Dental Sedation when Novocain Fails

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I had a nasty toothache and went in to see my dentist for an emergency appointment. He gave me antibiotics to keep the infection at bay and scheduled me for a root canal in two days. I went in and for some reason he couldn’t get me numb. He’s now giving me a referral to a sedation dentist. Why will that work if the Novocain doesn’t?

Catherine

Dear Catherine,

A woman holding the side of her jaw in TMJ pain

Your dentist is right on target with what he’s suggesting. It’s very common when a patient has some level of dental anxiety. Your metabolism jumps up with anxiety. The theory is, depending on the level of anxiety, the higher metabolism causes you to burn off the numbing medication so quickly you don’t get the effects.

How a Sedation Dentist Helps

Ideally, you should get oral conscious sedation. Your sedation dentist will give you a pill before your appointment, which will completely relax you. In fact, you’ll be so relaxed, you won’t be able to drive yourself to your appointment.

Your dentist will expect you to have a ride to and from his office. Additionally, you’ll want someone who is able to stay with you for a few hours after your appointment until you are lucid and steady on your feet again.

This form of sedation is so strong, that most patients completely sleep through their appointment. This will help you get your root canal treatment done no problem.

Please don’t put this off or you’ll have another emergency dental appointment without being able to save your tooth. Then, you’ll need to invest in a great tooth replacement option such as a dental implant.

I know you are nervous, but believe me when I tell you sedation dentistry has changed the lives of even the most fearful of patients.

This blog is brought to you by La Jolla Dentist Dr. Stephen Doan.

Uber as My Dental Sedation Transportation

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I have been told I’ll need dental sedation for a procedure and that I have to have someone to drive me to and from the appointment. I told them I could get a cab or an Uber and they said, “No.” They said it has to be someone who can accompany me in, stay and bring me home, and then stay with me at home after the procedure. I don’t know anyone in town. I’ve only lived here a few weeks. All I can do is get a ride. Would it be that big of a deal if I hired the Uber driver to come in with me and pretend they’re a friend? Obviously, I’d have someone to drive me back that way. I’d just pay them extra for their time during my procedure.

Lucy

Dear Lucy,

Woman Sleeping in Dental Chair

You are in a tough spot. You need a medical procedure which requires dental sedation, but you don’t know anyone who can stay with you. While I’m sure you could hire an Uber driver who’d be willing to lie and say they’re your helper for the day, I’m not sure you really will want to do that. Here’s why.

First and foremost, you’ll be in a very vulnerable position. You won’t be completely lucid and certainly won’t be steady on your feet. You won’t know anything at all about the Uber driver you get. I hate to say this but people can be quite evil sometimes. What if they rob you blind or harm you physically? You’ll have no defense abilities and will be completely at their mercy.

Second, you actually will need someone to stay with you throughout the day. While dental sedation is very safe, it doesn’t mean that there won’t be any complications. Every patient responds a little differently. Without proper post-operative care, many things can go wrong. You certainly don’t want to end up with an emergency dental situation as a result.

Even in the best case scenario, where everything goes perfectly according to plan, you’ll still be quite unsteady on your feet. To keep from being injured, you’ll need someone who can help you get too and from places like the bathroom.

Two Solutions to Get Your Dental Sedation

Option One: Talk to a faith group. If you have a religious faith, call a local church and let them know your situation. I’d be willing to bet most churches would be more than happy to help a stranger in a legitimate need. Even if you’re not a member of a faith group, many of them would still be willing to help. You’re likely safer with someone recommended to you from a bishop, rabbi, or priest.

Option Two: See if your insurance will cover a home health nurse for a day. It’s very possible you can get someone either through your medical insurance or by paying out of pocket. It will be worth the safety and peace of mind you get.

This blog is brought to you by La Jolla Cosmetic Dentist Dr. Stephen Doan.

Pediatric dentist won’t sedate my young daughter

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We just found out that my young daughter needs several large fillings done and possibly a crown. We’ve always gone to a pediatric dentist and we love how they go out of their way to make our kids feel safe and comfortable. I’m confused because he is suggesting that we bring Hannah back 3 or 4 times in order to get all the work done. I assumed they would just sedate her and get it all done at once… wouldn’t that be easier on everyone? — Meredith

Meredith,

There’s no doubt that young children can benefit from sedation – especially if they are faced with extensive dental work. Although there are several types of sedation available, the main advantage is that it relaxes and calms patients without actually putting them in a sound sleep.

It can be a great option for kids who have severe dental anxiety or who have special needs. A dentist may even prescribe it if a child tends to be a wiggle worm in the dental chair and can’t sit still for long periods of time.

But, it’s important to remember that pediatric dentists are specially trained to deal with young and often fearful patients and they do so every day. That’s why they don’t sedate every child that requires treatment or has a large treatment plan. The goal of any dentist is to treat their patients in the safest manner possible, and no matter how safe a medication is, there are still risks of reactions and side effects so you should know what to expect.

And while sedating your daughter may be more convenient and save you from bringing her back for multiple appointments, your dentist has likely determined it’s simply not the best option for her. Good luck!

This blog is sponsored by AACD Accredited dentist, Dr. Stephen Doan. Find out more about the services he provides by visiting his La Jolla cosmetic dental website.

Is a sedation dentist the only one who can help with my dental anxiety?

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I’m embarrassed to admit this, but when I was a kid, I hated the dentist so much. At age five, I actually kicked my dentist in the teeth (with my little cowboy boots, none the less), and after that, my mom really never made me go back. Now I’m almost thirty and I haven’t been in a dental chair since that fateful day. I’ve battled with some medical issues that have really affected my teeth, but I can’t even stand the thought of going to the dentist. I tried and I was so anxious that I practically hyperventilated.  My dentist doesn’t help much either… he just makes me feel like I’m being a baby.  I can’t control this. I honestly wish that I could! My friend told me my only option would be a sedation dentist, but I don’t know if that will work either because I definitely won’t be in control at all. What options do I have besides seeing a sedation dentist if I want to control my anxiety and get all my work done? — Seth

 

Seth,
Oh boy… I’m betting your dentist didn’t enjoy that little rodeo! However, please know that you are not alone. Many people just like you had bad childhood experiences at the dentist that caused life-long anxiety.

And yes, a sedation dentist is probably your best option, but not for the reasons you might think. Sedation dentists, number one, have a good understanding of dental anxiety. There are many dentists who just brush anxiety aside and basically take the stance that patients just need to buck up and power through the work. A sedation dentist goes through extensive training to become certified, because they know that anxiety is real and that anxious patients need extra help. For you, this means that you’ll likely have a completely different experience — even if you choose not to take any medications. You’ll find a relaxing environment that often includes music and TVs, to put you at ease.

Most dentists do “conscious sedation” these days. That means you’re conscience during the procedure, leaving you very much in control. Doctors like it because you can be an active participant and follow instructions. However, you’ll be relaxed enough that you really won’t care about what is going on even though you are aware of it and there are people surrounding you.

It’s definitely worth your time to meet with a sedation doctor and see what it’s all about. He or she will likely start with an exam and x-rays, but it will be a great way to get to know the doctor before signing on for any additional treatment.

This blog is sponsored by AACD Accredited dentist, Dr. Stephen Doan. Find out more about the services he provides by visiting his La Jolla cosmetic dental website.

Can I sleep after sedation and then drive myself home?

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I am having some extensive dental work done in a few weeks and I will be sedated for it. I’m hoping to get everything done in one visit, but my dentist said the medication will make me very groggy and I can’t drive myself home. My wife just found out she needs to go stay with her mom out of state for an extended period of time, so she won’t be around to go with me. About how long will the medicine stay in my system? Do you think they would let me sleep off the medication in office for a while and then drive home? I really don’t want to put this off, but I don’t have anyone else who can go with me. — Matthew

 

 

Matthew,
You’ll have to talk with your dentist to find out what medication he/she will be using. However, keep in mind that each person reacts differently to sedation so the effects can vary. If you are like most people, you’ll be groggy for the rest of the day, so it’s dangerous — for you and for others — to get behind the wheel of a car.

Have you had your consultation to go over your diagnosis and treatment options? If so, the dentist should have discuss what medications they use and how they’ll affect you. Most sedation dentists will require that another adult be along for your appointment – to drive you to and from the office and to be with you for several hours after your procedure. While you’ll probably be in and out of sleep at the office, don’t expect that the medication will wear off enough for you to drive home. You’ll want someone to drive you, and most likely you’ll be in bed (or at least on the couch) for the rest of the day.

The benefit of sedation is that you will be relaxed enough that your dentist can get as much done in one visit as possible. But don’t be surprised if you might need to come back. Sometimes dentists can run into unexpected issues with a particular procedure and that may require you to schedule another appointment. If part of what you need done is just fillings, you might be able to do those without sedation on a shorter visit. If you do end up needing multiple appointments with sedation, be sure to plan ahead because each visit would require you to have a driver and helper for the rest of the day. Hopefully you’ve addressed all of these issues in your consultation. Good luck!

This blog is sponsored by AACD Accredited dentist, Dr. Stephen Doan. Find out more about the services he provides by visiting his La Jolla cosmetic dental website.

Will sedation cause an adverse effect with my anxiety meds?

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I need to see a sedation dentist, but when I call to try and schedule a consultation with an office, I’m finding that some won’t take me because I am on medications for depression and anxiety. I’m thinking about trying to research drug reactions first instead of telling the next dentist up-front. I want to find someone that will help me — not tell me they can’t treat me and push me off on someone else. Help! — Steven

 

Steven,
Researching sedation dentistry drugs on your own is really not going help you because dentists select medications based on their personal philosophy, past experience with patients who have used the drug, and of course, each patient’s unique needs and medical history. There’s no way for you to guess what medications might be used.

But here’s the good news… your situation is not unusual and doctors treat anxious patients everyday who are just like you – with either specific dental phobias or generalized anxiety and already take something to help with it.

You absolutely need to take a full list of your medications to your consultation. Be specific on the amounts you take and when because you want to avoid an overdose or contraindications. With this information, the doctor can then determine which medications will be best for your situation. If, for some reason, he/she can’t help you, they should be able to refer you to someone who can so you don’t have to bounce around from office to office.

If you have time, you could see if it’s possible to fax or send the list to the office ahead of time.  The staff can review it and let you know up-front if they can treat you or not and then you won’t waste an appointment. In all likelihood, however, the office will probably give you a green light to come in for the consultation and the doctor will go over your treatment options then and there. Good luck!

This blog is sponsored by Dr. Stephen Doan. Find out more about the services he provides by visiting his La Jolla cosmetic dental website.

My parents are ignoring my dental issues!

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I just turned 17 and I know it sounds hard to believe, but I have NEVER been to the dentist. I guess my parents didn’t think it was a priority. In the last several years, I’ve noticed changes in my teeth – several have started hurting every so often and they seem to be very sensitive to cold. I’m not sure what a cavity looks like, but I have brown areas on several of my teeth. I’ve started getting concerned about my wisdom teeth as well because I have pain in my jaw back there and I swear I can see a tooth showing through my gums. My mom seems to just ignore me when I tell her about it. A friend of mine recently had her wisdom teeth out and she went to a sedation dentist. I think I need to see a sedation dentist, but I can’t seem to convince my parents – they just won’t listen. Help! — Brandi

 

Brandi,

So sorry that your parents are not listening or acknowledging your concerns about your dental care. In many cases, when parents don’t make their child’s dental needs a priority, it’s because they grew up in a house that didn’t value preventative dental care or they perceive that they simply can’t afford dental care.

Visiting the dentist on a regular basis is an essential part of being healthy. Dental problems can affect overall health and lead to diabetes, heart disease, and a myriad of other issues. Poor dental health can also affect kids in many other ways – from confidence and self-esteem issues to problems eating and sleeping. This can lead to behavioral issues and even affect performance in school.

From what you describe, it sounds like you may have several cavities – and they are likely quite large if you are having the sensitivity issues. They need to be treated right away, in hopes that you can be saved from root canals, crowns, or even having teeth pulled. Wisdom teeth are a concern at your age, too, so they should be addressed as well.

There are resources available if income is a barrier. There are lots of dental plans that can help make care more affordable too, and some offices will do CareCredit or payment plans. Your school might have information that can help you as well – ask a guidance counselor can help you navigate the process if your parents don’t support you.

Whether or not you see a general or sedation dentist, make an appointment as soon as possible so a full diagnosis can be made and a course of treatment can be laid out. Good luck!

This blog is sponsored by Dr. Stephen Doan. Find out more about the services he provides by visiting his La Jolla cosmetic dental website.

Is it Safe to See a Sedation Dentist?

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I need to have extensive dental work done and I only feel comfortable with this amount of work if I am sedated. However, I have recently heard a  story on the news that a young girl died getting treatment from a sedation dentist. As I investigated a bit more, I found other cases in which this same thing happened. Now I am second guessing whether or not I should even get this dental work done all at once, or if I should avoid sedation and make my way through one treatment at a time. Is it really dangerous to see a sedation dentist?

 

Sincerely,

Phil

 

Dear Phil,

Dr. Doan is a La Jolla sedation dentist who discusses the pros and cons of this service with many patients. We understand your concerns, and we cannot deny that any type of sedation, whether dental or medical, is not completely without risk. That being said, the odds are in your favor that you will have no problem at all. Most dentists go their entire career without a patient experiencing issues from sedation.

It is general anesthesia that poses the greatest risk, and even then the risk is very small. In dentistry, general anesthesia is not the norm. Most patients are treated with medications formulated to relieve anxiety and to relax the body and mind. These are not intended to put you “under.” This means that you will be able to breathe without assistance and swallow on your own.

Prior to treatment, your dentist should review your medical history and obtain a list of any medications you are currently taking. This enables him or her to compare important data in advance of your treatment so you are given the proper dosage of sedative or anti-anxiety medication.

Another important aspect to consider is that your dentist has completed extensive training in order to safely deliver sedation to patients. This training also involves how to handle an emergency situation. First and foremost, a dentist must know how to recognize a problem and must call emergency services right away. The cases that you found likely involved general anesthesia and a lack of recognition, or lapse in time before calling an ambulance.

You deserve to have peace of mind about your upcoming treatment. We suggest that you speak with your dentist and ask questions. How will you be monitored while sedated? Will they be able to tell you are getting sufficient oxygen? Will you be monitored constantly while under their care? What is their emergency protocol should an issue arise? Knowing that your dental office has such measures in place should enable you to feel you are in good hands.

 

This blog is sponsored by La Jolla cosmetic dentist Dr. Stephen Doan.

 

 

Why Doesn’t Novocaine Numb me?

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Hello,

I have a real challenge with seeing the dentist, I don’t get numb! I’ve recently had a string of visits with my dentist to try to repair two front lower teeth that are partially dead due to a previous sporting injury. Half of the nerves in these teeth are still alive, but the teeth are badly infected. My dentist says that I need root canal therapy, but has not been able to get me sufficiently numb, so treatment has yet to be done. I don’t think my dentist really knows what to do for me at this point. He has refunded the fees I paid for treatment, but my teeth still aren’t fixed.

Charles

 

Dear Charles,

First, know that you are not the “odd man out” in this experience. There are large numbers of patients who have difficulty when it comes to getting numb for dental treatment. Here’s what could be at the heart of your troubles . . .

Just about every person experiences a certain sense of anxiety when they need to have dental work done. If the nerves of the tooth do not get numb after the first round of injections, anxiety will (understandably) increase substantially. What a lot of dentists fail to recognize is that higher levels of anxiety can actually counteract the effects of numbing medication. The more your dentist tries to get you numb, the higher your stress, and the higher your body’s resistance to numbing medication. It can be a vicious cycle that leaves everyone frustrated and perplexed.

As a La Jolla sedation dentist with DOCS certification, Dr. Doan routinely relies on various forms of sedation to ease patients’ nerves during dental treatments. One of the advantages that has been noticed with sedation is that anti-anxiety medications can improve the effects of novocaine. You may find the help you need from nitrous oxide, aka “laughing gas,” or from some form of oral conscious sedation, such as a low dose of Valium or Halcion. Take note that, if you choose an oral sedative, you will need to arrange for someone to escort you to and from your visit.

 

This blog is sponsored by La Jolla cosmetic dentist Dr. Stephen Doan.

 

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