I speak to lots of nervous patients every week, and one question that often comes up is “can’t you just knock me out for my treatment?” I guess what I am really being asked is what can you do for me that will reduce my level of consciousness such that I don’t know anything about what is going on. In days gone by a general anesthetic was the standard approach but in these more enlightened times most of patients would rather avoid this whenever possible. This leaves us with sedation.
Dental Sedation can be done with a small injection in the back of the hand ( called IV Sedation ) or using a gas called Nitrous Oxide ( often called RA sedation). Clearly for anyone with a needle phobia the IV option already sounds challenging! Either way the aim is that you remain conscious throughout treatment but at such a low level that you will not be hugely aware of what is going on and preferably remember very little or none of it when you recover.
A second issue which is really the most significant one for me, is that should you be unfortunate to experience toothache, and it does happen to the vast majority of the population at some time in their life, you cannot always guarantee the availability of a sedation service.
Generally dentists who provide sedation have had additional training as have the dental nurses who support them, so you simply cannot arrive to see any dentist and be guaranteed sedation. Even if a practice does offer sedation, there may be issues if the right combination of staff are not on duty that day. This then leaves you with a terrible dilemma of living with the problem or facing your fears head on in a crisis situation. Neither option is a good one and likely to help you in your quest to feel more relaxed about dentistry.
For these reasons, I feel that the best approach for the majority of patients is to address their fears slowly and gradually with a caring and sympathetic dentist and nurse who have a genuine interest in helping them. This way we can treat your dental fear as well as treating your dental problems. In time most patients find that this approach leads to a reduction in their anxiety levels and they are more able to cope with routine care.
A typical example that I often hear from patients who come to our dental practice in Edinburgh is “I used to take a whole day off work when I came to the dentist even if it was just for a very short visit but now I just come along before or after work .”
I know that the non sedation route is not the fastest but in terms of treating dental fear in Edinburgh it has proved to be very effective for our patients in the long term. Let me know your thoughs on this……..