Somewhat scared of sedation!

[Nat]

Hey everyone, some of you may know that I am due to have a ton of dental work done under IV sedation, I am a little bit worried about this though, I have met the best dentist in the world and he has taken my dental work at my own pace but in 1 months time I am due to have 4 teeth out and a root canal . I have been given a letter of do's and dont's and I was wondering if anyone could tell me why I cant do certain things before the dreaded D day!

I am only allowed to wear flat heeled shoes,
Do not smoke for at least 36 hours before?? WHY!!
Do not wear make up.

I also am worried about the whole procedure really! Its all I have been thinking about and my appointment isnt until the 5 June! I am scared I will either panic and not know about it while being sedated, I am worried about it not working and I am also worried that I will have a drunk feeling, now while I like the happy drunk state I dont like the dizzy, groggy crappy feeling you can get whilst being drunk!

I have never had any sort of operation before so have never had a GA and the whole idea of being in a trance like state worrys me a bit. I have read some stories where people say they fall asleep, will this really happen as I want to be awake the whole time so as I can not be this nervous for the next set of treatment I am booked in for, which is 2 weeks after! I am probably not making much sense right now, I do tend to gabble on a bit when I have so many questions in my head, I cant seem to get them all out!

 

[vicki]

Hi Nat

I don't know whether you've seen it or not but there's a page about IV sedation here:

IV Sedation

Find out all about IV dental sedation: what does it feel like, is it safe, and how do the sedation drugs midazolam and remimazolam differ?

www.dentalfearcentral.org

I am only allowed to wear flat heeled shoes,
Do not smoke for at least 36 hours before?? WHY!!
Do not wear make up.

At a rough guess (and this is me just guessing... I have had IV sedation before but not at the dentists), the reason that you need to wear flat heeled shoes is that some people do feel a bit dizzy/woozy for a while after the sedation - so obviously if you're wearing 6 inch stilettoes there's more chance of you maybe tripping up (same thing as when you've had one pint too many ). The bit about not smoking is usually the same for people having a GA as well - I don't smoke but when I've had GA's in the past, I've asked why (just out of curiosity ) and the answer was that it's to just to make sure that your lung function is as good as it can be. The reason for no make up is usually so that they can keep an eye on your skin colour - to make sure your circulation is OK. None of this is anything to worry about though . It is all, as they say, just precaution and standard procedure.

I am scared I will either panic and not know about it while being sedated

I'm sure they're used to people having a panic before sedation (I know I certainly have done in the past ) so if it happens, try not to let it worry you - it's OK. Although if you're sedated, the chances of you panicking are pretty much zero - because you're sedated .

I am worried about it not working and I am also worried that I will have a drunk feeling, now while I like the happy drunk state I dont like the dizzy, groggy crappy feeling you can get whilst being drunk!

I think everyone experiences it slightly differently but I haven't honestly (and I've been reading, posting and moderating the support board for quite a few months now - although not necessarily in that order ) read a post from anyone who said it was absolutely awful. Even if you do feel a bit dizzy/drunk/crappy/groggy, it's nothing that can't be fixed with a few hours sleep followed by lots of TLC from your family. And besides, you'll be so chuffed and pleased with yourself for having the work done that you probably won't care even if you do feel slightly crappy .

I have read some stories where people say they fall asleep, will this really happen as I want to be awake the whole time so as I can not be this nervous for the next set of treatment I am booked in for, which is 2 weeks after!

Nobody falls asleep - you are conscious the whole time but because you don't remember anything about it, it feels like you must have been asleep. Once the drugs have gone in, the whole thing feels like about one minute... or less maybe... I can't remember!

Hope this helps .

 

[Nat]

Thanks Vicki, Im not sure if reading that helped in any way! It made me feel a bit nervous about everything! I had that horrible butterfly feeling in the pit of my stomach, not quite the intended effect im sure!!

I also forgot one other question I had, I read on one of the posts here that if a dentist uses IV sedation they should have some letters after their name I cant find it now so I dont suppose anyone could tell me what they are?

 

[vicki]

You're bound to be nervous about everything - especially if it's the first time you've experienced it. Even people who've had it before get nervous - I know I do .

I find it sometimes helps if I write down absolutely everything that's worrying me (it doesn't matter how small it may seem). Then I work through the list to try and answer the worries because as usual, it's the great fear of the unknown that makes me feel scared. And that's what this place is here for - to try and answer your worries.

I'm not too sure about the letters after the dentist's name question (as in I'm not sure what the letters would be) but if he uses IV sedation then he will have been on training courses which qualify him to use it - plus he will have loads of experience in sedation as well. You could post a question on the Dentistry Questions board (or I can move this thread if you want?) .

 

[Nat]

Thanks, if you wouldnt mind doing that I would appreciate it, I will write a list of things and speak to my husband about them, see is he has any suggestions that may help me realise why I am so frightened. He had a motorbike accident last year and was sedated heavily for some of the treatment he received so although it isnt the same, he has first hand experience of how it feels and can hopefully help me put my mind at ease about the whole experience!

 

[letsconnect]

Hey Nat ,

as Vicki said, the flat heeled shoes are because you'll probably feel a little woozy afterwards and nobody would want you to hurt your ankle - it's a lot more difficult to walk in high-heeled shoes! The no smoking bit I'm not too sure about, I actually haven't heart of this before. Maybe ask Gordon on the Dentistry Questions board? The do not wear make-up bit is, as Vicki said, so that your skin colour can be monitored. It's easier to see how someone is feeling if they're not wearing make-up, and with a nervous patient, your dentist would want to make sure you're feeling alright!

There's no drunk feeling with IV sedation (nitrous oxide is the type of sedation that creates a happy drunk feeling), and you will not have a dizzy groggy crappy feeling.

You will be awake the whole time. You will be able to respond and make your wishes clear. But afterwards, it may feel as if you've been asleep, because benzodiazepines produce an amnesic effect. Then again, this isn't always the case - you may remember being aware, but deeply relaxed.

People should never fall asleep during conscious sedation. That wouldn't be conscious sedation, but deep sedation, and in the UK, deep sedation is classed the same as GA - it needs to be carried out in a hospital! So in the UK, the chances of this happening are pretty much zero.

I have read some stories where people say they fall asleep, will this really happen as I want to be awake the whole time so as I can not be this nervous for the next set of treatment I am booked in for, which is 2 weeks after!

You could let your dentist know that you'd prefer it if he kept the level of sedation light. Bear in mind though that the bulk of the stuff you dread most is going to be done during your first session, and that many people without any dental fears whatsoever might opt to have IV sedation for having several teeth removed at once, simply because it's more comfortable! You can always "get used to" the whole idea of being in the dental chair later (and it sounds like this is something that's important to you for the long run - which of course is a great idea ).

Believe me, I've read tons of first-hand reports (as well as a book) about IV sedation over the past 2 or 3 years, and the only negative ones I've come across were in cases where a dentist who was perceived as unsympathetic or uncaring was using it. I've never ever read about anyone having a bad experience when done under the care of a dentist like yours .

 

[brit]

Nat
Letsconnect is right - you've got loads of time to get over your fear whilst unsedated - during the more routine stuff later. Once you've had all your current dental work done, you'll probably go for years without ever needing any treatment- so it makes a lot of sense if you're very nervous to have the potentially less than pleasant stuff done with the aid of these wonderful modern drugs.
If it makes you feel any better, it was routine practice in the UK in the 1970s  to 'gas' children in order to do multiple extractions  - I had this done at least 3 times as a child. This was actually a General Anaesthetic procedure but with a gas mask (horrible smell) rather than the infinitely preferable line in the back of your hand of today.
This old fashioned crude form of general anaesthesia was also quite risky, hence why to err on the safe side the more modern form of GA  is now only available in hospitals in the UK.

For nervous adults, I/V sedation seems like a much safer and preferable option to me than GA in hospital or just having a local for several extractions, in that you are still conscious but you are unlikely to remember very much afterwards - that has to be a bonus.

I was 14 before I ever actively consented to just having a tooth out with local anaesthetic only  - that was yet another healthy tooth which had to be removed so I could wear a brace.  I really liked and trusted my dentist at the time so it was actually not a big deal but in your shoes - 4 extractions and a root canal - I'd just be grateful i/v sedation is available. You can try anything once!! If you really don't like the sensation, then you can re-evaluate for the rest. I understand you've got 2 i/v sessions planned?

You've come so far - I know you'll be fine - is your partner staying with you on the day?
All the best

 

[Nat]

Hi Brit, I actually have 3 two hour sessions, all of which I will be treated with IV My hubby is coming with me to the appointments but I wont let him into the treatment room, I know if he is there I will have an excuse to panic as I wont be embarrased in front of him but if I am in a room with strangers, I will be embarrased if I freaked out so he will be waiting for me, hopefully! He is staying with me for the rest of the day though!

I soo remember the gas mask days! That is where my fear stemmed from, A very scary dentists looming over me, trying to put this mask with the most horrible smell over my face while 4 nurses held me down All this and I was only about 8 or 9 at the time.

I guess my main concern is freaking out while the dentist tries to put the IV in or not liking the feeling so much that I have some kind of panic, anxiety attack. He has told me how it feels and I do trust him completely, Like Vicki said I guess its fear of the unkown!

 

[vicki]

I soo remember the gas mask days! That is where my fear stemmed from, A very scary dentists looming over me, trying to put this mask with the most horrible smell over my face while 4 nurses held me down   All this and I was only about 8 or 9 at the time.

I think most people would be frightened in that situation. A similar thing happened to me when I was younger (although it was in hospital when I was having surgery) and is part of the reason behind my fear as well.

A number of things are different for you now though;

1) You're having IV sedation not inhalation (Nitrous Oxide) sedation (unless you want it) so there won't be a horrible smell/mask etc. .

2) You've found a dentist who you like and trust. From your description above, this wasn't the case before. But it is now .

3) You were younger then and weren't necessarily in a position to make the decisions. You are now though - so if you do or don't want something, you can say so. It's your choice .

I guess my main concern is freaking out while the dentist tries to put the IV in or not liking the feeling so much that I have some kind of panic, anxiety attack. He has told me how it feels and I do trust him completely

It's important to remember that you're always in control of what's happening, so if you get scared, do let your dentist know so that he can put your mind at ease. If the thought of panicking beforehand is worrying you, maybe oral sedation might be an option for you - a pill to take beforehand might take the edge off some of the anxiety?

 

[happydancyfeet]

Hi Nat, I dont know if this will help alleviate any of your fears but I really hope it does help.........
I can sooooo relate to your fears of the gas mask, I've been there too!

I have had 4 sedation appointments over the last 6 months or so, and thought maybe telling you how things went for me would help.

The first thing that worked for me was to arrive just a couple of minutes prior to the appointment, so no waiting in the waiting room, feeling the tension and anxiety building up as much.

Secondly, because they knew just how bad I was , they didnt hang about, ushered into the treatment room, all the while they were talking to me about mundane things, ie ,, did you get your jumper from Next etc, sat in the chair, iv inserted in my arm (I'm needle phobic too but honestly never felt a thing). Next thing I know, I'm in a recovery room with my partner, and it was 2 hours later. I felt sleepy but walked to the car and talked all the way home during a 30 min drive, cant remember what i was saying tho lol. And I didnt remember anything about the treatment and felt absolutely nothing.
I'm sure it will be the same for you.

I was also given a list of do's and dont's. I understood the reason behind no high heels, but questioned the "no make-up" I was told not to worry about that, the leaflets hadnt been updated, so I could wear a little. BUT, everywhere is different. I WAS advised not to wear nail varnish though, cos they put a clip thing on your finger to monitor you and they get a better reading without varnish on the nails.

AS for the letters after the dentist's name, mine has BDS and FDS after hers............grrrrr, kicking myself now for not looking that up before i posted a reply, how stupid of me

Hope this helps a little Nat

 

[Nat]

Hey Happy,

Thanks for the reply, it has somewhat put my mind at ease a little, I quite like the idea of one minute being in the chair, then 2 hours later coming round thinking it has only been about 10 minutes! I was thinking last night it would be nice to be so relaxed that its sort of like having a well earned rest from the rigmorole of life! I am still worried but keep saying to myself, I deserve a rest and if being sedated gives me that feeling then I will be happy!

I have been told that they have a device that will let me watch a DVD while being treated, it hooks over your ears and sits on your eyes an I am assuming that it has a small screen in it?? I just wonder if I am watching a film while being very relaxed I will fall asleep (habit of mine is falling asleep while watching a film!) I have also been told if I want to listen to music I can do so but I also want to be able to communicate with the dentist so I guess its a catch 22 really!

One more question I have sounds a bit silly! will I be able to keep my mouth open for a long period of time, I tend to gag when I have something in my mouth for a long period of time (sounds dodgy I know! ) So if the dentist is working on me, will being sedated stop the gag reflex and will they have some kind of device in my mouth to keep it open, this scares me a lot really as I will have no control of my mouth and wont be able to shut it if I do start to gag! I just worry about the silliest things. I want to be able to open and close my mouth when I feel the need to.

 

[happydancyfeet]

HI Nat,

Everyone is different and will need different levels of sedation, they will assess your needs at the time. I had a fairly deep sedation, especially the first time, as I really didnt want to remember anything that would put me off going back. Even under a deeper sedation you WILL be able to communicate with the dentist and wont fall asleep.
I cant see the point of listening to music or watching a film while having  IV sedation?  But,  anything that makes you feel more comfy and relaxed has got to be a bonus.  Within 5 seconds of having the IV inserted  I was sedated and I dont remember a thing.

As for gagging under sedation, I'm sure i've read somewhere on here that someone with a bad gag reflex was absolutely fine under sedation and had no problems.

Take care Nat  

 

[Tate]

That's odd, I've smoked for about eight years and I had sedation operation for over 8 hours (ironic?) and it didn't cause a problem.

I also smoked the night before and the morning of - right before I took the pills.

But if you were ordered not to, I guess don't.

My dentist never said not to and the only fear he expressed was of me burning myself.
He said not to smoke one after I took the pills.

 

[Nat]

I am being a pain now, I just cant seem to get my head around the whole being sedated situation and its freaking me out! I am fine when posting to others about IV but when it comes to me I just go into panic mode

Weird isnt it how you just dont seem to be able to take your own advice on things doesnt it!

 

[brit]

Hi Nat
Maybe you're trying to be too calm about it. It's normal to be slightly apprehensive about medical procedures unless they are completely trivial. Powerful drugs are involved here.

Logically you accept from the accounts you've read on here and from other research, that it's probably going to be the easiest trip to the dentist's you've ever had  - if only because you won't remember much about it at all.  Sounds good to me - a bit like a general anesthetic but without the same level of risk.

I don't remember you saying you were needle phobic or anything. Are you being given any oral medication to calm you, to take beforehand - if not - maybe you can ask for some.

BUT he's not going to be expecting you to win 'Calmest Patient of the Year Award' , so it doesn't matter if you go in there weak at the knees and in tears    - anything less than this and he'll probably be surprised at how well you're coping...the point is.. it doesn't matter...you will be mentally 'out of there' within a short space of time.

I reckon the only thing worth losing sleep over is the afterpain but often that's much easier than you expect or non-existent too - if you're not Freakout or Harper! They have been very unlucky on that score.

I know what you mean though - it's easy for the others to be brave after the event -your reaction is normal....I bet you'll soon be the one posting to reassure others.

However relaxed you eventually become about dental treatment, I reckon it's nice to be 100% unaware if extractions are involved - you'd have to be pretty weird to find them pleasant when awake.
Your dentist has your best interests at heart, in not wanting you to have any more negative experiences - other stuff you probably will be able to do without sedation as you build up your trust in him.

It's a shame you have to wait so long between appointments- too much time to devote to worrying! You know you can do it   - it'll be easier than all those other visits you've made so far.
All the best
Brit

 

[Nat]

Hi Brit,

I am needle phobic too but seeing as the IV is going to be in my hand I can look away!! Its needles in the mouth that really freak me out!

I have Diazepam but the doseage I have seems very low as when I went for my first initial consultation I cried and felt very very shaky while waiting in the waiting area and it didnt feel like it worked for me I have 2.5mg so maybe I could take 2? Would that be dangerous for me seeing as I will also having the IV.

Thanks for your encouraging words, like I said it does make me feel a bit better reading how everyone here highly rates sedation dentistry, I just wonder all these silly things like will it work, will i freak out and worry about it constantly. I have such a long wait too which really doesnt help does it!

 

[brit]

Hi Nat
No idea on the dosages - can you e-mail/telephone and ask?

Have you had painful dental injections in the past, because I always worried before I ever had one that it must be really painful in the mouth - much worse than your arm or whatever but in fact when I had my first one at 12, I didn't feel it at all. Bonjela numbing cream was used even back then though. I can honestly say I've never found one painful. Your new dentist may well have a good painless technique -my 4 year old didn't object to his as I posted before! You won't know till you try something without the sedation.

Because of extremely bad experiences at 10, I'm firmly in the 'needle good - drilling pain bad' camp however.

Back of the hand - glad that's less of an issue for you - looking away makes it easier I'm sure. I've had a couple of these i/vs in the back of the hand for childbirth related things and as other people have said, often you don't feel it at all. They usually say 'just a little scratch' but again I've never felt it. Good technique I suppose.

It's still so long away, you've got to start putting it to the back of your mind or you're going to have a stressful start to the summer. If you can't forget about it - try instead to focus on the positives afterwards and keep reading the positive I/V sedation stories...haven't read any negative ones at all. I'm sure it always works - if you're not under, they won't start work.
Cheers
Brit

 

[happydancyfeet]

HI Nat,

I had the same questions when I first went for IV  sedation, I didnt think 2.5mg before the appointment would be enough.  My dentist advised me to take 5mg the night before and 2.5mg an hour before the appointment. People are different, in that we all have different metabolisms, so its probably best to have a lower dosage before the IV. My dentist didnt want me taking 5mg before and arriving too doped up I'm sure the 2.5 mg dose will be fine. But, if you're still worried, give them a ring and check.......... I wouldnt take a double dose without them knowing.

 

[harper]

hi nat
just wanted to try and make you feel better.
i didnt go to the dentist for 22yrs and eventually had to when most of them were falling out and my husband made me go. i was terrified ,cried & screamed like a small child i still feel unwell on the day i have to go and have trouble getting in the door but once in im better. when i first went i had 3 lots of iv sedation my dentists idea. i remember him showing me a list of the people who were having sedation on the computer and one days were there were loads of people which helped a bit. i realised i wasnt the only one who is/was scared. i wasnt worried about the sedation but the whole dentist thing i was still am although not as much terrified of. ive had 3 appointments under sedation one to do a rct and the ext scale and polish,one for 12 fillings and one for 3 crown preps. i have funny viens and if i go for blood tests or anything like that they dissapear and still i never felt the iv going in. out of all the things i had done i only remember one crown prep and that was because it was lr7 which is a long way back and he later told me that my tongue kept getting in the way! i can honestly say if your scared have the sedation,i only remember 1 thing out of everything and had my eyes covered so i didnt see anything either and the best bit i never knew id had the local i only felt pain after when i had the extended scale and polish. i dont have the sedation now because i want to try and beat this fear and if i have the sedation i feel like im just having the teeth sorted out but not the fear if that makes sense? ive still got some more things to have done but even though im having a rough time at the moment with the pain i know deep down its only because i never went for 22yrs and not dentistry its self. my advice-if you cant do it normaly have the sedation but my BIGGEST bit of advice find the right dentist. mine said something one day ill never forget he said i think your braver than you think and he said ill never hurt you. ill never forget what hes done for me. hope this helps