Why don't dentists use knock out gas anymore.

[Nightryder]

I had toothache recently & googled why don't dentists use knock out gas anymore, I didnt find an answer but did find this forum, although what i have is so far beyond a phobia there is no name for it. As a child living in England going to the dentist wasnt too much of a drama as a whiff of that awful smelling gas & when you woke up it was all over.
I came to Australia age 14 & by age 16 I had a realy bad tooth that I had nursed for ages until nothing would work & went to see an emergency dentist on a Sunday,He was horrible, nasty, rough & had no patience & this was the first time I had ever had needles.
Fast forward & I am now 28 & again had been nursing a bad tooth for a long time, until chatting to the kids over dinner & I bit down on this bad tooth, it was never the same again & I had no choice but to see a dentist,this time the dentist was a tiny Asian girl who looked about 12 but she was lovely, 5 needles & an unbelievable amount of drama & she gets the tooth out,she tells me the root of the tooth was wrapped around my jaw bone thats why she had so much trouble getting it out. I went home & crawled in to bed I felt dreadfull, this was a Monday I was still in bed on the Friday after a horror week & that was the day I started to feel a bit better.
Fast forward again & I am now 52 & over the years I have learned a lot about fixing toothache but I have a realy bad rotten broken tooth that nothing would fix & this was different I knew the tooth was infected, so off I went to the dentist knowing he would xray see the infection & give me antibiotics,which is exactly what happened, It was at this time I also confessed to my doctor about my horror of the dentist & he gave me more antibiotics & I had no toothache for over 3 years, luckily for me my doctor also has a fear of the dentist so now if I get an infected tooth he just gives me more antibiotics.
I am now 60 years old & have rotten & broken teeth but wild horses will not get me to see a dentist, Does anyone have any ideas that would help.
Jenn

 

[ScaredyCat22]

Do you mean nitrous oxide? as in Laughing gas? it is still used but it doesn't last long so there are better ways of dealing with both pain and fear. I have never heard it called knock out gas so maybe you mean something else? People can choose to be sedated, whether by pill or by IV.

 

[Nightryder]

Ive no idea what it is called but it put you to sleep, Here in Australia there is an iv sedation but it only puts you out for a short period & is only good for procedures that dont take very long, its also horrendously expensive & I need so many teeth taking out it could not be done in one session, ideally I would like all my teeth taking out & I did wonder if there is a way to go into hospital & go under a general anesthetic but if you call any dentist to inquire they want to look at you & assess the situation, this doesnt work for me they dont understand me & they cant touch my teeth, they will start them off aching, & as not all of my teeth are rotten yet & with todays attitude of save teeth at all costs I think I would have a battle getting any dentist to agree,
Jenn

 

[ScaredyCat22]

I do know of people who have had their teeth out under general anesthesia, but I am in the states and things are probably different here. I know of someone who lost all her teeth at a very young age due to grinding her teeth. She chose to go to an oral surgeon and have all her teeth removed in a single appointment under anesthesia. Yes it is very expensive. I had my wisdom teeth removed that way and the cost was in the thousands of dollars.

 

[comfortdentist]

In the USA very few dentists use any general anesthesia as today the requirements are an additional 3 years of hospital based training beyond any other training. The liability insurance is 3x as much. Mine for IV sedation is 2x. The cost of a general anesthesia case in South Florida is in the range of 1500-2000 for a case. IV sedation is 500-1000+. For me to offer general in my office which I can I need to bring in a dental anesthesiologist.
Why is this all true? Safety of patients. people die every year on dental offices and so the requirements have increased and this results in increased costs for everyone. I think my fees over a year break even for my costs to provide IV sedation. I don't do as many cases as I could as I don't push it like so many doctors do.

What amazes me with all my training and experience in sedating patients safely is that people actually take street drugs with unknown content and strength and "sedate" themselves.

 

[vicki]

I think what you're referring to is the old style general anaesthetics that used to be available many years ago in dental surgeries in the UK. I'm 35 now and I vaguely remember my Dad having a tooth removed and having gas (as in a general anaesthetic). I think I was about 10 years old at the time, so that would have been in the late 1980s.

I don't know about the situation in Australia, but the reason that it was discontinued here in the UK was purely due to safety. To administer a GA properly and safely, the appropriate equipment, facilities and training must be in place in order to cope with any problems or emergencies. I seem to remember that there were a few cases of people dying whilst under anaesthetic in the dentist's chair (years ago) and so general anaesthetics have been confined to hospitals only now, where there they have the appropriate facilities and staff.

The alternative, as you've discovered, is IV sedation and for some people, this works very well. Depending on the level of sedation, some people say that it feels pretty much the same as a general anaesthetic because one minute, they're injecting the sedative drugs and the next, you're 'waking up'.

Depending on what's available in your area, seeing an oral surgeon who works in a hospital may be an option. If you absolutely need a GA, then that might be the answer. If you wanted to go down this route, they would need to meet you and examine your teeth, otherwise how would they know that they were providing the best (and correct) treatment for you?

If you decided to go for IV sedation, the dentist would still need to have a look at your teeth before doing any treatment, because not to do so, would be unprofessional. They would need to come up with an appropriate treatment plan, discuss it with you and get your consent before going ahead with any treatment. It may well be that some of your teeth don't need removing and that with a bit of help, they could be saved, but you won't know for sure until you let a dentist have a look.

My past history is a bit complicated, so I won't go into the details here, but I had years of horrific experiences at the dentist when I was younger, to the point where I stopped going when I was 15 and was old enough for my parents not to know. The experiences left me with flashbacks and panic attacks and even when I eventually visited a dentist and tried to get back into the routine of going again every six months, I could hardly talk, was paralysed in the chair, experienced flashbacks, couldn't bear to see anything, let alone for them to touch me.

I'm a bit different to you, in that because of what happened to me in the past, I can't really bear the thought of any kind of sedation, because I need to know what's happening. I couldn't see how things were ever going to be any different for me and I thought I would always be confined to experiencing this awful terror. What was worse, last year I was referred to see an endodontist for a root canal to be re-treated and ended up needing 8 roots canals and fillings. The length of the appointments needed and what was involved was a huge no-no for me, but after I met the endodontist for an initial consultation and managed to confess to being extremely 'nervous' (a bit of an understatement!), I decided to give it a go. Admittedly, I do need to take Diazepam to get me in the chair for treatment, but the thing that has made the biggest difference is the people who are treating me - the endodontist and the nurses who work there have all been so patient, kind and supportive, no matter what has happened (and their nerves must be worn to a frazzle after my appointments).

It's now nearly 2 years since I first went there and I've had 8 root canals, 8 fillings and now that it looks as though I've got a teeth clenching habit, he's made me a splint to wear which has required quite a few appointments to adjust it. Yes, I'm still fairly nervous during appointments and if I needed any further complicated treatment (such as the 8 crowns which will inevitably loom on the horizon at some point), then I would probably need to take Diazepam again. But for the past few appointments, I have actually been fairly relaxed (without any drugs!), had a laugh and for the first time ever, I've felt like a normal person again.

I used to want all my teeth taking out because I thought that was preferable to having to visit the dentist. If I had dentures then nobody could ever hurt me again. But looking back, if I'd had all my teeth removed, I would be sat here now with either a set of dentures or a mouthful of implants. Yes it has caused me a fair amount of anxiety and it hasn't been easy, but things are definitely getting better.

Even if you do actually want all your teeth removing, whichever dentist you choose, is still going to have to have a look, otherwise they'd be negligent. You're the customer here, so when you go for the initial appointment, you can discuss your worries and concerns before they go anywhere near your mouth and you only let them do what you're comfortable with.

Different things work for different people; for some people having sedation and not being aware of anything is the way to go, others need more TLC or a combination of both. For me, it's totally about whether or not I trust the dentist and feel safe there. You need to find what works for you.