Anxious Patients

Anxious Patients

What are your emotions when you think about scheduling a dental appointment? How do you feel when you walk into the reception room, with its aseptic smell and the din of the drill. Or, further, when latex-clad hands invade your mouth?

Either you’re shuddering right now, or you’re running your tongue across your teeth, wondering whether you’ve arranged for your next cleaning. For some, visualizing yourself in the dentist’s chair can make you a tad uneasy, especially if in the past you’ve experienced a root canal or had a tooth pulled. You might even have concluded that we all loathe dragging ourselves to the dentist. And while it’s true that dental-related anxiety affects an estimated 15 percent of patients, a substantial majority are able to get through this necessary health-care regimen unfazed.

Every dental professional wants their patients to feel calm and relaxed. And frankly, the simple reason for their concern is that your comfort makes their job a whole lot easier. Does that mean that if you’re not nervous, you’ll receive better care than if you are? Hopefully not. But consider that dentistry is like working in the world’s tiniest garage. When a patient is anxious, another level of difficulty is added to the dentist’s work, whereas the calmer you can be—despite whatever discomfort you may be experiencing—the more you’ll optimize the outcome of your dentist’s efforts.

Analogy

As an analogy, have you ever tried to remove a splinter from the finger of a crying child, who’s pulling his hand away in panic? For the same reason that almost reflexively a child resists a splinter removal (turning the ordeal into an exasperating tug of war), some patients simply can’t make it through a dental appointment without their anxiety taking over. It’s no surprise that fear of pain is the number one reason people get nervous before and during dental visits—even to the point of avoiding them altogether. If you have difficulty tolerating trips to the dentist, can you find a way to relax or emotionally desensitize yourself?

Common Worries

Here are some common worries—and strategies to subdue them:

  • “It’s going to hurt!” — If you’re nervous about pain, let your dentist know; we can administer anesthesia comfortably so you don’t have to suffer. Afraid of needles? Sedation dentistry is common, and all you need is a designated driver to shuttle you to and from your appointment. For patients who can’t get past an unrelenting fear of the dentist, this is usually the best option.
  • Bad experience in the past — This seems to be the second most common complaint of apprehensive patients. Sometimes the overall experience of the appointment leaves you feeling unsettled — or worse, repulsed. Perhaps the office over-billed you, the hygienist wasn’t thorough, the assistant was annoying, or the dentist was insensitive. It happens, and it’s unfortunate. But it shouldn’t prejudice you against future visits either (whether with the same dentist or a new one). It’s almost always helpful to tell dental staff about your past experience, so they can understand exactly what offended you. It may require some patience, but you should be able to find a team that will be a good fit for you. And that can make all the difference.
  • Feelings of helplessness or loss of control — Not being able to talk or being confined to a chair with a “noose” around your neck (not to mention being drill-shy) can evoke feelings similar to claustrophobia. If this is you, let the assistant know at the beginning of the appointment how you’re feeling. During the appointment, raise a hand to take a break (and we can stretch our backs at the same time).
  • Embarrassment about your oral health — You may have gone years without a cleaning. Maybe you put off treatment, and you’re embarrassed or ashamed by the compromised state of your mouth, or what the dentist might say to you. But consider: dental professionals have seen it all. It won’t phase them, so it shouldn’t phase you either.
  • Anxiety About Cost — Dental work can be expensive, especially if your insurance doesn’t cover it. Still, regular appointments with your hygienist help reduce the need for more costly treatments later on. We will work with you to create a comfortable financial arrangement.

If you experience any of these worries (or others not mentioned here), they can all be overcome.

Communicate your feelings to your practitioner. And try this trick: feel gratitude for your teeth and for your access to good care.

What Is Sedation Dentistry?

Sedation dentistry uses medication to help patients relax during dental procedures. It’s sometimes referred to as “sleep dentistry,” although that’s not entirely accurate. Patients are usually awake with the exception of those who are under general anesthesia.

The levels of sedation used include:

  • Minimal sedation — you are awake but relaxed.
  • Moderate sedation (formerly called “conscious sedation”) — you may slur your words when speaking and not remember much of the procedure.
  • Deep sedation — you are on the edge of consciousness but can still be awakened.
  • General anesthesia — you are completely unconscious.

What Types of Sedation Are Used in Dentistry?

The following types of sedation are used in dentistry:

  • Inhaled minimal sedation. You breathe nitrous oxide — otherwise known as “laughing gas” — combined with oxygen through a mask that’s placed over your nose. The gas helps you relax. Your dentist can control the amount of sedation you receive, and the gas tends to wear off quickly. This is the only form of sedation where you may be able to drive yourself home after the procedure.
  • Oral sedation. Depending on the total dose given, oral sedation can range from minimal to moderate. For minimal sedation, you take a pill. Typically, the pill is Dormicum, and it’s usually taken about an hour before the procedure. The pill will make you drowsy, although you’ll still be awake. A larger dose may be given to produce moderate sedation. This is the type of anesthesia most commonly associated with sedation dentistry. Some people become groggy enough from moderate oral sedation to actually fall asleep during the procedure. They usually can, though, be awakened with a gentle shake.
  • IV moderate sedation. You receive the sedative drug through a vein, so it goes to work more quickly. This method allows the dentist to continually adjust the level of sedation. We work with qualified sedation specialists, in our rooms, to ensure you are completely safe and well managed throughout the procedure
  • Deep sedation and general anesthesia. You will get medications that will make you either almost unconscious or totally unconscious — deeply asleep — during the procedure. While you are under general anesthesia, you cannot easily be awakened until the effects of the anesthesia wear off or are reversed with medication. This usually takes place in a hospital theatre setting, where we will carry out your treatment.

 Sedating a patient is normally a very safe procedure, patients and parents can help reduce the risks and stress level for themselves or their child before, during and after the treatment