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Use of Xanax for Dental Work



Mar 2, 2015
Lot et Garonne
i used to suffer with bad anxiety generally, but thankfully am so much better - EXCEPT with dental work, which never fails to bring all the old panic feelings flooding back!
I have a tooth infection, but cannot see a Dentist for another few weeks. My Dr gave me antibiotics and the infection and pain has gone.

The anticipatory anxiety is a real killer. However what is really getting to me is the possibility of having to have a Root Canal. I have never had one before, and the thought of wearing a dental dam with my awful gag reflex, and having to sit through a long procedure is something I am unsure I can tolerate.

My Dr had prescribed Xanax 0.25g. I will take one the night before, but do not know how much to take before the appointment and also the timing. Should I take 0.5g, as I need to make sure I am free of anxiety? My husband will be driving me.

I feel trapped, and my life is on hold at the moment.

Thank you so much for your time.
Hi @Snowy,

I think we've had the Xanax dose question before, and because Xanax is not available as an NHS prescription drug in the UK, our dentists here weren't sure. Though perhaps @drhirst might know as it's available as a private prescription?

Anyway, I came across this Benzodiazepine Equivalents Converter: https://clincalc.com/Benzodiazepine/

Not sure how reliable this calculator is, but apparently, 30 mg Temazepam (which would be the most commonly recommended premedication in the UK) equates to 1 mg of Xanax (Alprazolam). I also had a look at some research where Alprazolam was used as a premedication, and they seemed to use either 0.5mg or 1mg.

Having said all that, the best person to ask is your GP, as they know a bit more about you than anyone on this forum (e.g. your age, other medical conditions, previous use of medication and how you react to it etc. etc.).

A lot of people find that a dental dam actually helps with the gag reflex, because it prevents things from touching the inside of your mouth and also because it makes it easier to remember to breathe through your nose. There are some more tips here in case you haven't come across the page yet:

Best of luck with your appointment!
I am so grateful for your replying so quickly to my enquiry. I live in France, and my GP prescribes it for me to take as necessary. I only take it in times when I feel panicky - flying or like now, for Dental treatment. I find that psychologically knowing that I have is enough!

I have only ever taken 0.25mg. However, I am seeing a new Dentist who speaks English and I believe was trained in Ireland. Here in France, apart from the large cities, there seems to be a lack of centres dealing with phobic patients.
if I were having an extraction or a filling, I Would be fine, but a root canal taking so long, I am unsure how I would cope. I am unsure of the dam, as as soon as he puts it on my mouth I think I will just panic! How do you swallow - as I seem to need to close my mouth to swallow.

Honestly, I am so annoyed at myself! So I might have a dry run with taking a 1mg Xanax and see how I feel.

Thanks so much.
I think the 1 mg is the equivalent of an oral sedation dose (as opposed to a premedication dose), so please do discuss this with your GP and dentist beforehand, rather than experimenting :) ...

Good to hear that you found a dentist who speaks English, how do you get on with them?

The swallowing question seems to come up a lot - I suppose it's no different from any other dental treatment or routine cleaning in terms of keeping your mouth open? The Xanax should help a lot with taking your mind off it. Actually, coming to think of it, there might also be some tips on this page:

(under the "Feeling unable to swallow with your mouth open" section)
I agree with letsconnect, discussing with your doctor is key.

I'm prescribed 2mg as and when needed for acute severe anxiety which works great (I go to sleep for a few hours because I'm tired) but I was once prescribed 5mg during a mental health crisis and it was much too much for my body. It wasn't necessarily different or worse from 2mg but my body felt the higher dosage between doses, so just check and make sure before you up it.

Take care and let us know how you get on.
Thank you so much for your reply. I just want to be able to relax and let the Dentist do whatever is necessary, without being hypersensitive to everything, and not feel I am about to panic!
i was thinking between 1mg to 2mg, but will definitely check with my Doctor.
i have been waiting 2 months for this appointment, which has really allowed my anxiety to ramp up.
@Snowy I'm sorry if I came off as poo pooing. I'm sure 1mg will be great because it should get you nice and relaxed. Just be safe is all.
" Though perhaps @drhirst might know as it's available as a private prescription?"
Apparently it is, but I have no experience with it at all so could not advise on the optimum dose to help Snowy with her gagging.
I suspect the doctor could advise on whether the increased dose would help and be safe. It certainly looks like it may work from reading what letconnect has gleaned but proper medical advice is essential when dealing with benzodiazepines.
Just wanted to say thank you for your kind replies! As an update, and in case it helps anyone else, I found a few helpful UTube Dental Fear Hypnosis which really helped me!
It turned out that my new Dentist is the most kindest Doctor, put me at my ease straight away, and I ended up having to have my tooth extracted as it was the tooth itself that was loose, and not just the crown. It was a really good experience, and everything I had been anxious about never materialised, and I am now sore but pain free!

The worst part was the 6 weeks of anticipatory anxiety, waiting to see the Dentist!
Hi @Snowy, that is fantastic news! How wonderful to hear that you've found a great dentist, and that you had such a good experience :) .

Thanks so much for the update! And congratulations!!
@letsconnect sorry I am a little late to the party. But why is Temazepam the oral sedative of choice in the UK, do you know? I ask because I've had it and all it did for me, was make me sleepy but I still managed to have a full blown panic attack in the dentist chair. Silent tears rolling down my face as I was panicking and wanting the experience to be over. It was a little bit hellish.
After coming back home, later, I was curious as to why this happened. Then I read that temazepam has poor anxiolytic properties compared to other benzos. It might be an issue to bring up with the NHS or the dental association? Maybe this needs updating? I don't know but personally, I did take them as precribed, I had to start the night before, then one in the morning then another before getting to the dentist. It was awhile ago, I don't remember exactly what the doses and times were but I followed to the letter and still had a massively traumatic experience. Except I was a little sleepy...
I am so sorry you still had anxiety after taking Benzo’s. I do appreciate that in the U.K. these are not prescribed. I am English, but have lived in France for over 15 years, and here Xanax is available on prescription. I only take it for dental visits, flying or under extreme stress. They are only 0.25mg per tablet. My Dr told me to take one the night before my appointment, and then 1 an hour before my appointment. It also helps that my Dentist is the kindest man and I realise how lucky I am to have found him.
As I said in my follow up posting, that I listened to a few UTube Dental Phobic hypnosis videos in bed every night for about 2 weeks, and I did find it changed my attitude and made me feel very positive. Hope you find a medication that does work for you!
@Snowy Ahh it's not all benzos. My post was about temazepam specifically. I am from north america originally and I've had Xanax before, but I found them so easy to build a tolerance, that's probably why they don't prescribe it in the UK, it's a sneaky beast.
But even just oral benzos are not enough for me, I have deep issues and like you I have other phobias. I did several sessions of emdr and tapping with a private therapist and that I think did help, but I am not sure that my trauma is ever going to to go away - as a book title goes - The Body Keeps The Score.
@Snowy can you share which youtube hypnosis videos you found helpful? Thanks :)

But why is Temazepam the oral sedative of choice in the UK, do you know?

I suppose because temazepam has a shorter duration of action than diazepam (valium), and thus doesn't interfere with daily life as much. And also, by and large, it seems to give a better kind of sedation for dentistry (presumably there have been studies, maybe @Gordon knows more).

Having said that, most forms of oral sedation can be a bit hit-and-miss and may work great for one person and not for another (and people may react differently on different days). Sorry to hear that you found it ineffective! It goes without saying that, sedation or no sedation, it's really important that your dentist does their best to make you feel relaxed... sedation is not meant to override the human factor, but complement it.
@letsconnect that's what I read too that temazepam acts quickly as a sedative and has a shorter half life than diazepam, but is a less effective anxiolytic, but it's weird because it (temazepam) is used as a sleeping aid and is more of a hypnotic whereas diazepam is ok to use in the day. I can take diazepam in the day for anxiety and it doesn't send me to sleep.
I think my dentist is not entirely comfortable with my level of phobia. He has told me before that he has never seen anyone with a phobia as severe as mine.
it seems to give a better kind of sedation for dentistry (presumably there have been studies, maybe @Gordon knows more).
To be honest, I'm not sure of any actual studies, it would be very difficult to arrange a proper clinical trial, as there are so many potential confounding factors that it would be almost impossible.
The use of Temazepam was widely worked out by organisations such as SAAD and the Royal College of Surgeons, mostly informed by clinical experience, as in "we know what works for us".

Oral sedation is the most convenient but least reliable form of sedation, I would choose it as a last resort personally.