time, it simulated the full experience of being sedated and having people working in my mouth. In the end, it was an absolute breeze. The medication made me a little bit cold, and that was the only side effect (they gave me some blankets, so it was fine!). It made me a bit sleepy, but I never lost my ability to respond or my awareness of what was going on. I just felt a lot less freaked out than I normally would. And the impulse to panic was completely shut off (wow!).

Feeling emboldened by this, I went ahead and scheduled the required double root canal with sedation. The sedation dose was increased a bit this time, but it still wasn't enough that I ever felt completely "knocked out" (this is something that I understand varies a lot from person to person). With the sedation, I was able to get through 5 hours of dental work without any panic and without even really minding it all that much. Who knew that was even possible?

If you're considering sedation, here are some other things to know about the experience. When you're sedated in this way, the dentist will have you on an automatic blood pressure monitor that will periodically inflate and take your blood pressure. You can hear the machines beeping, and of course you feel the blood pressure cuff. I thought this would freak me out, but on the drugs I actually found the regular rhythm comforting. Also, they put a little clip-on monitor on your finger that shines a light through your blood to make sure you are getting enough oxygen. Finally, after the procedure is done, you are in a drugged out and stupid state for most of the rest of the day. You really are a stupid, sleepy, goofy person, so you need to be sure you have a good friend or family member to take care of you! All I wanted to do was watch chick flicks and eat comfort foods and it was actually pretty relaxing.

Anyway, if you're nervous about the idea of sedation, those are my experiences as someone who was nervous too. If you have a doctor and dentist who are willing to work with you in this way, "building up" to the experience can help. But for this panic-disorder patient, oral conscious sedation enabled me to get my teeth completely fixed with no panic! It was amazing.

Good luck with your own story!
 
coolin

coolin

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Re: Sedation success for a panic disorder patient - got through double root canal!

This is an excellent example of good individualised care from a dentist and an excellent, well written success story. I think it should have 'sticky' status or something similar :)
Oh and don't forget to recommend the dentist in the recommendations section - it can be done anonymously by contacting a moderator :)
Edit - I see you have already :)
 
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healthyteeth

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Oct 6, 2016
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Re: Sedation success for a panic disorder patient - got through double root canal!

That is great to hear about your experience.

By any chance, for your root canal, how much Halcion did they give you? I'm going in for a 45-minute procedure. They are giving me .25mgs for it. I'm really hoping that's enough to prevent me from launching into rapid fire heart beats. Your situation sounds extremely similar to mine.

Thanks so much for your time.
 
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