By Dr Mike Ingram BDS MSc
For many people the thought of going to the dentist creates feelings of deep anxiety. For some this is such a problem that they do not attend a dentist at all; or only when driven to by toothache.
By not attending regularly small problems that could be prevented or treated conservatively often get left until they cause great pain and infection. By then usually the only solution is extraction of one or more teeth. Unfortunately infected teeth can be difficult to get numb, and they can also be difficult to extract. This does little to help the nervous dental patient as it makes them only more determined to avoid dental treatment in the future!
Many people have dental problems which they would like to have treated, but are so anxious that they can’t bring themselves to do something about it.
If you haven’t been to a dentist in years because you suffer from fear of dentist or dental phobia, help is at hand.
Intravenous (IV) Sedation Dentistry and Fear of Dentists
IV Sedation is a safe and effective method of controlling a patient’s anxiety. It differs greatly from General Anaesthesia, as the patient is conscious throughout. This makes it safer and possible to carry out in a normal dental surgery.
During IV Sedation, the patient has a sedative drug fed through a small cannula inserted into their forearm or back of their hand. The amount of drug given is carefully measured to give just the right effect. Patients feel relaxed and sleepy and often have no memory of the treatments they receive.
Other methods of sedation include Oral Sedation (where a dose of diazepam (Valium) is given before the appointment. The efficacy of this method varies greatly from person to person, with some people experiencing no discernable benefit whatsoever. Commonly people can have a ‘hangover’ from the effects of the drug wearing off. There is also still a considerable social stigma attached to Valium.
Inhalation Sedation (also known as Relative Analgesia) uses a mixture of Nitrous Oxide and Oxygen (laughing gas). This is very effective for children but is usually not powerful enough to sedate adults.
Some dentists practise hypnotherapy to help ease patient’s anxiety. This can be very effective for susceptible patients.
With sedation dentistry or oral conscious sedation, dental patients will experience a state of very deep relaxation. You can still speak and respond to the requests of others.
Many dental patients take advantage of the different levels of sedation or sleep dentistry that allows the dentist to perform multiple oral treatments and procedures that might normally require more frequent dental visits.
Any treatment routinely carried out by your own dentist can be carried out under sedation including:
- Teeth whitening (bleaching)
- Replacing dental crowns or dentures
- Fillings, including root fillings
- Gum disease treatment
Who is a Candidate?
Adults who have…
- high fear of visiting the dentist
- had traumatic dental experiences
- difficulty getting numb
- a bad gag reflex
- very sensitive teeth
- limited time to complete their dental care
- complex dental problems
- hate needles and shots
- hate noises, smells and tastes associated with dental care
- are afraid and embarrassed about their teethWhatever is causing your obstacle having the smile that you want, help is at hand to help you overcome it.
Dr Mike Ingram is a member of the Society for the Advancement of Anaesthesia in Dentistry and runs Ingrams Dental Practice in Coalville with his wife.