Category Archives: Sedation Dentistry

Traumatic Tooth Injury and Dental Anxiety

I took a pretty bad fall and now two of my teeth are starting to turn black. Is there something that can be done to help this? I have to tell you I haven’t been to the dentist in two years because I have horrible dental anxiety. The last time I went the teeth were healthy.

Brooke

Dear Brooke,

woman asleep in the dental chair from dental sedation

When a tooth turns black after an injury, it means the nerve inside the tissue of your teeth has died. The treatment for this will be a root canal treatment. Then a dental crown can be placed over the tooth to both protect the tooth and to improve its appearance.

I do understand that you are not comfortable at the dentist and have some dental anxiety you are dealing with. I want to make sure you know there are dentists who work with anxious patients. By seeing a sedation dentist, you can have a completely anxiety-free and pain-free dental experience.

Most dentists offer two levels of dental sedation: nitrous oxide and oral conscious sedation. Nitrous is sometimes called laughing gas. It doesn’t actually make you silly as it does give you a relaxed, floaty feeling. This is often enough for some patients to have an easier dental experience. It has the additional benefit of allowing you to get on with your day immediately following your appointment.

If your anxiety is stronger, and for some it is debilitating, then I would suggest oral conscious sedation. This is so strong that some call it sleep dentistry because you are so relaxed you can sleep through your appointment. The only real downside is that, because of its strength, you will need someone to drive you to and from your appointment as well as stay with you for a few hours after your appointment until you are lucid and steady on your feet.

This blog is brought to you by Gilbert Dentist Dr. Matt Roper.

Discouraged About My Teeth

I stumbled across your website and am hoping you can help me. I’ve never been so discouraged in my life. I grew up in a very poor family and we could not afford the dentist. They were good parents who worked hard, but dentistry is expensive. I have always had bucked teeth and braces were a wild dream. I spent most of my childhood being teased. Then in high school, I developed a tooth infection. I had a root canal treatment done, but we could not afford the follow-up treatment so I was left with a hole in the back of my tooth. Then, my first year in college the tooth broke in half. It was a front tooth! I was a freshman in college with no resources. One of my professors noticed I always put my hand over my mouth when I was talking and offered to get me a dental crown. I literally cried. Fast forward seven years. I’m married and we have dental insurance. The problem I am facing is my teeth need so much work I just can’t seem to keep up. My dentist seems to have given up as well. He even suggested we just extract them and get dentures. I’m barely 26 years old! Is there any way to save my teeth?

Carol

Dear Carol,

Woman covering her mouth with her hand

You have had a rough go of things and I am sorry. I did love the story about your caring professor. The compassionate people in this world give us hope, don’t they? While you have a tough situation with your teeth. It doesn’t sound like you have anything unfixable. The first thing I would do is look for a dentist who is willing to work to save your teeth. It sounds like they one you are currently with may not be the best fit for you.

Whatever you do, don’t let him extract all your teeth and give you dentures. When teeth are removed, your body begins to resorb all the minerals in your jawbone, the result of that is the shrinking of your jaw. In about twenty years, you won’t even have enough bone left in your jaw to retain your dentures. There is a way to preserve that bone, using dental implants, but it is very expensive and I don’t think you truly need your teeth extracted.

There are two things you can do to get a handle on this quicker. The first is at home. Most people think brushing is what keeps their teeth healthy. While it is a major contributor, if you are someone who snacks throughout the day, you are inadvertently sabotaging your efforts. Your saliva is a tremendous weapon against oral bacteria because of the minerals contained in it. If you limit your snacking, then you will give those minerals their best chance of fighting decay.

The second thing is to get as much work done as possible at each visit to try to get ahead of this situation. As I am recommending you find a new dentist anyway, look for one who offers dental sedation, specifically something like oral conscious sedation. This will completely relax you and even allow you to sleep if need be. Patients who use this are able to get significantly more work done at each visit.

Before you know it, you’ll be caught up on that dental work.
Hopefully, this helped.
This blog is brought to you by Gilbert Dentist Dr. Matt Roper.

My 5 Year Old’s Teeth are Rotting

I have a difficult 5-year-old. I do brush her teeth, but she is a nightmare when I do it. Actually, she’s a bit of a Tasmanian devil. This is especially true in the dental chair where she refuses to cooperate any time they try to do work on her. She now has one molar with a cavity, two that the dentist is saying need to come out, and decay on several other teeth. What is your recommendation for something like this? I don’t know how to get the work done for her.

Patty

Dear Patty,

Young girl in a dental chair smiling

I can tell you are worried and want the best for your daughter. I do have a way for your daughter to get the dental care she needs with minimal fuss, but I am also going to suggest some tough love to help in the long run with her oral health care. The extensive amount of decay you are describing at her age is almost always a result of constant snacking and drinking.

Our saliva is a big help in the fight against decay. It contains minerals that help fight bacteria between meals. But, when we are snacking or drinking (with the exception of water) too often, it doesn’t give our saliva time to do its job. This leads to extensive decay, even when we have good oral hygiene.

I’m going to strongly recommend you don’t let your daughter eat between meals for a while. She won’t starve and it will help her be hungry for the nutritious meals you make rather than snack throughout the day and not get the value out of the healthy food you make. Juice and soda should also be limited because of the citric acid and sugar contained in both of them.

When you have a child who will not cooperate with their pediatric dentist but there is important work that needs to be done, you may have to use dental sedation. This is sometimes called sleep dentistry because even adults are so relaxed when they use this aid that they can sleep through their entire procedure.

What you don’t want to do is put off this treatment at all. Tooth infections are considered dental emergencies. This is because our jaws are close to our hearts, lungs, and brains. A dental infection can turn life-threatening quickly.

This blog is brought to you by Gilbert Dentist Dr. Matt Roper.

Dental Care for Addication Recovery Patients

I am on methadone treatments while I am in addiction recovery. I have a lot of dental needs as a result of neglect during my years of addiction. I’m in a lot of pain, but the last time I went to a dentist he refused to give me any pain meds for after the treatment. It was excruciating. I don’t know if I can go through that again. Is there any dentist who will understand my situation? I am willing to allow them to talk to both my doctor and counselor. I’m hiding nothing. I just need to get my teeth tended to without having to face agony afterward.

Paul

Dear Paul,

Man in pain, grabbing his cheek in need of emergency dental care.

I am sorry for all that you are facing. You show remarkable courage for both your ability to face your addiction as well as your desire to get your oral health under control. One of the things you are facing is that many dentists are afraid of the Drug Enforcement Administration (DEA) which sometimes cracks down without considering the individual case.

What you need is a dentist who is willing to put his compassion above his fear. You may be better served looking for a sedation dentist. They are already compassionate and treat patients with dental anxiety. You may have to do some calling around, but I am convinced you will be able to find one who will be willing to work with you. Be upfront before scheduling and ask to talk to the dentist directly, explaining you have a unique situation.

One other suggestion. With a sedation dentist, you should have the option of using oral conscious sedation(OCS). This will allow you to get more work done in each sitting than would otherwise be possible, enabling you to catch up on your work much sooner. Plus, it is strong enough that if you wanted to, you’d be able to sleep through your dental appointment.

This blog is brought to you by Gilbert Dentist Dr. Matt Roper.

12 Shots of Novocain to Get Me Numb

I recently had a tooth extracted. The whole procedure was a nightmare. It took twelve shots to get me numb. I don’t know how a dentist can miss a spot that many times! Have you heard of this happening before? Is there a way for a dentist to find the right spot the first time so I don’t have to go through that again?

Paula

Dear Paula,

woman wearing nitrous oxide nose piece

While it is possible that your dentist missed the spot to numb your tooth over and over again, it is much more likely that you had some dental anxiety in the beginning which worked against your numbing medication. Then, as you were still in pain, your anxiety went up even more, creating a vicious cycle. There are too many dentists who do not realize the link between anxiety and the inability to get numb in the dental chair.

The simplest solution to this is to find a dentist who offers dental sedation options. It may be all you need is some nitrous oxide, which is administered with a nose piece, as in the image above. This can relax you enough to enable the Novocain to do its job properly. However, if your level of anxiety is super high, you will be better served with oral conscious sedation. This is significantly stronger, in fact, you will likely sleep through the entire appointment. Be aware though, that it is so strong you will need someone to drive you to and from your dental appointment. You will not be able to do this on your own.

Those who have dental anxiety have found that by using the appropriate level of sedation for stressful dental procedures, they are able to have stress-free as well as pain-free dental appointments.

Dealing with a Missing Tooth

You didn’t mention what tooth was extracted. In most cases, it will be very important to replace the tooth. This isn’t just for appearances sake, though that is important. Without that space being filled, the adjacent teeth will start to drift or tip into the empty space. This will throw off your bite, which can lead to painful jaw problems and even daily migraines.

The best option for replacing a single tooth is a dental implant. This is what I would recommend to a patient of mine.

This blog is brought to you Gilbert Dentist Dr. Matt Roper.

Must I Go to an Oral Surgeon to Get Dental Work Done?

My dentist tried to numb me for two different procedures. Neither time worked. I’ve always ended up having to go to an oral surgeon and have my work done with an I.V. that knocks me out. That makes getting any dental care quite expensive. Am I condemned to spending a fortune and still not having healthy teeth? Have you heard of someone in my situation before? Is there a different solution?

Matt

Hi Matt,

Someone asleep from dental sedation

Yes, I think I know exactly what is going on here. The great news for you is there is a solution. One thing I’ve found is that patients with dental anxiety have trouble getting numb. Sometimes it will seem like the numbing medication is working but once the work starts, they can feel pain. However, if they can be relaxed with something like nitrous oxide before the Novocain is administered, then when they are relaxed give them the numbing medicine, it works almost every time.

Some patients have such a high level of anxiety that they need a stronger level of sedation. For those patients, I recommend oral conscious sedation.

For either of these, you will not have to see an oral surgeon. Just do an internet search for a “Sedation Dentist”. They are able to help you in the office, saving you a good amount of money. You will also find that if you use oral conscious sedation, your dentist will be able to do a lot more work in each sitting. This will allow you to catch up on your work more efficiently. In fact, you’ll probably sleep through all the work.

One thing to be aware of, however, is oral conscious sedation, though administered with a simple pill, is so strong you will need someone to drive you to and from your appointment.

Once you’ve caught up with your work, if you’re looking for a quick, inexpensive way to improve the appearance of your smile quickly, I’d consider teeth whitening. That one procedure takes years off the appearance of your smile.

This blog is brought to you by Gilbert Dentist Dr. Matt Roper.

How Much Dental Work Can be Done at Once?

I will be honest and admit that I have neglected going to the dentist for many years now. However, it has gotten to the point that I need to do something. I can see decay and a couple of broken teeth. I’m sure I need even more work than I think I do. In order to get this over with fairly quickly (you can probably tell dentists aren’t my favorite thing), how much work can be done in one sitting, so I can minimize the appointments?

Kirk

Dear Kirk,

Someone asleep from dental sedation

While each dentist varies from office to office in how much they’ll do at each appointment, you will find the dentists who are willing to do the most in one sitting are sedation dentists. There is a procedure, oral conscious sedation (OCS), that enables both the patient and the dentist to get through more work at a time. Some people have dubbed it sleep dentistry because they are so relaxed they end up sleeping through the entire procedure.

There are many reasons patients avoid the dentist. One of the leading causes is dental anxiety, which can usually be traced back to a traumatic dental appointment. Having a means to experience stress-free and pain-free appointments with OCS has changed many lives.

Avoiding a Dental Emergency

Hopefully, you’ll find a sedation dentist fairly soon. I am especially concerned about the broken and decayed teeth. These can quickly turn into a dental emergency if the pulp of the tooth becomes infected. When you think about how close your jaw is to your heart, lungs, and brain, you can see how a simple tooth infection can turn life-threatening.

People tend to underestimate the seriousness of toothaches, which is why even in the twenty-first century we still have people who die from a tooth infection.

I’m not saying this to frighten you. I just want you to recognize, if the tooth starts to feel pain or if a pimple develops on your gums, both are signs of an infected tooth and you will need to be seen as soon as possible.

This blog is brought to you by Gilbert Dentist Dr. Matt Roper.

How Can I Get My Dentist to be More Gentle?

Hello,

I’ve been seeing my dentist for a few years now, and I’m happy with him, but he is the worst at giving shots. My last dentist gave me shots and they didn’t hurt this badly. I had to get numbed to get a cavity filled, and worked up the courage to ask him to be more gentle. He brushed off my concerns, saying that shots are supposed to hurt. The shots he gives are unbearable. I need another filling, and I’m dreading going back to this dentist. Is there anything I can do?

Jirard in Los Angeles

 

Hi Jirard,

The truth is, numbing a patient with minimal discomfort takes skill, time, and patience. If your dentist leaves the numbing gel on for some time, or delivers the injection slowly, this will lessen the discomfort. This gives your body time to adjust to the numbing agent. Injecting it quickly can cause the skin to stretch from too much liquid, and can increase pain.

Your dentist is placing the numbing agent as close to the affected area as possible, but trying to avoid the nerve. Everyone’s bodies are different, so it’s possible he came too close to your nerve, or even hit it. Hitting a nerve sends a shockwave of pain through your mouth.

You did the right thing by speaking up. However, your dentist not only dismissed your concerns, he refused to try. This is a major red flag, and shows he lacks in bedside manner.

There is something you can do to minimize pain. Make sure you are hydrated, as this can make getting numb easier. Also, feeling anxiety before numbing can cause a counter effect, where it’s harder to get numb. You can try relaxing techniques before going to the dentist, or ask for nitrous oxide to relax in place of the shot.

Since you are dreading going back to this particular dentist, it may be time to look for a sedation dentist in your area. Sedation dentists focus on gentle dentistry, which can reduce dental anxiety and pain. It may be worthwhile to find a dentist that listens to your needs.

This blog post is brought to you by Gilbert gentle dentist, Dr. Matthew Roper, of Vista Dorada Dental.

 

 

Why Won’t Novocain Make Me Numb?

Hi,

I need a root canal on two front teeth on my lower jaw. Despite an infection and nerve damage, my dentist cannot get these teeth numb enough for a root canal. He did over 5 injections in my gums and even used a numbing paste, but it still wasn’t enough! He didn’t charge me, but I’m tired of living off pain killers. I need this root canal, but can’t unless I get numb. What can I do?

Miranda, from Mexico

 

Hi Miranda,

Your problem sounds like it’s related to dental anxiety. Research has shown that each time the tooth fails to get numb, anxiety increases substantially. Anxiety counteracts novocain; the higher your anxiety, the more difficult it is to numb your mouth.

Unfortunately, your dentist did not understand the correlation between increased anxiety and the need for more novocain. The dentist needs to write you a script for anti-anxiety medication. You will be instructed to take the medication before your appointment, about 30 minutes to an hour before. No matter the medication, you will need someone to take you to and from the appointment.

Another option is to find a sedation dentist that offers nitrous oxide. The difference between taking anti-anxiety medication prior to your appointment or getting nitrous oxide is that nitrous oxide will wear off shortly after the appointment. Gentle dentists offer sedation dentistry, as they understand how anxiety-inducing going to the dentist can be.

If your dentist does not offer sedation dentistry, try to find one, and hopefully under their guidance, you can be numb enough to finally get your root canal.

This blog post is brought to you by Gilbert sedation dentist, Dr. Matthew Roper, of Vista Dorada Dental. Dr. Roper offers both nitrous oxide sedation or a prescription for Triazolam for dental anxiety.

 

Can You Get Sick from Dental Sedation?

Hi,

I started seeing a gentle dentist for my dental anxiety. Sedation is supposed to calm your nerves, but I’m worried about getting it at my upcoming dentist’s appointment. I’ve heard it causes nausea, and the painkillers you get afterwards can cause drowsiness. Those two side-effects mixed together is a recipe for disaster. I’ve never had any adverse reactions to medications before, but I’m still worried. Is choking on your own vomit a risk after dental sedation? Or am I overthinking this?

Samira, Sterling, Colorado

 

Hi there Samira,

There are different levels of sedation and medication a dentist can provide.

The first is nitrous oxide, Also known as laughing gas. This is the sedation of choice for gentle dentists, because it works fast and wears off quickly afterwards, before you even leave the office. You may experience some nausea afterwards, but not necessarily vomiting. Most procedures using nitrous are relatively short, but the longer you are under sedation, however, the amount of nausea you may experience increases. To reduce this risk, don’t eat before your appointment.

The second is oral conscious sedation (OCS): This method uses nitrous oxide and an oral medication (like a sedative, anti-anxiety medication, or anti-histamine) prescribed by your dentist. The type of medication prescribed will depend on your dentist’s personal preference and which one best suits your needs; for instance, at Dr. Roper’s office, he prescribes Triazolam, a safe method of oral sedation.

It’s also recommended you have someone take you to your appointment and check in with you for a few hours after the appointment. Again, to combat nausea, your dentist will schedule you for a morning appointment, and instruct you to not eat the night before or morning of your appointment. Even with this stronger sedation, no cases of asphyxiation during sleep have occurred, so please do not worry.

In summation, nausea is a common side-effect of sedation, but vomiting is not. Talk to your doctor about your fears, and they should be able to give you advice on how to minimize your experience with side-effects.

This blog post is brought to you by Gilbert sedation dentist, Dr. Matthew Roper.