Best, most effective drugs for a dentalphobe
April 27, 2010 5:08 AM   Subscribe

Help me figure out which drugs I need to get through my next dental appointment.

Realizing that I won't have dental insurance when the COBRA runs out in May, and knowing I have a dental phobia, I finally went in and got 1 1/2 crowns and a root canal. I did this by using 2 old 1 mg lorazepam pills, and in the case of the root canal, by paying the endodontist for lots of laughing gas. I thought my dental phobia was over.

But when I went in for a filling sans drugs, I freaked, by which I mean I shook so hard the session was terminated. My dentist prescribed diazepam for our next visit; I went in, thought I'd be fine, and freaked again.

What drugs can I ask my dentist - who does not offer nitrous oxide - to give me for the completion of the crown, and for that last filling? As nice as it would be to find a dentist who deals with phobic patients, I don't think I have time for that - COBRA ends in a month. I need effective drugs. Three 2 mg tabs of diazepam isn't doing it.
posted by goofyfoot to Health & Fitness (15 answers total) 2 users marked this as a favorite
 
You may want to see if your current dentist can recommend a sedation dentist. I'm sure you're not the first patient your dentist has had who has strong anxiety.
posted by xingcat at 5:20 AM on April 27, 2010 [1 favorite]


You're 1) trying to self medicate, and 2) asking random strangers on the internet to recommend prescription drugs.

Don't do this.

Besides, dental insurance is almost bound to be cheaper than COBRA, which charges ridiculous, even punitive premiums. Call around for quotes for dental insurance and do this the right way.
posted by valkyryn at 5:21 AM on April 27, 2010


Response by poster: I'm sorry if my question comes off as quest for self-medication. My intention is to get some feedback from other dentalphobes on drugs which worked for them that a dentist can prescribe.
posted by goofyfoot at 5:54 AM on April 27, 2010


I don't know anything about the drugs, but I just had my crown finished last week, and it was nothing. All they're really doing is cementing it in place.
posted by MexicanYenta at 6:07 AM on April 27, 2010


Why not just ask for lorazepam again?
posted by PhoBWanKenobi at 6:45 AM on April 27, 2010


Can you ask your doctor for lorazepam? S/he's presumably the one who prescribed it in the first place, and doc's are generally willing to give a small amount more of anxiety meds if you explain what's freaking you out. And yeah, it sounds like it wouldn't be easy to switch dentists now, but try hard in the future to find a phobic-friendly dentist. My dentist has a sign on the wall, "We cater to cowards" and it makes me feel better just to see it.
posted by Margalo Epps at 7:08 AM on April 27, 2010 [1 favorite]


I am not your dentist nor your doctor nor your pharmacist...but FWIW....I'm a hardcore dental-phobe, too, but my most recent trips to my dentist have been blissfully anxiety-free, thanks to (prescribed, legal) sub-lingual Halcion (wikipedia). It didn't quite render me unconscious, but it did put me in a state of utter relaxation and I just didn't care what the dentist was doing. Had a friend drive me home, slept it off for a few hours, and have virtually no memory of anything that happened in The Chair. YMMV>
posted by davidmsc at 8:08 AM on April 27, 2010


Yeah Halcion really makes the dentist not scary at all - I had it for my first root canal. But it's sort of like using a bazooka gun to kill an ant. That stuff is strong. Actually, it kind of makes the dentist so un-scary that it goes back to being scary again because you're so drugged.

I'd suggest switching dentists -- tell your dentist that you really need nitrous oxide and that you have to go to someone who uses it; s/he'll understand. Nitrous oxide was plenty strong enough for me and to be honest Halcion was a bit much for a root canal. I am super, super anxious about the dentist and have actually cleared out a waiting room on more than one occasion with my screams (seriously) so if the nitrous works for me, it should work for you.
posted by k8lin at 9:10 AM on April 27, 2010


Not a meds recommendation, but my dental anxiety has been significantly reduced at dentists that had TV in the ceiling. Having the distraction, and maybe more importantly having my hearing blocked, always makes a huge difference. (I get twitchy even during cleanings.) You might consider taking your iPod or whatever; a Walkman made my horrible dentist bearable during my high school days.
posted by epersonae at 9:27 AM on April 27, 2010


Can you at least wear headphones? That can help a lot.

I'd also switch dentists to one that has the gas. There are ones that will put you completely under (for severe phobias), but I don't think the risk is worth it when the gas should be fine.
posted by meepmeow at 9:58 AM on April 27, 2010


It is not unreasonable for you to approach your current dentist and discuss anxiety relieving options. You might want to do it before your next visit, rather than in the chair.
The dosages you have quoted so far are both light, even for a small adult, so there is room to adjust to your needs, but as has been stated previously, this is not a proper discussion for the internet.
Treat this issue as part of a long term strategy to insure that you can manage your anxiety in the chair as you age, not as simply an expedient way to get through the next visit. build a trusting relationship with your current dentist, or find another with whom you can manage this problem. In the long run it will make it easier for you to keep up with preventive work and hopefully stay away from root canals, crowns, extractions and the big ticket things that cause anxiety and are costly.
Good luck.
Oh yes, IANYD.
posted by OHenryPacey at 11:02 AM on April 27, 2010


My dentist prescribed Halcion for me, and it chilled me out/made me sleepy enough to endure the dental work.
posted by jenfullmoon at 12:39 PM on April 27, 2010


I don't know anything about the drugs, but I just had my crown finished last week, and it was nothing. All they're really doing is cementing it in place.

Yeah, seconding this. I've you've already done the crown prep, switching from the temp crown to the regular takes about a minute with the dental assistant rather than the dentist and doesn't hurt at all; you don't need to be numb for it.

That said, I'm amazed that any dentists think they can remain competitive without offering laughing gas. If nitrous oxide works for you (it made everything worse for me, so it's not a panacea), switch to one of the gazillion dentists who offer it.
posted by Violet Hour at 12:25 AM on April 28, 2010


Response by poster: Thank you all for your posts. Clearly it's past time for me to ask my dentist to sit down with me - even though I can't be her patient after the end of COBRA - and help me be less terrified. I will ask her to tell me what's going on during my treatments (she talks a lot, but mainly to her assistant, and always in Russian). And I will ask for effective drugs.
posted by goofyfoot at 10:46 PM on April 29, 2010


Response by poster: My dentist said she could not offer anything better than the diazepam, and I was reluctant to take another lorazepam pill that was years out of date (I got that script in the early 00s for psoriasis).

I resolved this by asking my GP for medication, describing the situation and presenting the options. He prescribed a 1 mg clonazepam tablet for anxiety, and let me have six of them. So I took one and 1/2 of these before the filling, and the filling went fine. No freaking, no shaking - I'm sure the dentist was just as relieved as I. And I never want anything to do with dentist, or the various 'pams, again.

Problem solved. Resolved.
posted by goofyfoot at 5:36 PM on May 24, 2010


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