Terrified of both dentistry and sedation

[Gordon]

Midazolam or Nitrous Oxide.

 

[Neurospicy]

Thank you, one drug at a time makes it simpler as well.

Are these what everyone else use, will it apply to people's stories about conscious sedation?

I've used diazepam and temazepam on an occasional basis (couple of times a month) for many years, with no worse than very occasionally feeling more heavily sedated than usual.

The one that concerns me is when a sleep specialist put me on clonazepam for a parasomnia, and after a week I developed suicidal ideation as a paradoxical response. I do get paradoxical responses to sedating meds sometimes, apparently it's more common in those of us with EDS.

The thing that put me off conscious sedation all those years ago was a gastroenterologist cheerfully telling me that some people are fighting it, but they don't remember a thing. Does this happen often with dentistry, and if so, what do you do?

 

[Gordon]

Are these what everyone else use, will it apply to people's stories about conscious sedation?

In the UK yes. In the US they occasionally use some opiates with the IV Midazolam. But not allowed in dentistry in the UK.

The thing that put me off conscious sedation all those years ago was a gastroenterologist cheerfully telling me that some people are fighting it, but they don't remember a thing. Does this happen often with dentistry, and if so, what do you do?

Some people are more resistant to the sedation effects than others, it's normal with drug responses.

Sometimes you need to add a bit more Midazolam. Sometimes it just isn't going to be enough so you have to stop and change to either an alternate sedation modality e.g. go from inhalation to IV or switch to GA in hospital.

It doesn't matter whether or not the patient will remember or not, you can't treat somebody who is clearly not co-operating. I generally let the escort stay in the surgery until the treatment starts to have an independent witness (assuming patient and escort are happy with this).

It really doesn't happen often, literally a handful of times in over 40 years in my hands, while doing a lot of sedation.

 

[Neurospicy]

It doesn't matter whether or not the patient will remember or not, you can't treat somebody who is clearly not co-operating.

Ah, I think we've misunderstood each other. I wasn't thinking about whether it would make your job impossible, I'd taken that as read. I was worried that it would be traumatising for me.

I have medical trauma, and I've also experienced other, much more serious trauma when sedated (not unconscious). If I were to end up distressed, and either had to deal with me being off my head and fighting it, or clinicians treating me poorly, and then remembered or half-remembered it afterwards, this would be really bad for my PTSD.

And sadly I've had a number of incidents of clinicians treating me poorly. The incident where it was a dentist is why I didn't return to the NHS special dentist, and it made my dental phobia much worse.