Tag Archives: nitrous oxide

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

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

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.

Emergency Dentist

Can a Tooth Infection Spread to My Brain?

I’m worried about this tooth infection I have. I went to the dentist and he provided me with an antibiotic but told me not to take it until two weeks before my procedure, which isn’t for another month. I read somewhere that a tooth infection can spread to my brain, but he is insisting there is nothing to worry about. What do I do?

Miranda

Dear Miranda,

toothache

While it is true that a tooth infection can spread to your brain, as well as your heart and lungs, there are some dental infections that are so small, you’d have time before you had to worry about that type of spread. Starting the antibiotic in two weeks, will help prevent it from spreading as well.

The danger often comes when there are patients who avoid the dentist out of fear. By the time they see a dentist, if they do at all, the infection has progressed so far that it is a dental emergency and they need treatment right away or they can put their lives in danger.

This doesn’t sound like you. However, I’m sure you know someone in your life who suffers from dental anxiety. For the benefit of those who do struggle getting to the dentist I want to post here that dental sedation can change their life. By using something like nitrous oxide or oral conscious sedation, which is even stronger, you can have an anxiety-free dental appointment.

Not only will that prevent them from waiting until they need a painful emergency procedure, but it will also allow them to get caught up on their dental care, giving them a healthy smile for the first time in a long time. In turn, this makes the remainder of their appointments easier.

When You May Have a Problem

Though I said this infection likely won’t be a problem, sometimes a dental infection will surprise us and take off suddenly. If your pain worsens or you develop a fever, call your dentist and have him move up your appointment.

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

Sedation Dentistry

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.

Sedation Dentistry

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.

Dentist

How Much is Too Much Dental Work to Get at One Time?

Hello,

My dentist recommended I get a lot of dental work – both cosmetic and general work. I need some cavities filled, one tooth filed down, and several root canals done. I’d also like to get my teeth whitened at this time. Can I get all of this done at once? Or will it take multiple visits?

Tammy, from Mesa, Arizona.

 

Hi Tammy,

To get the most work done at once, you’ll need a sedation dentist. The dentist will put you under oral conscious sedation. Without the sedation, it varies from dentist to dentist how much they will do at one time.

The procedures you need done are not complicated. However, it depends on where in your mouth you need the root canals done. It will take double the time if the root canals are needed in the back of your mouth, versus the front. Your best bet may be to see an endodontist for the root canals, as they are the most experienced and can work fastest.

If you have an experienced root canal dentist or endodontist that can work quickly, your appointment can be completed in about four hours. However, this also depends on your endurance. Without sedation, it may be best to break up the appointments.

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

 

Sedation Dentistry

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.

 

 

Sedation Dentistry

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.