These mythical awesome dentist -- where do I find one?
October 6, 2010 3:18 PM   Subscribe

How do you find a dentist who is good with very anxious patients? Is it appropriate to ask, when making the appointment, if he’s willing to prescribe a sedative and/or use gas? I hear (often on askme) that people have marvelous, caring dentists who are willing to do whatever is necessary to make them comfortable, but where do you find one? I’ve got this list of dentists covered by my insurance, I need one that can fill my cavities without leaving me in hysterics, and I don’t know how to go about discovering who that will be.

I have dreadful dental anxiety; the cleanings alone push me just to the edge of a panic attack. I also have my first cavities ever. My current dentist’s idea of dealing with my anxiety was to say “If you feel like you need a break, raise your right hand and I’ll stop for a minute.” This won’t work. I don’t think either of us need to go through that. However, I don’t think full-on IV sedation is necessary for me either. Just pills to get me through the door and nitrous to keep me still.

I have generalized anxiety problems and occasional panic attacks. They’re sufficient that for really stressful situations, the standard lowest dose of valium doesn’t even take the edge off. Without some kind of help, there’s no way I’ll be able to make myself go to the office, let alone lie there while I get drilled and shot up with novocaine, so obviously I need a dentist who understands that.

I feel like I’m missing the point somehow. Do I just as the person making the appointment “Hey, does Dr. Such and Such do sedatives? I’ve got major anxiety and I need help.” I’m in San Francisco, if that makes a difference.
posted by mostlymartha to Health & Fitness (14 answers total) 5 users marked this as a favorite
A lot of dentists advertise that they deal with nervous patients. The term you want is "sedation dentistry" -- just googling that and San Francisco got me this guy, who was only one of several options.
posted by katemonster at 3:22 PM on October 6, 2010

Many dentists will offer gas or the like if you ask. Dental anxiety is VERY common and they should not act like you're asking for something strange if you ask. (if they do, of course, move on. They're the one with a problem (business-wise), not you.
posted by randomkeystrike at 3:25 PM on October 6, 2010

to clarify - yes, mention it AT THE TIME OF THE APPOINTMENT.
posted by randomkeystrike at 3:25 PM on October 6, 2010

Hi, I'm gingerbeer and I have dental anxiety. I see Drs. Ganji and Yang, at 450 Sutter. They've always been really great with me. I would tell the person on the phone that you have a lot of anxiety, and need medication for it, and see what they can do for you. Ask what their protocol is for anxious patients and push back if you don't think it's sufficient.
posted by gingerbeer at 3:26 PM on October 6, 2010 [1 favorite]

Lifelong sufferer of dental fear here. My dentist, Helen Lawson (nee Alderson), specializes in dental fear and is very proactive about making sure you're comfortable and pain-free, and I recommend her highly. Her office is downtown.
posted by phliar at 3:39 PM on October 6, 2010 [1 favorite]

as a piggyback question - how do you get past them thinking you're looking to score drugs? anytime i mention that local anesthetics wear off me quickly (to the point that something has to back it up), they start treating me like a suspect junkie/doctor shopper (and no, i don't look like a junkie - i'm a 29 year old housewife).
posted by nadawi at 3:45 PM on October 6, 2010

I have never had your issue with dentists (although getting cavities filled was not the most fun experience I have ever experienced), but I really enjoyed the care I received in San Francisco at Glen Park Dental. They are right across the street from the bart stop and are friendly, helpful, and high tech.

That said, they're not cheap, so I would make sure your insurance plays well with them first (call em, all I know is Delta Dental they take). Still, I would definitely call and ask them about this issue. Their first appointment is always (or at least was when I joined) a meet and greet ONLY (not even a cleaning), so you will have a chance to meet a doctor and see if they take your issues seriously / have good solutions. They also have more than one doctor and more than one hygienist working at the practice, so I encourage you to ask if one of them specialize in this area, and make sure they are available for your appointment.

Once again, although I thought they were great, I cannot speak to your issue specifically, and it sounds like gingerbear can.

As someone who did get my first cavities filled recently, I can say that the experience of mouth-numbing was weird. Since I don't know what part of the dental experience will be problematic for you, I will just mention it briefly. When I drank my first glass of water afterwards, I could only feel the glass contact my lips on the left side of the mouth. While to me this was an awesome one-time experience, this might not be the sort of thing you don't want to dwell on after you are done getting fillings. I would suggest making sure you have eaten before hand, and have something non-mouth and non-talking related to occupy your time with for 2-3 hours after.
posted by Phredward at 4:17 PM on October 6, 2010

Dr. Blende. I'm in the same boat as you, and we're their specialty. I had two LONG (4-5 hour) sedation sessions (I hadn't been to the dentist in about 10 years). It went quite well, and they continued to be great for follow-ups and cleanings.

And they're right there in San Francisco!
posted by Robson at 6:31 PM on October 6, 2010

Like a lot of things I think it's part luck. word of mouth, Knowing someone who is close to the dr. or a happy customer. I am blessed to have found mine.
posted by patnok at 6:36 PM on October 6, 2010

call a dentist and ask. some do, some don't--i think it's mostly a business decision (whether htey want to invest in the training to administer it, equipment, insurance, etc.). it's a common request--if they don't do it, they can probably recommend someone who does. you won't be judged.
posted by thinkingwoman at 7:03 PM on October 6, 2010

What you are experiencing is perfectly normal. I get a lot of patients who have a history of trauma when it concerns to go to a Dentist. There is no problem in asking if the doctor uses any form of sedative (gas or pill). You should tell them in the beginning of the appointment so the doctor can take it into account during treatment.
And try to relax, nowadays dental practice is quite painless and secure.
posted by Cheirinhos at 7:30 AM on October 7, 2010

I know dentists in the UK are not keen to prescribe sedatives and gas is unusual - general anaesthetic tends to be used for involved operations such as wisdom tooth extraction.
posted by mippy at 8:38 AM on October 7, 2010

how do you get past them thinking you're looking to score drugs?

by waiting until you are there in the office, in person, to go into details about your concerns. initial contact with the office should be to ascertain, very briefly, that they have good experience with anxious patients.

over the phone, if you're nervous in general, there are no visual cues and a steady stream of 'nervous talk' may raise an alarm. but once you are there, in person, they should be able to tell you are sincere and honest.
posted by kuppajava at 9:11 AM on October 7, 2010 [1 favorite]

Regarding your piggyback question, informing your dentist that you metabolize anesthetic quickly and usually require a booster is not a flag that you are a drug seeker. It is good information to have and should make your experience better.
My experience is that patients who have dental anxiety are often patients who have had work done with inadequate attention paid to how numb they are. Your dentist should ask you questions to determine if the anesthetic has taken, and should test your tooth or gums in a non-aggressive way as the procedure begins. Good feedback can only help. DO NOT feel that you are being difficult if you don't feel numb enough.
There are lots of reasons for dental anxiety, don't get me wrong, but your mention of needing extra anesthetic is a good clue and should be mentioned.
posted by OHenryPacey at 9:21 AM on October 7, 2010 [1 favorite]

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