Category Archives: Sedation Dentistry

How can I get my wife to stop requesting sedation at the dentist?

I’m afraid that my wife may be using sedation dentistry as a crutch. I don’t really blame her for wanting to have the meds, but it throws us into a bit of chaos every time she needs to have dental work done. Without going too much into detail, her childhood dentist was pretty brutal. He left her with an intense fear of the dentist. Her teeth looked fine when I met her, but as the years went by, they deteriorated quite a bit and she refused to see a dentist. We found a sedation dentist to help her and I will say that she has been a godsend. We made it through the series of appointments necessary to get her smiling again and life is good.

However, every time something comes up now- even if it’s a tiny cavity being filled- she asks for oral conscious sedation (OCS). We’ve got a good relationship with this doctor and my wife seems to trust her, but it’s hard for me to take the day off work just because my wife needs a filling. Plus, our insurance doesn’t cover it, so you know who’s paying for it- me. I don’t mean to sound insensitive, but it seems like this has gone on long enough. At some point, she should be able to go without the meds, right? At what point can I safely interrupt this trend and tell her to be mature about this?

Thank you,

Raymond

 

Dear Raymond,

This is a particularly interesting question with no definitive answer. However, we can explain what might be happening.

Any Kind of Trauma Can Leave Lasting Emotional Scars

We don’t know what happened specifically with your wife, but trauma of any kind can have a lasting impact on a person. For example, a child who is ridiculed in school may begin to think that school is a bad place where he or she does not belong. The child will associate learning with ridicule and have trouble excelling. A child who is beaten by a parent learns to avoid their parent and often avoids relationships later in life as a result. Some children never learn how to form close bonds with others.

A person who witnesses a violent event, such as a shooting, may also develop post-traumatic stress disorder (PTSD). They can become hypervigilant and anxious and be unable to return to the place where the event happened. Or they might be constantly on alert waiting for it to happen again. These people can often muddle through life without treating the underlying problem, but their quality of life diminishes. For example, the bullied child may never finish school. The abused child may never have a healthy relationship. The crime witness may withdraw from the things he or she loves.

The Right Way to Address Trauma Varies

The field of mental healthcare is filled with many different methods to help people overcome trauma so they can live healthy and full lives. Arguably, the most well-known is talk therapy. There are also other avenues a licensed mental/ behavioral healthcare professional might try, such as Eye Movement Desensitization and Reprocessing (EMDR), coaching, and teaching the person healthy coping mechanisms. We don’t know the level of distress you wife feels or how deep it goes, so it’s difficult to say what type of therapy she needs.

A Sedation Dentist Can Help Reduce Anxiety, Now and Forever

For some, dental anxiety doesn’t go away without some kind of care from a mental health specialist. Choosing OCS or a similar variant is a crutch in some cases, but if it empowers them to get the care they need, it’s worthwhile. For others, the extra care afforded by a sedation dentist lets them build positive memories with their dental care team. In time, with lots of positive experiences, your wife’s prior experiences may diminish so much that she sees the treatment as a positive and enjoyable thing. However, all this is probably happening in her subconscious. Even if she trusts her doctor and knows the office is safe, she’s already been conditioned to be fearful. There is no timeline or formula that flips a switch and allows her to not have anxiety.

In short, there is no right time to take control and insist your wife has dental appointments without sedation. She’s not doing anything wrong and if she’s anxious, she’s likely unable to control it. While there is no harm in having an open discussion with her about how she feels about treatment without the medication, it’s best not to insist on it. If anxiety seeps into other areas of her life, it may be worthwhile for her to talk to a mental health professional and start dealing with some of the underlying causes. If it’s purely dental anxiety, please respect it. Your support will make a world of difference in her confidence and willingness to continue with getting treatment.

 

This blog is sponsored by Plano sedation dentist Dr. Miranda Lacy.

Will sedation dentistry legislation require insurance companies to provide more benefits?

My sister lives in California and has been raving because she says there’s a law there requiring insurance companies to cover sedation dentistry. She and I both had terrible experiences as children and don’t do well for any kind of dental procedure unless we have some kind of medication to get us through. This is big news because we’ve always had to pay out-of-pocket for it, and we don’t have the best teeth. I’ve looked and looked, but I don’t see anything that discusses this law- either as something in place or upcoming. Any news?

Thanks, Emilia

 

Dear Emilia,

Head and shoulders photo of a man and woman lying in a field of flowers, for information on sedation dentistry from Plano TX dentist Dr. Miranda Lacy.California has some incredibly progressive laws in many respects. Many regulations originate in California before they are adopted in other states. California Assembly Bill 2643 amends Section 1367.1 of the Health and Safety Code and Section 10119.9. SB 2643. It outlines a number of regulations that have to do with “the use of general anesthesia, conscious sedation, and oral conscious sedation (OCS) for pediatric and adult patients.”

  • The current language of the laws stipulates that dental anesthesia only has mandatory coverage in a hospital setting. As you probably know, there are many people who genuinely require anesthesia, but don’t need to go to a hospital for treatment.
  • The proposed legislation would force new insurance plans to cover it effective January 2019.
  • The proposed law is being sponsored by the California Dental Association and California Society of Pediatric Dentistry. It is not yet approved. If passed, it could make a major difference for people like your sister who lives in California.

Sedation Dentistry and Insurance

Throughout the rest of the country, coverage for any form of anesthesia or OCS varies based on the insurance policy. While most insurance companies recognize that OCS makes it possible for many people to receive treatment,  manage their oral health better, and possibly reduce expenses for insurance companies overall,  most insurance companies are reluctant to add sedation dentistry as a necessary and valuable benefit.

It sounds as if you’ve personally made your oral health a priority and have found a way to budget for it, which is commendable. Patients who are still trying to find a way to manage dental anxiety and get necessary treatment may be able to find a plan that specifically covers OCS. It is worth noting that very few offer coverage and when they do, it can be costly.

As an alternative, it’s helpful to speak with your dentist about what your anxiety and finding affordable dental treatment. Most dentists will work with you to overcome the issues, perhaps by doing as much work as possible in a single appointment or doing the work in phases. Your dentist may have additional solutions.

This blog is sponsored by Plano sedation dentist, Dr. Miranda Lacy.

Pain and sensitivity after sedation dentist filled 2 teeth

Last week I saw a sedation dentist and got 2 teeth filled. It was so hard for me to keep a dental appointment because of my anxiety. After learning about sedation dentistry, it gave me the courage to do something about my teeth. My understanding from the Internet is that sedation helps you relax and it makes the pain less intense. I received the fillings because I thought they would fix the pain and sensitivity in my teeth, not cause more of it. The pain and sensitivity haven’t gone away and this is a huge disappointment. What’s going on? Am I going to need to have the fillings redone? Bahja

Bahja – Sedation dentistry does relax you and decrease the pain during a dental procedure. Sensitivity and pain after a tooth filling are normal. For the first 24 hours after having cavities filled, you should avoid hard or sticky foods that can irritate your teeth or cause the filling to dislodge.

Sedation dentistry can make getting cavities filled easier

As the nerves in your teeth calm down, sensitivity should gradually diminish. You will find that foods or drinks that are hot or cold will increase sensitivity in your teeth. If you had deep tooth decay that might have been close to a nerve, it is not unusual to feel pain and increased sensitivity, and it can take up to four weeks for the sensitivity to go away.

If you notice that you have pain only while you are chewing, it is possible that the fillings in your teeth are too high. Another indication that a filling is too high is that it will prevent the biting surfaces of your teeth from closing together. If you are experiencing either of these issues contact your sedation dentist’s office.

This post is sponsored by Plano female dentist Dr. Miranda Lacy.

Why can’t I get sedation dentistry for a root canal?

I’m wondering why I can’t get sedation dentistry for a root canal. 2 of my bottom left molars have really been hurting me. Unfortunately, I put off the dental appointment so long that I can’t chew on that side of my mouth without intense pain. Last Thursday, I had a dental appointment and the dentist told me that I now need root canals and crowns for both teeth. If I had gone to the dentist earlier, the situation wouldn’t be so bad. I was expecting the dentist to say that I only need fillings. I asked to be sedated for the procedure, but this dentist told me that he doesn’t do sedation because he is gentle and none of his patients need sedation, especially for something as simple as a root canal. My level of fear is so high that the thought of going to a dentist for a root canal is making me nauseous. Am I asking for too much? Why can’t I get sedation dentistry for a root canal? Daniel

Head and shoulders photo of a man and woman lying in a field of flowers, for information on sedation dentistry from Plano TX dentist Dr. Miranda Lacy.Daniel – A gentle dentist is able to give you root canal treatment that is painless. But if your anxiety level is high, sedation dentistry can help keep you calm. Even dental fillings or cleanings can be performed with sedation.

The important thing is not to skip the root canal treatment. When the pulp, or soft tissue, inside your tooth is infected, the infection must be removed. Otherwise, the damaged pulp will cause nerve irritation and pain. At some point, the pulp in the tooth will die, and you won’t feel pain anymore. But your tooth will still be infected, and the infection can spread to the bone and to other teeth.

What Happens During Root Canal Treatment?

  • Your dentist will make an opening on the biting surface of the tooth. Dental tools will be used to clean out the tooth, down to the roots.
  • The pulp will be replaced with a dental filler material. The roots of the tooth will be sealed with a dental adhesive.
  • A temporary filling or a temporary crown will be placed over your tooth.
  • Your tooth will be shaved to allow the permanent crown to fit over it. Usually, permanent crowns are custom made in a dental lab.

Sedation Dentistry Will Help During Root Canal Treatment

Sedation dentistry is helpful during root canal treatment. In addition to helping you stay calm, it will decrease your sensitivity to pain. If your dentist is unwilling to provide some form of sedation, you can schedule consultations with at least two other dentists who will provide it.

Depending on the dentist, you will learn about three different levels of sedation:

  • Nitrous oxide – This colorless, odorless gas is often referred to as laughing gas. You’ll breathe it in during the appointment. When the procedure is complete, you’ll be given pure oxygen to reverse the effects.
  • Oral conscious sedation – In advance of your appointment, you will take commonly prescribed anti-anxiety medication. You’ll come to the office relaxed and ready for your root canal treatment.
  • IV sedation – Anti-anxiety medication is given to you intravenously.

For each consultation, ask the dentist what types of sedation he or she offers. Ask about safety precautions while you are sedated. You can find a sedation dentist by asking friends, family members, or coworkers for recommendations. Also, you can search online for a dentist near you. Be sure to check patient reviews.

Act promptly to prevent your infected molars from causing more problems in your bone or adjacent teeth.

This post is provided by Plano, TX female dentist Dr. Miranda Lacy. Dr. Lacy’s office is convenient to Addison, Allen, Carrollton, Farmers Branch, Frisco, Garland, Highland Park, and Little Elm.

Afraid of being sedated by a new dentist but I need 2 crowns

I know that sedation dentistry is probably the best thing for me, but my current dentist doesn’t offer it. I just can’t relax in her office. It’s not her. It’s me.

I have to switch dentists because she doesn’t offer sedation. I need 2 new crowns and I’ve put it off for too long. Now there is a problem of letting a complete stranger sedate me. It’s part of my fear and I know that I am going to have to get over it. There has to be a first time.

What can I do to get over the fear of having a new dentist sedate me? I don’t want to go into the office and make a fool of myself because of my fear. Thank. L.E.

L.E.

Sedation dentists are used to seeing fearful patients, so don’t worry how your anxiety will be perceived by the dentist or their staff. Your anxiety is common among millions of Americans.

How to Choose a Sedation Dentist

  • Before you choose a new sedation dentist, have consultations with a few dentists who have been recommended by friends or family members, or with whom you think you may be comfortable.
  • Speak with each dentist about your fears. Find out what he or she does to help anxious patients relax and what levels of sedation are offered.
  • Meet the staff, take an office tour, and become familiar with the office.
  • After you have chosen a dentist, if you are still very uncomfortable, continue to ask questions and talk about your concerns until you feel comfortable. Don’t proceed with getting dental crowns before you are comfortable.

Receiving sedation will be easier if the dentist is no longer a stranger to you and you know what will be done to help you relax and have a pain-free experience.

This post is sponsored by Plano female dentist Dr. Miranda Lacy. Dr. Lacy’s office is convenient to Addison, Allen, Carrollton, Farmers Branch, Frisco, Garland, Highland Park, and Little Elm.

Can I Insist on a Female Sedation Dentist?

I need to have my wisdom teeth pulled and I plan to see a sedation dentist for it. I already have a dentist and I think she’s awesome, but she won’t sedate me for the procedure. Actually, she doesn’t even provide any kind of gas or anything. I even asked her if she’d just prescribe something for me to help take the edge off during the procedure and she won’t even do that much. I’m really disappointed because I already know and trust her, but it’s her practice, and her rules, I guess. So, instead of pulling my wisdom teeth, she gave me referrals to a couple different sedation dentists. Actually, I think these guys are oral surgeons who just happen to provide sedation services as well. Anyway, I feel kind of bad saying this, but I’m not comfortable with male doctors. I’m not saying they’re bad or dangerous or anything like that. I’d just feel better if my doctor was a woman, especially if I’m going to be sedated. Again, I don’t think a male doctor would do anything bad, I just feel more comfortable with a female physician, especially for something like this.

Here’s where the problem comes in- she referred me to a couple different oral surgeons and told me I could choose one, but they’re all men. I called my insurance company to see where I could go, and then I asked them if they could tell me which ones were women. Instead of helping me, the insurance agent gave me a hard time about it saying, “Their credentials are the same. What does it matter?” Well, it matters to me. A lot. I don’t think I should be made to feel bad just because I want to see a female doctor. I’ve called around to most of the offices on my list and it looks like they’re all men. Seriously. Are there no female oral surgeons?!?

What are my options here? Is it ok that I’m insisting on seeing a woman, or am I being unreasonable? Thanks, Anonymous

Dear Anonymous,

You’re not being unreasonable at all. Some people simply feel more comfortable with a female practitioner, and that’s okay. When you’re choosing a dentist, you need to feel comfortable and know that you can trust him or her. In fact, many insurance companies that post lists of their physicians online actually allow you to search by gender for this very reason.

At the same time, you’re experiencing one of the odd quirks of dentistry. The latest stats indicate 98% of oral surgeons are men. This has been the topic of scientific research; trying to uncover why so few women get into the field and what can be done to attract more women to it. Sadly, very little has changed over the years, and it continues to be a male-dominated profession.

There’s a very real chance that there are no female oral surgeons in your area, particularly if you live in a smaller community. So, you have a couple of options.

1) Visit the office of a male oral surgeon and see if he has female staff members who will be with you during treatment. Offices usually have an assistant assigned to each patient, and the majority of assistants are female. You can also ask if the anesthesiologist, if one will be present, is female. So even if you can’t have a female doctor, you may feel some comfort by having women around you while you’re medicated.

2) Search for a female sedation dentist. It sounds like your dentist was willing to do your extractions, which means a specialist isn’t really needed for the extractions. You may be able to find a female general dentist in your area who provides oral conscious sedation.

This post is sponsored by Plano female dentist Dr. Miranda Lacy. Dr. Lacy’s office is convenient to Addison, Allen, Carrollton, Farmers Branch, Frisco, Garland, Highland Park, and Little Elm.

 

Is sedation dentistry safe if I’m a coward at the dentist?

I am a coward at the dentist and I have a low tolerance for pain. I know I need sedation but I’m concerned about the safety. A normal person would be numbed with local anesthetic, but it doesn’t work for me. My dentist has tried numbing me 2 hours before my appointment but it has no effect. It’s as if nothing was done at all. He isn’t a gentle dentist either. So I’ve put off any serious dental work. Within the past two weeks I received a postcard in the mail from a nearby dental office. It’s a husband and wife team that practices sedation dentistry. Is this really a safe alternative? Is there any way to tell whether or not it would work on me before the dentist starts drilling in my mouth? Thanks Lizzy

Lizzy – Your case is not unusual.  Millions of Americans have dental anxiety or dental phobia and consider themselves to be dental cowards. It helps to have a gentle dentist, but sometimes that isn’t enough. When the anxiety is high enough, local anesthetic either wears off very quickly or doesn’t work at all. Sedation dentistry is a safe alternative.

Conscious oral sedation uses common anti-anxiety medication to relax you. You’ll still be conscious and have your reflexes, and your vital signs will be monitored. But you’ll be completely relaxed. Some dentists use nitrous oxide to calm the patient so that the local anesthetic will be effective. Remember sedation is not local anesthetic, but it helps you relax so that the anesthetic will work. It can also help you experience less sensitivity to pain.

Sedation Dentistry Is Safe

Sedation dentistry is safer and less expensive than general anesthesia. It helps you to have a pleasant dental experience, and it’s likely that you won’t recall what happened during the appointment. It is safe. Your medical and prescription history is reviewed to determine if you are a candidate for it. During your dental procedure, your vital signs are monitored.

You can find a gentle dentist who enjoys treating fearful and anxious patients. It’s important that you get the treatment you need, so that you can maintain good oral health. Sedation dentistry can help.

This post is sponsored by Plano dentist Dr. Miranda Lacy. Dr. Lacy’s office is convenient to Addison, Allen, Carrollton, Farmers Branch, Frisco, Garland, Highland Park, and Little Elm.

Will sedation dentistry work if I’m already on anti-anxiety meds?

Will sedation dentistry work if I’m already on anti-anxiety meds? I also take an anti-depressant. The thought of needing 2 root canals is making me very nervous. My concern is that the medication I’m already taking will cancel out the sedation drugs. I’m also concerned about interactions. Each day my teeth are really getting uncomfortable so I know I’m going to have to act soon. If I can’t get sedation I’m not sure I could make it through the appointment. What would a dentist do in my case? Thanks. Rody

Rody – The medication a dentist selects for sedation during dental treatment is based on several factors, including:

  • His or her treatment philosophy
  • Experience using the drug
  • A patient’s medical history
  • The dental procedure

Sedation dentists who regularly treat anxious patients know how to assist those who have general anxiety and already take some form of anti-anxiety medication.

Remember to provide your dentist with a complete list of your medications, the dosage, and how often you take them. The information you provide will prevent negative drug interactions. It will also help the dentist determine which anti-anxiety medication to use. There are a variety of options to help you relax during dental treatment.

You can also contact the dental office and ask if you can fax or e-mail the list of your medications before your consultation. It will give the dentist time to review it and provide you with an idea of which medications can be used during dental treatment.

Whenever necessary, your dentist will be willing to work with your primary care doctor and your pharmacist to select sedation medication that will be effective during your dental procedure.

This post is sponsored by Plano female dentist Dr. Miranda Lacy. Dr. Lacy’s office is convenient to Addison, Allen, Carrollton, Farmers Branch, Frisco, Garland, Highland Park, and Little Elm.

After a sedation dentistry appointment, can I stay at the office until I can drive home?

I finally decided to see a sedation dentist for 4 crowns that I need badly. I need 2 fillings also and am anticipating being in the office for a while. I am wondering if sedation dentists have provisions for patients to stay in the office until the medication wears off. If it can wear off in the office, I prefer to drive myself home. How long does it take for the medication to wear off? Jamison

Jamison – You first need to have a consultation with a sedation dentist to determine which level of sedation you will receive. If you receive oral conscious sedation, you will likely be drowsy for the rest of the day. You will still need a ride home.

What to Expect with Sedation Dentistry

Below is some helpful information on what’s involved in receiving sedation dentistry

  • Your first appointment is a consultation for diagnosis of the issues with your teeth, along with treatment options.
  • Your medical, prescription, and dental history will be reviewed to determine if you are a candidate for sedation and which medication should be used.
  • For the day of your appointment, the sedation dentist will advise you to have an adult drive you to the office, take you home, and stay with you for the rest of the day. This is a precaution for you, because if you’re at home and you need anything, your drowsiness can contribute to an accident.
  • After your procedure plan to stay at home, preferably in bed or on a sofa.

Sedation allows dentists to complete as much work as possible. But if any of your teeth require extensive work, you’ll probably have to return to the office until treatment is complete.

After your consultation, your dentist will provide you with a treatment plan. Your sedation dentist will let you know if all of your dental work can be completed in one day, or if multiple appointments are required. Dental crowns usually require at least two appointments. Crowns are usually made in a lab, so you would return to the office to have them bonded to the natural teeth that the crowns are preserving.

Depending on your comfort level with the dentist, after your first treatment appointment, you might prefer to only receive local anesthetic and to waive medication that will make you drowsy. In that case, you would be able to drive home.

We suggest that you find a sedation dentist who is also a cosmetic dentist. A trained cosmetic dentist will produce natural-looking results that help you smile with confidence.

This post is sponsored by Plano female dentist Dr. Miranda Lacy. Dr. Lacy’s office is convenient to Addison, Allen, Carrollton, Farmers Branch, Frisco, Garland, Highland Park, and Little Elm.

 

Can I refuse sedation dentistry with wisdom teeth removal?

I need to have all of my wisdom teeth pulled and I don’t want sedation. I haven’t seen a dentist recently, but I know it’s my wisdom teeth that are hurting and the pain is getting worse. Before I go in I want to know if sedation is necessary or just something the dentist will try to convince me to get. I don’t like people doing anything to me medically or otherwise without me being fully aware of what’s going on. I am not afraid of the procedure. I just want to be full aware and awake. Can you tell me if sedation is standard for wisdom teeth removal or can I go without it? Thanks Brooklynn

Brooklynn – It’s good that you recognize that dental care is needed for your wisdom teeth. Whether or not you need sedation dentistry depends on the condition of the teeth and their roots. Wisdom teeth are especially painful when they are impacted.

Impacted wisdom teeth can lead to a variety of oral health issues, including those listed below:

  • Damage neighboring teeth
  • Become infected, and in some cases form a cyst that affects nerves, other teeth, your jaw, and facial muscles
  • Become difficult to clean and promote bacteria and gum disease
  • Bacteria can enter your bloodstream and affect your organs, including your heart and kidneys

You will receive an anesthesia evaluation. Local anesthesia will definitely be administered. Your dentist or oral surgeon is concerned about your comfort during wisdom teeth removal. If the removal of the teeth is anticipated to be complex or time consuming, sedation dentistry might be recommended.

There are various levels of sedation:

  • Nitrous oxide
  • Oral conscious sedation
  • IV sedation dentistry

Before you decline sedation, ensure you understand what to expect during the procedure. Ask the dentist about what you will be able to hear, see, and feel more intensely than you would without sedation. It’s your right as a patient to accept or decline care, but sedation dentistry can make the removal of impacted wisdom teeth a much more pleasant experience.

This post is sponsored by Plano dentist Dr. Miranda Lacy. Dr. Lacy’s office is convenient to Addison, Allen, Carrollton, Farmers Branch, Frisco, Garland, Highland Park, and Little Elm.