Easing Dental Anxiety: Sedation Dentistry

by | Jul 9, 2015 | Dentistry

If your child is anxious about visiting the dentist, is it a case of the apple not falling far from the tree?

A study published last year in the Journal of Pain Research found a definite correlation between parents’ dental fear and that of their children. An earlier study found that parents may transmit their own fear – though that means the possibility of positive “emotional contagion” exists, too.

dentist above patientFor many, a bad childhood experience can be enough to stir up dental anxiety. Others struggle with feelings like claustrophobia or have a dislike of dental tools or particular sounds or smells they’re exposed to during treatment. As a result, many avoid the dentist for even standard cleanings, which leads to higher rates of caries and periodontal disease – as well as the need for more intensive, even emergency, treatment down the road.

Fortunately, sedation dentistry offers relief for both for adults and kids.

One of the most common sedatives – one we use here in the office – is nitrous oxide, more commonly known as laughing gas. Odorless, colorless and safe, nitrous creates a feeling of deep relaxation and tranquility – and, yes, make things seem a little funny. (Before it was used in medicine, it was mostly used recreationally, for amusing demonstrations and “laughing gas” parties among the well-to-do. Dentists began using it in the mid-19th century.)

Inhaled through a nose-piece, nitrous also helps reduce pain, though not so much that local anesthetic isn’t needed, as well, for invasive procedures such as fillings, crown preps and surgeries.

In addition to calming the anxious, nitrous can be helpful for patients who have a strong gag reflex, sensitive teeth or are undergoing a particularly lengthy procedure. The onset of sedation is quick, and so is recovery afterward. Most people can safely have nitrous oxide – adults and children alike.

But not everyone. If you have breathing problems or can’t tolerate your nose being covered with the rubber mask, nitrous is not a good option. It should also be avoided by women in their first trimester of pregnancy and people with severe emotional disturbances.

Fortunately, there are other options, such as IV sedation, which offers a higher level of relaxation while still allowing you to remain conscious. (In some surgical cases, general anesthesia may be called for.) It’s also a good option if your level of anxiety is on the strong end of the scale. Onset is quick, and the patient is constantly monitored for safety.

Here in our office, we have two caring and exceptionally trained anesthesiologists we bring in to help our patients who require this type of sedation.

Compared with the effects of nitrous, which wear off completely after several minutes of exposure to pure oxygen, those of IV sedation wear off more slowly (though not as slowly as oral sedation, which many dentists use – basically, a drug cocktail), and you will likely need someone to drive you home after your appointment. The plus side is that the relaxation it provides is profound. Dental treatments become quicker and easier.

And certainly, there are plenty of effective non-narcotic options for dealing with dental anxiety, as well. A study published last fall, for instance, found that hypnosis

is beneficial as an adjunct intervention to reduce anxiety in patients undergoing tooth removal, particularly with regard to its non-invasive nature.

Similarly, deep breathing practices and guided meditation before and at the beginning of your appointment – when anxiety is usually highest, lessening as the procedure goes on – can be helpful in creating an inner feeling of calm.

There are also a wide array of herbal medicaments that can help reduce anxiety, relax muscles and dull pain. Effective calming herbs include chamomile, passionflower, lavender, hops, lemon balm, hyssop, mugwort and St. John’s wort. The supplement GABA is also helpful for calming.

If you decide to try botanicals in any form and are taking any prescription medications, be sure to talk with your doctor first. Just as there can be bad interactions between different drugs, there can be bad interactions between herbs, supplements and drugs.

Most importantly, talk to your dentist. Let us know how we can make you feel more comfortable. We will work with you to pinpoint and provide the best solution to help you deal with your dental fear.

Image by Matthew

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