brit
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Sounds like a good plan..best wishes....
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Dental Phobia Support
Welcome! This is an online support group for anyone who is has a severe fear of the dentist or dental treatment. Please note that this is NOT a general dental problems or health anxiety forum! You can find a list of them here.
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fluffyjo
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Well its over and things didn't exactly go swimmingly. I spoke to the dentist about the lack of la last time and he assured me he would make sure i had enough this time. The first couple of fillings went ok, i didn't feel any discomfort but when it came to the 3rd one i was in a bit of pain and tried to communicate this to the dentist to which he replied dont worry its just a bit of pressure from the drill. So i wasn't paticularly happy about that. The blindfold issue was resolved, i asked why he used a blindfold and he said it was because alot of dental phobics dont like to see whats going on. I said i wasn't happy about him using it so he didn't. The other problem i now have is that 2 of the teeth i expected to be filled weren't, when i asked why these 2 teeth weren't filled he said they weren't on his list. So whether thats an oversight on my own dentists part i dont know. Am going to call the surgery tomorrow to find out. I dont want to be apying to have 2 more fillings when they were supposed to be done at the same time as the others.
To be honest by experience has put me off having sedation treatment in the future, i'm going to be brave and go for la next time.
To be honest by experience has put me off having sedation treatment in the future, i'm going to be brave and go for la next time.
brit
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Glad you survived and it's behind you![[smiley=hugging.gif]](/forum/styles/default/xenforo/smilies/dfcsmilies/hugging.gif "Hugging [smiley=hugging.gif]")
....don't worry it's just pressure lol![[smiley=evil.gif]](/forum/styles/default/xenforo/smilies/dfcsmilies/evil.gif "Evil [smiley=evil.gif]")
!
Did they seem surprised when you said you'd felt the extraction last time? Did they apologise at all? Did you have any language barrier at all?
I think that particular dentist needs a sedation refresher course but yes, I'm sure your normal dentist will be a better option for the fillings which have been overlooked (another cock-up maybe?). When you felt sth from the 3rd filling, he should have topped up your LA immediately as she would/will......sorry your trust in dentists has been so undermined by the dual sedation experience but I don't think you were in very competent hands on the sedation or LA front.
You've done really well to go through with it...please don't let it put you off returning to your normal dentist but please do tell her what went wrong on each occasion and then she can think twice about referring someone else.
It seems like you were undersedated on both occasions - the fact you knew which filling was being done implies that....how aware do you think you were of the whole session the second time. A patient adequately sedated who didn't want to see anything, wouldn't need a blindfold as they would be pretty unaware anyway.
You could also still make a formal complaint if you wanted to which would help protect unsuspecting others from a similarly bad experience. Thanks for updating us. Keep in touch.
....don't worry it's just pressure lol! Did they seem surprised when you said you'd felt the extraction last time? Did they apologise at all? Did you have any language barrier at all?
I think that particular dentist needs a sedation refresher course but yes, I'm sure your normal dentist will be a better option for the fillings which have been overlooked (another cock-up maybe?). When you felt sth from the 3rd filling, he should have topped up your LA immediately as she would/will......sorry your trust in dentists has been so undermined by the dual sedation experience but I don't think you were in very competent hands on the sedation or LA front.
You've done really well to go through with it...please don't let it put you off returning to your normal dentist but please do tell her what went wrong on each occasion and then she can think twice about referring someone else.
It seems like you were undersedated on both occasions - the fact you knew which filling was being done implies that....how aware do you think you were of the whole session the second time. A patient adequately sedated who didn't want to see anything, wouldn't need a blindfold as they would be pretty unaware anyway.
You could also still make a formal complaint if you wanted to which would help protect unsuspecting others from a similarly bad experience. Thanks for updating us. Keep in touch.
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S
Stress Doc
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I agree with Brit. What you were subjected to is a textbook case of how not to treat a patient. It seems the dentist had very poor monitoring skills and did not tune into your situation and needs. If someone tells you what you are doing hurts, STOP 
. You have the right to be treated with dignity and respect.
You should file a complaint. This needs to be looked into and prevented from happening to another person.
It took courage to endure that type of treatment and not explode in the office. I think you have more fortitude than you think.
LA administered by a caring and skilled dentist will give a pain free experience. Best wishes for upcoming appointments.
. You have the right to be treated with dignity and respect. You should file a complaint. This needs to be looked into and prevented from happening to another person.
It took courage to endure that type of treatment and not explode in the office. I think you have more fortitude than you think.
LA administered by a caring and skilled dentist will give a pain free experience. Best wishes for upcoming appointments.
brit
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She does have loads of fortitude, but i.m.v. people who find it hard to be assertive with dentists (and I count myself among them although I am not phobic) would NEVER explode, cry maybe.
Sedation drugs aside, her obvious point to make is...'you did not do what you promised you would after the insufficient LA the first time, you did not keep your word, you dismissed my pain and put it down to pressure, I am not happy and will be taking it further'.....but it's really really hard for many people to say all that...they can probably write it in a letter but to say it at the time to the person who has hurt you and let you down is really really difficult....and she was under the affects of some degree of sedation anyway.
I really do hope she puts a complaint in writing.
F
fluffyjo
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I called the dentist today about the 2 fillings that weren't done yesterday and i have to go and see my own dentist tomorrow to sort out getting them done, i hope they dont expect me to pay again as they should have been part of the treatment i've already had.
I also feel i was under sedated on both occasions, i wasn't paticularly aware at the beginning of my treatment but became aware half way through. I dont know if they just use a set amount of sedation for everybody? I thought it would depend on your body weight. The syringe was already set up when i got in there so i know they didn't take my body weight into consideration.
They didn't seem like they were surprised about me being able to feel the extraction and no i didn't get an apology but the dentist wasn't english and tbh i'm not 100% sure he actually understood what i was saying, i'm not using that as an excuse though as theres no excuse for not using enough anaesthetic.
I'm hoping when i go and see my own dentist tomorrow it will be a much more pleasant experience and yes i'm seriously thinking about putting in a formal complaint.
Thankyou for all your support.
I also feel i was under sedated on both occasions, i wasn't paticularly aware at the beginning of my treatment but became aware half way through. I dont know if they just use a set amount of sedation for everybody? I thought it would depend on your body weight. The syringe was already set up when i got in there so i know they didn't take my body weight into consideration.
They didn't seem like they were surprised about me being able to feel the extraction and no i didn't get an apology but the dentist wasn't english and tbh i'm not 100% sure he actually understood what i was saying, i'm not using that as an excuse though as theres no excuse for not using enough anaesthetic.
I'm hoping when i go and see my own dentist tomorrow it will be a much more pleasant experience and yes i'm seriously thinking about putting in a formal complaint.
Thankyou for all your support.
brit
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From your comments, it's becoming clearer and clearer what may have happened to cause your two successive failures - you need to ask Gordon about dosages but as I understand it, it should be calibrated to each patient's needs (not necessarily weight based as I understand it from previous answers) - the rule of thumb is if the patient can ask for more they can have more.
If you look at the upcoming cases on the GDC website, the number of cases involving non-UK trained dentists who may or may not have some kind of language barrier seems to me to be disproportionately high.....the whole point of 'sedation' is that the patient is 'sedated' and feels no pain......you gave him a second chance and he failed again....please make a formal complaint to the practice.....surely you don't want him to keep doing that to others as well. How long before someone has the nerve to complain?
I know you are in a difficult situation re the outstanding stuff and your usual dentist....there was already some kind of communication failure between your dentist and the sedation dentist as to what treatment was to be done....could he maybe have decided not to do the last two fillings because you felt pain from the third maybe? and for some reason his sedation method involved a safe set dose regardless of patients real sedation dosage needs?
I read some in progress NICE guidelines on I/v sedation on the net recently (they were draft) but it specifically stressed that set dose stuff was inappropiate. Gordon does i/v sedation a lot and he would know about established current practice and what current guidelines actually are. His comments on the other thread relate only to the blindfold issue not the feeling pain issue I think.
There seems to be widespread flaunting of the right to a written treatment plan in the UK NHS (and even maybe private sectors although the bill in private sector tends to be helpfully specific after the event lol) - very rarely are they issued judging from posts on here and yet they form an important part of informed consent which the GDC seems to take seriously but they can't take action if patients keep taking stuff lying down. I'mamazed at the number of posters who come away from NHS checkups with seemingly very little clear idea of what treatment is proposed. Something written would at least crystallize it a bit especially where referral is involved.
Maybe start your next session with the usual dentist by asking if she is the principal dentist, who is the principal, is her practice linked to his etc (shared premises don't mean it is) as this will help you gauge whether she wishes to assist you in having his shortcomings addressed on a continuing education basis or whatever.
I think you have been severely let down twice.
How about writing down your whole experience in letter form and giving it to her at the start of your appointment and then see how she reacts??? If she's as nice as you say, she should think twice about referring any other patients to him at least until he's had some i/v sedation retraining/appropriate cultural care for a UK patient.
On a piece of paper: Thanks for seeing me today but before doing anything we really need to discuss my two sedation appointments as I believe I was undersedated on both occasions despite the dentist saying at start of second appt he would ensure I got enough local anaesthetic this time (I felt the extraction) . A blindfold was also used at my first appointment. I really feel I wasn't treated appropriately and that I have a right to lodge a complaint so I would appreciate any guidance you as my longstanding dentist can provide......
Also I thought all 5 fillings were being done under i/v sedation...not just 3 although since the third one caused me pain which he put down to pressure and continued till the end, I was wondering if he decided not to do the last two as he realised I was undersedated and insufficiently numb? you get the idea????
Good luck
If you look at the upcoming cases on the GDC website, the number of cases involving non-UK trained dentists who may or may not have some kind of language barrier seems to me to be disproportionately high.....the whole point of 'sedation' is that the patient is 'sedated' and feels no pain......you gave him a second chance and he failed again....please make a formal complaint to the practice.....surely you don't want him to keep doing that to others as well. How long before someone has the nerve to complain?
I know you are in a difficult situation re the outstanding stuff and your usual dentist....there was already some kind of communication failure between your dentist and the sedation dentist as to what treatment was to be done....could he maybe have decided not to do the last two fillings because you felt pain from the third maybe? and for some reason his sedation method involved a safe set dose regardless of patients real sedation dosage needs?
I read some in progress NICE guidelines on I/v sedation on the net recently (they were draft) but it specifically stressed that set dose stuff was inappropiate. Gordon does i/v sedation a lot and he would know about established current practice and what current guidelines actually are. His comments on the other thread relate only to the blindfold issue not the feeling pain issue I think.
There seems to be widespread flaunting of the right to a written treatment plan in the UK NHS (and even maybe private sectors although the bill in private sector tends to be helpfully specific after the event lol) - very rarely are they issued judging from posts on here and yet they form an important part of informed consent which the GDC seems to take seriously but they can't take action if patients keep taking stuff lying down. I'mamazed at the number of posters who come away from NHS checkups with seemingly very little clear idea of what treatment is proposed. Something written would at least crystallize it a bit especially where referral is involved.
Maybe start your next session with the usual dentist by asking if she is the principal dentist, who is the principal, is her practice linked to his etc (shared premises don't mean it is) as this will help you gauge whether she wishes to assist you in having his shortcomings addressed on a continuing education basis or whatever.
I think you have been severely let down twice.
How about writing down your whole experience in letter form and giving it to her at the start of your appointment and then see how she reacts??? If she's as nice as you say, she should think twice about referring any other patients to him at least until he's had some i/v sedation retraining/appropriate cultural care for a UK patient.
On a piece of paper: Thanks for seeing me today but before doing anything we really need to discuss my two sedation appointments as I believe I was undersedated on both occasions despite the dentist saying at start of second appt he would ensure I got enough local anaesthetic this time (I felt the extraction) . A blindfold was also used at my first appointment. I really feel I wasn't treated appropriately and that I have a right to lodge a complaint so I would appreciate any guidance you as my longstanding dentist can provide......
Also I thought all 5 fillings were being done under i/v sedation...not just 3 although since the third one caused me pain which he put down to pressure and continued till the end, I was wondering if he decided not to do the last two as he realised I was undersedated and insufficiently numb? you get the idea????
Good luck
letsconnect
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Well done for getting through it 
. You sound as if you can finally see the light at the end of the tunnel ![[smiley=cloud9.gif]](/forum/styles/default/xenforo/smilies/dfcsmilies/cloud9.gif "Cloud 9 [smiley=cloud9.gif]")
!
This sounds very strange; IV sedation is given through a tube so it can be topped up at any time (the technical word for this is "titrated" - i.e. given in incremental doses). Maybe the syringe was for something else
I, too, hope that you will lodge a formal complaint - having something in writing might prompt them to look at how they can improve! (rather than having to rely on their intuitions about "what phobic people want"
).
Best wishes for tomorrow
. You sound as if you can finally see the light at the end of the tunnel !This sounds very strange; IV sedation is given through a tube so it can be topped up at any time (the technical word for this is "titrated" - i.e. given in incremental doses). Maybe the syringe was for something else
I, too, hope that you will lodge a formal complaint - having something in writing might prompt them to look at how they can improve! (rather than having to rely on their intuitions about "what phobic people want"
).Best wishes for tomorrow
F
fluffyjo
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The anaesthetist definitely had a syringe set up. He proceeded to insert the iv and then put the contents of the syringe into it. I'm not sure if a tube was used after the initial syringe or not.
This whole thing is really getting me down, i'm exhausted by it all.
This whole thing is really getting me down, i'm exhausted by it all.
brit
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The anaesthetist definitely had a syringe set up. He proceeded to insert the iv and then put the contents of the syringe into it. I'm not sure if a tube was used after the initial syringe or not.
This whole thing is really getting me down, i'm exhausted by it all.
Was there a separate anaethetist as well as the dentist? If so it's even more strange you were undersedated since the dentist would concentrate on the dentistry and the anaethetist on your sedation level but whoever was primarily responsible should have been monitoring whether or not you were adequately sedated/numbed.
What kind of explanations did you get upfront? Did they say which drug they were using?
I can well understand that it is all getting you down..it's so unfair...sedation was supposed to be a stressfree solution for you. Maybe just send a written letter to your current dentist until you feel more up to continuing the battle? It can be therapeutic writing it down whether you use it or not ultimately.
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fluffyjo
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Yes there was a separate anaesthetist brit. They didn't tell me the drugs they were using. Tbh it was like as soon as i got in the chair the anaesthetist had the iv in while i was explaining to the dentist what had happened on the previous occasion. It all seemed to happen so quickly, it was almost as though they couldn't wait to just get it over with and get the next patient in.
brit
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No verbal explanations whatsoever about what to expect? Did you sign a consent form or did they forget that bit as well? They should not be operating in this cavalier manner and need it drawing to their attention. Your experience is extremely unusual - sedation failure is a very rare occurrence on here because most people know what they are doing and have received appropriate training. May not be around for a while but others will support I'm sure.
C
cupcake
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So sorry to hear about your bad experience(s) *hugs*
It does sound like this was all done in a very cack-handed way. Firstly, I'd say that it seems in all too many cases sedation seems to be used as an 'excuse' not to bother to treat the patient with very much basic respect for things like pain relief and bedside manner because they assume you won't be aware of it. This is why I am now increasingly anti sedation other than for absolute last resorts. Secondly I'd say this was not done in a very professional manner because:
(a) IV sedation can be topped up at any stage of the process. I know this as I had to have it for a medical procedure once. It wasn't a particularly positive experience for me over-all, but I can at least say that when I started screaming 'this hurts' the anaesthetist immediately upped the dose so I sort of lost awareness completely until it was over. They are supposed to monitor you constantly and adjust the dose accordingly so that if you're in any sort of distress they can give you a top-up
(b) all sorts of factors influence how high a dose you'll need. I'm tiny, but I also drink like a trooper so I apparently needed a bit more than the standard 'initial' dose it seems you were given. I've been told that a really skilled anaesthetist can get a good idea of whether or not a person is tee-total by how much medication they need to be sufficiently chilled!
So there you go - shoddy. I'm really sorry you had to go through it.
It does sound like this was all done in a very cack-handed way. Firstly, I'd say that it seems in all too many cases sedation seems to be used as an 'excuse' not to bother to treat the patient with very much basic respect for things like pain relief and bedside manner because they assume you won't be aware of it. This is why I am now increasingly anti sedation other than for absolute last resorts. Secondly I'd say this was not done in a very professional manner because:
(a) IV sedation can be topped up at any stage of the process. I know this as I had to have it for a medical procedure once. It wasn't a particularly positive experience for me over-all, but I can at least say that when I started screaming 'this hurts' the anaesthetist immediately upped the dose so I sort of lost awareness completely until it was over. They are supposed to monitor you constantly and adjust the dose accordingly so that if you're in any sort of distress they can give you a top-up
(b) all sorts of factors influence how high a dose you'll need. I'm tiny, but I also drink like a trooper so I apparently needed a bit more than the standard 'initial' dose it seems you were given. I've been told that a really skilled anaesthetist can get a good idea of whether or not a person is tee-total by how much medication they need to be sufficiently chilled!
So there you go - shoddy. I'm really sorry you had to go through it.
K
Karenw
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fluffyjo - I'm sorry you had such a rough experience again but hope you're feeling better now.
I had my IV sedation on Monday and am only just starting to feel normal again now. I had the opposite problem - I think I was very over-sedated. I had either 8 or 18mg of midazolam (I assume/hope it was just 8mg) and am only 48kg so I'm sure body weight isn't taken into consideration. I also needed a full 1mg dose of the reversal agent to bring me round afterwards and have been mostly asleep for the last 2 days.
I had my IV sedation on Monday and am only just starting to feel normal again now. I had the opposite problem - I think I was very over-sedated. I had either 8 or 18mg of midazolam (I assume/hope it was just 8mg) and am only 48kg so I'm sure body weight isn't taken into consideration. I also needed a full 1mg dose of the reversal agent to bring me round afterwards and have been mostly asleep for the last 2 days.
