Category Archives: Sedation Dentistry

Sedation Dentistry

Novocaine or Sedation for Porcelain Veneers?

I am on the cusp of getting porcelain veneers. I am a bit concerned about the procedure. I have a sensitivity to Novocaine as well as any drugs which can make your heart race. A friend of mine recently had the porcelain veneers procedure done and said that the green topical agent they put on her teeth made her very shaky and nervous. This went on for almost fifteen minutes. Do you know if there is epinephrine in the medication used in the procedure? If so, would I be better off having this done with dental sedation?

Sally

Dear Sally,

An image of a porcelain veneer being held up to a tooth.

Epinephrine’s function in a Novocaine injection is to restrict the blood flow and keep the medication more effective. However, any epinephrine in a body would have very little effect on the symptoms your friend experienced. It is more likely that she was dealing with anxiety. That would be a much higher amount of epinephrine than what would be in the medication given to you.

My advice would be to use a mild relaxant along with the Novocaine, such as nitrous oxide. This will keep the epinephrine in your body from getting too high and causing the issues you are concerned about. As I mentioned earlier, any epinephrine in the medication would be miniscule compared to a body’s reaction to anxiety.

I do not recommend you use a stronger dental sedation such as oral conscious sedation. Though stronger, you will not be lucid. Your dentist should place your porcelain veneers on with a temporary try-in paste. This is so that you can get a good look at the veneers and approve of them before they are permanently bonded on.

If you are practically asleep, as you would be from oral conscious sedation, then you would have no way to approve or disapprove the smile makeover. That is important.

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

Sedation Dentistry

Dentist or Oral Surgeon for Denture Surgery

I have always had a fear of the dentist. This really kept me from getting my teeth taken care of. I generally only ended up going in when there was a dental emergency. I know that wasn’t the best way to handle things, but what is done is done. I am now to the point that I need dentures. Most of my teeth are either missing, broken, or decayed. In that case, should I go to an oral surgeon or a dentist to have the remainder of my teeth extracted?

Bruce

Dear Bruce,

Image of dentures

I would go to a dentist who can do both the tooth extractions and the dentures. Most general dentists do pre-denture surgery. It is not a difficult thing to do. I would call to several offices and ask them what the dentist’s normal procedure is. Do not hint to them what you are looking for, just ask about their denture procedure.

Because you struggle with dental anxiety, I am going to suggest that you see a dentist who offers oral conscious sedation. This is sometimes called sleep dentistry because most patients are so relaxed they just sleep through the entire procedure. This will ensure you do not have to have any fear or pain during your procedure.

The reason for using a dentist instead of oral surgeon is to get the best fit possible for your denture. An oral surgeon won’t be as familiar with designing and fitting dentures, as a result they don’t know the things that can be done during the extractions to make this work better.

You should be aware that even the best fitting dentures will reduce your chewing capacity by 50%. There are also long-term consequences, including shrinking of the jawbone. Dental implants can help with both of these issues and I recommend discussing this with your dentist before making any final decisions on your treatment plan.

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

Sedation Dentistry

High tolerance for Novocain

I have always had a high tolerance for Novocain, which has made all of my dental appointments a living nightmare. I’ve been avoiding the dentist for quite a few years as a result. I am in a position now where I cannot put it off any longer. I feel certain at least two of my teeth will need to be extracted. I just need to grab the bull by the horns. Do you have any recommendations for how to do this with the least amount of pain possible? Also, I’ve been reading up on tooth replacement options. Are dental implants as good as they are advertised to be?

Carla

Dear Carla,

woman smiling in the dental chair with her dentist standing nearby

I can actually help you on both counts here. Your dentist may not have been aware that when a person has a high resistance to Novocain, it is usually a sign that they have dental anxiety. The higher the anxiety, the greater the resistance to the numbing medication. This is because your metabolism kicks in and burns the medication off.

What you need for the numbing medication to actually work is a way to deal with the anxiety. Most people can’t just turn it on and off at will. Instead, you need a dentist who offers dental sedation options. I recommend oral conscious sedation for you. It is sometimes called sleep dentistry because it is so strong that you can sleep through the procedure. You will need someone to drive you to and from your appointment as well as stay with you for a few hours after your appontment until you are lucid and steady on your feet. You will have an anxiety-free/pain-free dental appointment.

As for dental implants, yes, they are the top tooth replacement available. Once completed, it will be like having healthy, natural teeth in your mouth again. Just make sure you see an experienced implant dentist. It is an advanced procedure. Ask them how many dental implant procedures they have done as well as what their success rate is. Don’t settle for anyting under 95%.

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

Sedation Dentistry

What is the Fastest Way to Get Caught Up On My Son’s Dental Care?

My son has never been to the dentist even though he is nine years old. We’ve been broke for so many years. Now my husband has been offered a great job and it even has dental insurance. I am certain my son will need a TON of dental work (as will my husband and myself). What is the easiest and fastest way to catch him up on his needed care without traumatizing him. I remember hating the dentist as a child.

Patricia

Dear Patricia,

Happy girl in pediatric dental chair

I am glad you wrote and I can tell you care about your son! It’s always hard when their first experience with the pediatric dentist is to deal with decay, etc.. Ideally, their first visit is in their toddler years before there is a time for any problems to develop. That way they associate the dentist with fun. However, we realize the ideal is not always possible. You were in that situation, but are still trying to do the best you can for your son.

The good news is he may not need as much work as you think. If his genetics are working in his favor and he’s done a good job keeping up with his oral health care at home, you may just get lucky. I once had a woman who wasn’t ever able to go to the dentist growing up. Her first dental visit was when she married. She came in at twenty five years of age very nervous about what she’d find. Would you believe that woman didn’t have even one cavity! The entire office was amazed. It was a combination of superior oral care at home along with fantastic genetics when it came to her teeth.

The first thing I would recommend, because you do not know what type of shape your son’s teeth are in, is that you go to a pediatric dentist that also offers dental sedation. For his first appointment, you may want to have them use nitrous oxide so that he is relaxed. This is very mild sedation. He can be awake the whole time. Let’s say, however, that at your son’s first check up, they find a bunch of things that need to be worked on. Don’t panic. There is a way to do that without him feeling any pain whatsoever.

There is another type of sedation you can use for his treatment appointments called oral conscious sedation. This will make him very sleepy. In fact, he’ll sleep through the entire appointment which will allow dentists to get more work done during each appointment. This is the fastest way to get him caught up.

I hope this helps you.
This blog is brought to you by Gilbert Dentist Dr. Matt Roper.

Sedation Dentistry

Sedation Dentistry and Type-2 Diabetes

If I have type-2 diabetes can I still use sedation dentistry? I have to get my wisdom teeth out and I’m a huge baby when it comes to the dentist. He told me not to worry because I can be sedated. It wasn’t until a few minutes ago that I realized my diabetes might be a problem. I haven’t found anything online, but did come across your blog. I have a glucose monitor that keeps my blood sugar steady, but I do need to eat regularly. I just read the pamphlet that said not to eat the morning of the procedure. That will be a problem for me. Will any of this mess up my sedation?

Cassie

Dear Cassie,

woman asleep in the dental chair from dental sedation

I am so sorry you are having to deal with this. Diabetes brings so many worries into a person’s life. The good news is having sedation dentistry done, will not have to be one of them.

It sounds like your diabetes is being well controlled with your glucose monitor and you stay on top of things. That is wonderful and will be very important because of the impact diabetes has on your ability to heal.

My recommendation for you will be oral conscious sedation. This is sometimes called sleep dentistry because you are so relaxed you sleep through your appointment. Unlike general anesthesia, you will be okay to eat before the procedure with this type of sedation. It is administered by a pill. You will need someone to drive you to and from your appointment, as well as to stay with you for several hours after your procedure. Whoever you choose as your caregiver will need to make sure you are completely lucid and steady on your feet before leaving you on your own.

When you arrive at the office, all of your vitals will be recorded. Make sure to let them know your most recent HbA1c levels.

You probably already know this but diabetes can be hard on teeth and gums, so make sure you keep up with your regular check ups and appointments. You mentioned being a baby about the dentist. Don’t feel too bad about that. Dental anxiety is quite common. You could ask for some nitrous oxide for your regular, simple appointments. This is a gas that will relax you and take the edge of the appointment. It’s not as demanding as oral conscious sedation and you will be fine to drive yourself home afterward.

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

Sedation Dentistry

Can a Diabetic Use Dental Sedation?

I have type-2 diabetes and am about to have my wisdom teeth out. I understand that there is dental sedation available for this procedure. Will my being diabetic be a problem? I have a glucose monitor and my levels have been staying in a healthy range. One of the things I worry about is the ability to eat before a procedure because that affects my levels significantly. Am I a candidate for dental sedation or will I have to tough this thing out the hard way?

Karen

Dear Karen,

woman asleep in the dental chair from dental sedation

I am glad you wrote. Diabetes sure does make life more complicated, doesn’t it? The good news is this should not keep you from having dental sedation. Your levels are staying steady and it sounds like you keep up with your care. My suggestion is you ask for oral conscious sedation. This is administered by a pill but is quite strong. Not only will you be able to eat before your procedure, it will be important for you to do so. Also, don’t skip your insulin dose, though I doubt you would. If you didn’t have a monitor, we’d ask you to bring a glucometer, but your meter will make monitoring your levels during the procedure simple.

With oral conscious sedation, you will need a driver to get you to and from your appointment as well as to stay with you for a few hours afterward until you are lucid and steady on your feet. You may want to pick that person well in advance and make sure to train them in your diabetic care so they are prepared for any eventualities.

Other than that, you will want to keep a close eye on your healing and surgical site. It is harder for diabetics to heal, so stay on top of all your post-operative care.

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

Sedation Dentistry

Dentist Cut My Tongue; Shouldn’t I Get a Discount?

I had to have some dental work done. Three crowns in all. It was a horrible experience. He did give me nitrous oxide, but that did not really help. At some point, the dentist splashed some type of chemical in my eye, which burned like crazy. Then, his drill slipped and cut my tongue. Both he and the assistant gasped when it happened. And, I yelled because, obviously, that hurt a LOT. It’s been a couple of days and my tongue still hurts. I called to ask for a discount because of all the accidents he had. He just acted like none of it ever happened and said I probably bit my tongue because patients do that when they’re numb. Don’t I deserve an apology and a discount?

Steph

Dear Steph,

toothache

While you certainly deserve an apology and recognition of what happened, it appears your dentist is in defensive mode and is pretending what you said did not happen. That means you won’t get the apology or the discount unless you push it. There is not enough damage to warrant a lawsuit, but you could tell him you are going to write a negative review if he does not own up and take responsibility. That does have an impact on his business. Short of that, your only other option is to move on and find a different dentist.

If you do go with another dentist, I am going to suggest you find someone who offers dental sedation. You mentioned that the nitrous oxide didn’t help. Plus, with the number of accidents you had, I wonder if you weren’t wiggly. That’s not excusing what happened but would explain some of it. Both of those things together tell me that you have some dental anxiety. Plus, given this latest experience, you’ll have greater anxiety next time.

A dentist who offers sedation will have oral conscious sedation. This is a pill that you will take before your appointment. It is much stronger than nitrous oxide. In fact, you’ll probably find that you sleep through your entire appointment.

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

Sedation Dentistry

Dentist Wants to Crown All My Teeth

I haven’t been to the dentist is seven years because of anxiety. I finally plucked up the courage because I was tired of being embarrassed by my yellow smile. I told him I wanted to clean them, make sure they’re healthy, and improve how they look. After the exam, which was discouragingly painful, he told me I have 5 cavities. In order to treat the cavities and improve my smile he wants to crown all my teeth. I feel weird about that because not only are the other teeth healthy, but this is quite an expense he is recommending. I don’t have much experience with dentistry. Is this my only option?

Cal

Dear Cal,

woman asleep in the dental chair from dental sedation

The short answer is no, this is not your only option. You are wise to be concerned. The first thing I want to do is address your anxiety and then we’ll talk about your options. It took a great deal of courage for you to go to the dentist. After such a long period, it would be easy to just find excuses not to go. You are certainly not alone in your dental anxiety.

There is dental sedation available for patients in your situation. They can give you a pill that will completely relax you. In fact, some people call it sleep dentistry because patients almost always just sleep through their procedure. This will not only give you pain-free appointments, but it will also allow you to catch up on your dental work much quicker.

As for crowning every tooth, while I have not examined you, nothing you mentioned indicates the need for such a drastic treatment. You have five cavities and you want whiter teeth, is the way I understood what you wrote. If that is the case, all you need to do is have fillings placed on the teeth with the five cavities. Make sure your dentist gives you mercury-free composite fillings, and then get your teeth whitened.

That is faster, cheaper, and much more conservative with your tooth structure.
This blog is brought to you by Gilbert Dentist Dr. Matt Roper.

Sedation Dentistry

Should an Oral Surgeon Do This Extraction?

I had a tooth that I neglected years ago because of a phobia I have with dentists. When the pain became too much to bear I went to see somoene who did a root canal treatment. As expected, the appointment was a nightmare. I did not follow through with the dental crown and neither did the dentist. At the time, I considered that a blessing. Now, the tooth is so far gone that it broke. I went to see a different dentist and he said it is infected and needs to be extracted. He gave me two options because of the state of the tooth. I could do it with him using a local or with an oral surgeon using anesthesia. I was tempted to go with the anesthesia because at least it would be pain free. But, the cost is way more than I can do and the oral surgeon wants payment up front. Here is my question. Am I putting myself at risk by doing this with the dentist? If so, I guess I could try to get a loan to use the oral surgeon.

Dennis

Dear Dennis,

woman asleep in the dental chair from dental sedation

There should not be a reason that a dentist could not do this extraction for you in complete safety. However, that does not mean the dentist you saw is qualified or comfortable doing it. The fact that he suggested an oral surgeon tells me he is not. Plus, given your dental anxiety I do not think a local alone will be enough.

My suggestion is that you see a sedation dentist. They can provide you with oral conscious sedation. This is administered by a pill but strong enough where you can sleep through the entire procedure pain-free. Be aware that you will need someone to drive you to and from your appointment.

The really great news is people in your situation, with anxiety of the dentist, have found that using dental sedation has changed their lives. They’re not only able to get the help they need without fear, but are able to stay on top of their dental care from then forward.

I hope this gives you some confidence.
This blog is brought to you by Gilbert Dentist Dr. Matt Roper.

Sedation Dentistry

Dental Sedation with Wisdom Tooth Extraction

My 20 year old has an impacted wisdom tooth. The dentist thinks they will have to remove some of the bone. He wants her to go under general anesthesia for the procedure. Is this necessary because of the bone? I’m uncomfortable with using anesthesia unnecessarily. There are so many risks and we have a relative with serious complications to anesthesia. What would your recommendation be?

Kelly

Dear Kelly,

Someone asleep from dental sedation

Bear in mind I haven’t examined your daughter. However, at her age I would be very surprised if general anesthesia was warranted. With a twenty year old, the bone is still very pliable because there is not really any cementum accumulation at the roots. She is in the ideal age range to have her wisdom teeth extracted. As she ages, that cementum builds up and makes the procedure more difficult with a greater risk of complications.

My recommendation would be oral conscious sedation. This is sometimes called sleep dentistry. However, don’t push your dentist into that. His suggestion signals to me he is not completely comfortable with the procedure. Your daughter would be much better served finding a dentist who is experienced and confident. To find that dentist, simply do an internet search for “Sedation Dentist”, find out if they do wisdom tooth extractions, then schedule a consult with them.

If they recommend general anesthesia as well, there may be some complicating issues the first dentist did not explain to you. My guess is your second dentist will think oral conscious sedation will be perfectly sufficient.

There are always additional risks with general anesthesia. With your family history, it seems like that risk is higher. I’m with you on this one and would not want to jump into that unless it were absolutely necessary.

This blog is brought to you by Gilbert Dentist Dr. Matt Roper.
Click here to learn about our emergency dental services.