Have you had sedation dentistry? Can you tell me about it?
April 24, 2011 9:23 PM Subscribe
Have you had sedation dentistry? Can you tell me about it?
I need extensive dental work and am considering sedation dentistry, as that's the only way I'm likely to agree to such torture. Have you done this? If so, what was your experience like? What's it like to receive nitrous oxide? Or a more hard-core drug like Halcion?
I need extensive dental work and am considering sedation dentistry, as that's the only way I'm likely to agree to such torture. Have you done this? If so, what was your experience like? What's it like to receive nitrous oxide? Or a more hard-core drug like Halcion?
I have no idea what they used on me when I had my wisdom teeth removed, but I was out completely. They injected something in my arm and then told me to count backwards from ten. I don't recall making it past seven. Then I had a dream where some people in suits were chasing me and suddenly I was awake, and it was over. Just like that. The only real downside was how groggy I felt afterwards; I couldn't even walk back to the car without my mom's help! But I took a nap and all was well. If you're having a lot of work done and have someone to help you get home; it's worth it!
posted by katillathehun at 9:37 PM on April 24, 2011
posted by katillathehun at 9:37 PM on April 24, 2011
I had my four wisdom teeth removed under IV sedation. Though they call sedation "twilight" and say it's not full anesthesia, in my case, I was knocked out the entire time - or at least, I don't remember anything. (Except for one weird moment where I "woke up" and heard Tom Petty's "Free Falling" being played on the radio, and tried to sing along despite a massive mess of stuff in my mouth. She's a good girl....)
It's possibly that I was actually more awake than I recall, because afterwards, my wife told me that I asked her a dozen times about when we could go home, but I only recall asking her once! So I'd say if you can't recall, that's functionally the same as being totally knocked out.
Anyway, I certainly wouldn't have had my wisdom teeth out without sedation - like I said, it was all four at once, and they weren't in good shape. I was in quite a bit of agony once the sedation wore off (and for a week afterwards, with another week of duller agony after that), but the procedure itself was fine.
posted by Conrad Cornelius o'Donald o'Dell at 9:38 PM on April 24, 2011
It's possibly that I was actually more awake than I recall, because afterwards, my wife told me that I asked her a dozen times about when we could go home, but I only recall asking her once! So I'd say if you can't recall, that's functionally the same as being totally knocked out.
Anyway, I certainly wouldn't have had my wisdom teeth out without sedation - like I said, it was all four at once, and they weren't in good shape. I was in quite a bit of agony once the sedation wore off (and for a week afterwards, with another week of duller agony after that), but the procedure itself was fine.
posted by Conrad Cornelius o'Donald o'Dell at 9:38 PM on April 24, 2011
I had my wisdom teeth removed under sedation. They started with nitrous oxide to knock me out, but possibly pumped something else into me to keep me under. I remember that the nitrous oxide didn't do much at first, then made me a little light-headed. Then stupid things seemed really funny, and i don't remember much from that point onward. But i wasn't fully unconscious, because the surgeon talked to me a little while i was under. I was pretty groggy when i woke up - it took me a couple of hours to get past that.
posted by nml at 9:38 PM on April 24, 2011
posted by nml at 9:38 PM on April 24, 2011
I had nitrous oxide for wisdom teeth extraction. I didn't want to do general anesthesia (which is what katillathehun described above) because I'm a bit scared of the idea of being put unconscious like that.
In any case, I found the nitrous to be a valuable source of comfort during the stressful moments. Also, since it requires you to continue to breath it in, I could focus on inhaling more gas, which would at least somewhat distract me from what the oral surgeon was doing. For me personally, nitrous oxide was just enough sedation.
And if I did it over, I would definitely not forgo sedation.
posted by kosmonaut at 9:40 PM on April 24, 2011
In any case, I found the nitrous to be a valuable source of comfort during the stressful moments. Also, since it requires you to continue to breath it in, I could focus on inhaling more gas, which would at least somewhat distract me from what the oral surgeon was doing. For me personally, nitrous oxide was just enough sedation.
And if I did it over, I would definitely not forgo sedation.
posted by kosmonaut at 9:40 PM on April 24, 2011
kosmonaut: " I didn't want to do general anesthesia (which is what katillathehun described above) because I'm a bit scared of the idea of being put unconscious like that."
Just to clarify, it's almost definitely not general anesthesia - my understanding is that that is only administered in a hospital setting. The kind of sedation you get at a dentist's or oral surgeon's office is "twilight anesthesia," which Wikipedia describes as follows:
Just to clarify, it's almost definitely not general anesthesia - my understanding is that that is only administered in a hospital setting. The kind of sedation you get at a dentist's or oral surgeon's office is "twilight anesthesia," which Wikipedia describes as follows:
Twilight anesthesia is a type of anesthetic technique where a mild dose of general anesthesia is applied that affects the brain as well as the entire body. The patient is not unconscious, but sedated. During surgery or other medical procedures, the patient is under what is known as a "twilight state", where the patient is relaxed and "sleepy", able to follow simple directions by the doctor, and is responsive. Generally, twilight anesthesia causes the patient to forget the surgery and the time right after.posted by Conrad Cornelius o'Donald o'Dell at 9:44 PM on April 24, 2011
in college, i had all four of my wisdom teeth taken out at the same time and, i don't know what they gave me, but i was out. woke up and it was done. don't know that i would have been able to handle it otherwise.
posted by violetk at 9:53 PM on April 24, 2011
posted by violetk at 9:53 PM on April 24, 2011
This isn't directly responsive to your question, but I neglected my teeth for years and had to have major work done that took about three years. Like you, I was extremely nervous going in, but I pretty quickly got over that and began to feel sort of detached and objective about the whole thing. Having great dentists who specialize in this sort of work was key for me.
As for the sedation part, my wisdom teeth were removed under IV sedation (not full anesthesia, but like Conrad Cornelius o'Donald o'Dell, I don't remember any of it). That was wonderful: I remember breathing deeply while I waited for the IV to work, and getting a little sleepy, and then waking up after everything was done.
For a couple of my implants/tissue grafts the periodontist gave me a mild oral anti-anxiety drug (it was orange and tasted sweet and calmed me down a little). Otherwise I didn't end up taking anything for anxiety before any of the (many) other procedures I had.
posted by raf at 9:55 PM on April 24, 2011
As for the sedation part, my wisdom teeth were removed under IV sedation (not full anesthesia, but like Conrad Cornelius o'Donald o'Dell, I don't remember any of it). That was wonderful: I remember breathing deeply while I waited for the IV to work, and getting a little sleepy, and then waking up after everything was done.
For a couple of my implants/tissue grafts the periodontist gave me a mild oral anti-anxiety drug (it was orange and tasted sweet and calmed me down a little). Otherwise I didn't end up taking anything for anxiety before any of the (many) other procedures I had.
posted by raf at 9:55 PM on April 24, 2011
I am a major dental chicken, and avoiding the dentist altogether for 10 years plus, resulted in me needing a large amount of work done. I had Xanax, halcyon, and a shot of benadryl in the arm. I vaguely remember sitting in the chair at the beginning, and then nothing until afterwards, where I have a very, very faint memory of the nurse accompanying me out. My SO drove me home and apparently I chatted the whole way back as if normal. No memory of that either. Got home, had a nap, dmwokd up several hours later and felt no side effects other than the actual dentistry work. I would it again, it was really stress-free. Of course it's a little odd not having any memory of it, but frankly who wants to remember that?
Oh and although I was sedated, I guess the Xanax wears off before the halcyon, as the dental nurse said I struggled with her when she tried to put a wad of cotton wool in my mouth where a wisdom tooth had been removed. So clearly all instincts are still there. My lizard brain was protecting me!
posted by Joh at 9:58 PM on April 24, 2011
Oh and although I was sedated, I guess the Xanax wears off before the halcyon, as the dental nurse said I struggled with her when she tried to put a wad of cotton wool in my mouth where a wisdom tooth had been removed. So clearly all instincts are still there. My lizard brain was protecting me!
posted by Joh at 9:58 PM on April 24, 2011
I had twilight anesthesia when I had my wisdom teeth removed.
My oral surgeon used propofol and midazolam. It worked really well; I don't even remember feeling sleepy. The only thing I recollect about the surgery is waking up after it was done and begging the surgeon for my extracted teeth. For some reason, I was totally adamant that I wanted to keep them.
I don't know how anyone would do a tooth extraction without at least some sedation.
posted by easy, lucky, free at 9:59 PM on April 24, 2011
My oral surgeon used propofol and midazolam. It worked really well; I don't even remember feeling sleepy. The only thing I recollect about the surgery is waking up after it was done and begging the surgeon for my extracted teeth. For some reason, I was totally adamant that I wanted to keep them.
I don't know how anyone would do a tooth extraction without at least some sedation.
posted by easy, lucky, free at 9:59 PM on April 24, 2011
My experience with sedation dentistry: yours may be different.
The dentist and anesthetist will provide you with uncomfortable rebreathing apparatus. They will start the flow of gas, which will take a few minutes to take effect. The rebreather must be tight and snug, and you must breathe through your nose, because nitrous comes out of your lungs basically unchanged, and exhaling through your mouth will get your dentist high (eventually).
You will be willing and able to follow simple instructions. All the uncomfortable, icky things the dentist does will still be icky and uncomfortable, but you won't care so much (especially if novocaine is involved). Nitrous makes it very easy to think about anything else, but you likely won't remember it.
I have big lungs and a LOT of dentist anxiety, so I need a large volume of nitrous per unit of time. It takes me about fifteen minutes to recover fully from a nitrous session, where "recover fully" means "be clear-headed enough to drive." I seem to recover more quickly when the flow of nitrous runs out during a procedure, but this manifests as alert concern rather than "ouch" or "OH SHIT."
posted by infinitewindow at 10:04 PM on April 24, 2011
The dentist and anesthetist will provide you with uncomfortable rebreathing apparatus. They will start the flow of gas, which will take a few minutes to take effect. The rebreather must be tight and snug, and you must breathe through your nose, because nitrous comes out of your lungs basically unchanged, and exhaling through your mouth will get your dentist high (eventually).
You will be willing and able to follow simple instructions. All the uncomfortable, icky things the dentist does will still be icky and uncomfortable, but you won't care so much (especially if novocaine is involved). Nitrous makes it very easy to think about anything else, but you likely won't remember it.
I have big lungs and a LOT of dentist anxiety, so I need a large volume of nitrous per unit of time. It takes me about fifteen minutes to recover fully from a nitrous session, where "recover fully" means "be clear-headed enough to drive." I seem to recover more quickly when the flow of nitrous runs out during a procedure, but this manifests as alert concern rather than "ouch" or "OH SHIT."
posted by infinitewindow at 10:04 PM on April 24, 2011
I went under to get my wisdom teeth pulled out, like so many others. They gave me the laughing gas and gave me some sort of injection and within seconds I was completely out. I woke up really really really groggy, struggled to stay awake on the car ride home, and promptly passed out when I got back for about four hours.
posted by Geppp at 10:09 PM on April 24, 2011
posted by Geppp at 10:09 PM on April 24, 2011
I had sedation dentistry where they basically give you sleeping pills, and then a tiny bit of gas and I assume there were also so numbing shots in my gums.
However, I remember none of it. I took the pills in the morning then my mom drove me to the dentist where I was allowed to settle in with my ipod, a blanket and get comfy and fall asleep. After many hours I woke up groggy, was driven home and slept for 10 more hours. When I finally woke up the next day my jaw was a little sore and my teeth were in the best shape they'd been in for years.
My experience was extremely positive and if I needed that much work done again I wouldn't hesitate to do it again.
posted by Saminal at 10:33 PM on April 24, 2011
However, I remember none of it. I took the pills in the morning then my mom drove me to the dentist where I was allowed to settle in with my ipod, a blanket and get comfy and fall asleep. After many hours I woke up groggy, was driven home and slept for 10 more hours. When I finally woke up the next day my jaw was a little sore and my teeth were in the best shape they'd been in for years.
My experience was extremely positive and if I needed that much work done again I wouldn't hesitate to do it again.
posted by Saminal at 10:33 PM on April 24, 2011
I've had nitrous for fillings... I always put music on to cancel out the noise of the drill (which I hate) and prepare to have very pleasant hallucinations of uncovering the secret of the universe, which (inevitably( I immediately forget upon waking.
The one time I went under fully was to have several partial crowns all in one go. They put the needle in my arm, and the next thing I knew, I was waking up and the whole thing was over. Which was kind of surreal but certainly very pleasant.
posted by scody at 10:34 PM on April 24, 2011
The one time I went under fully was to have several partial crowns all in one go. They put the needle in my arm, and the next thing I knew, I was waking up and the whole thing was over. Which was kind of surreal but certainly very pleasant.
posted by scody at 10:34 PM on April 24, 2011
I signed in at the front desk to have my wisdom teeth removed, per prior appointment, and provided evidence that yes, indeed I had a friend along to give me a ride home later.
I was wheeled into a large, round, blindingly-bright room. Everything -- everything -- seemed to be stainless steel, including a large number of suspicious-looking devices and machines. There were a number of attending surgeons, nurses, clinicians, graduate students (?), and lord-knows-what-elses, a total of nine or ten people, which seemed like an awfully large number to me. Even more discomforting, every one of them was dressed in blood-red surgical gowns. While I was suitably dazzled by the Cronenbergarian presentation, one of these slipped an IV in my arm, and another asked me to count down backwards starting from 10.
My final memory of that place is opening my mouth to say the word "eight".
I woke up at home the next day.
Highly recommended.
posted by rokusan at 10:35 PM on April 24, 2011 [3 favorites]
I was wheeled into a large, round, blindingly-bright room. Everything -- everything -- seemed to be stainless steel, including a large number of suspicious-looking devices and machines. There were a number of attending surgeons, nurses, clinicians, graduate students (?), and lord-knows-what-elses, a total of nine or ten people, which seemed like an awfully large number to me. Even more discomforting, every one of them was dressed in blood-red surgical gowns. While I was suitably dazzled by the Cronenbergarian presentation, one of these slipped an IV in my arm, and another asked me to count down backwards starting from 10.
My final memory of that place is opening my mouth to say the word "eight".
I woke up at home the next day.
Highly recommended.
posted by rokusan at 10:35 PM on April 24, 2011 [3 favorites]
I'm sorry I can't tell you what the drug was, but when I got two implants in the front of my mouth I was asked to arrive 20 minutes early and was given a little white pill. The pill left me feeling a little drunk and wobbly, but I was alert and aware enough to walk into surgery and lie myself down, then lay there for the next who knows how long feeling relaxed and not particularly bothered about large noisy machinery in my mouth. They covered my eyes loosely with gauze so I couldn't see and stress out. I had to be driven home but was able to get off the surgical table and walk out by myself. I spent the next couple of days marvelling at how painless and relaxing the surgery was, thanks to that anonymous white pill.
posted by tracicle at 10:39 PM on April 24, 2011
posted by tracicle at 10:39 PM on April 24, 2011
I've had nitrous oxide. I'm usually not afraid of dentists, but I had to go back in for a second go on a filling. The nitrous made me feel relaxed, but I was conscious through the whole procedure. The dentist told me to concentrate on breathing to stem anxiety (deep breaths also get more nitrous into your system). Also got three shots of whatever is stronger than novicaine - didn't feel the shots since I had the nitrous.
(At the end, when they said I was done and could close my mouth, I couldn't. I found I was so relaxed my jaw had become a bit dislocated, and the dentist had to manipulate it shut. I have some TMJ though. Not meaning to scare you, I thought it was hilarious because of the nitrous.)
posted by shinyshiny at 10:42 PM on April 24, 2011
(At the end, when they said I was done and could close my mouth, I couldn't. I found I was so relaxed my jaw had become a bit dislocated, and the dentist had to manipulate it shut. I have some TMJ though. Not meaning to scare you, I thought it was hilarious because of the nitrous.)
posted by shinyshiny at 10:42 PM on April 24, 2011
I am a very anxious person and I had my wisdom teeth out with just the nitrous. (I only had to have three teeth out. The fourth one is still floating around up there somewhere.)
The assistant came in and put the little nose cover on my face, turned the gas on, asked if I was comfortable, and left. She came back in a few times and asked how I was feeling. The first time I'd started to get a little nauseated so she adjusted the oxygen to nitrous ratio. The second time she came in I told her I was getting a little freaked out that I wasn't feeling the gas yet, so I asked her to turn it back up and that I'd deal with the nausea. The nauseated feeling never came back.
She came in a third time and I was a little giggly. Apparently that meant the stuff was working. I had asked that they not put any of that pink numbing gel on my gums until after I was high because the taste makes me more anxious. When I got giggly that's when the doc came in and gave me the numbing gel. More waiting.
After a while (time starts to not matter) the dentist came back and asked how I was doing. I don't remember what I said, but I think it was some lame attempt at a joke. He gave me a shot and I felt it. I was upset, so they turned up the gas and left me for a little while longer.
Doc came back, gave me more shots and I didn't feel it. The rest of the procedure is kind of fuzzy.
At one point I kind of dozed off and dreamed that I was eating baby carrots. In reality I bit down on the dentist's fingers. Hard. I woke up when he yelled. He even had to take a minute and leave the room. I felt terrible and tried very hard to apologize to everyone (with a mouth full of all kinds of equipment.) I tried to sit up and the assistants had to hold me down. The dentist came back and said it was all a part of the job but that I "sure got him good." The assistant put a little block in my mouth after that to make sure it wouldn't happen again. (When I went in for my root canal I warned them and they put the block in from the get-go.)
After I was all done the nurse turned off the nitrous and gave me pure oxygen for awhile. The dentist came back and went over my after-care instructions. I must have been out of it still because I didn't hear him tell me not to take the pain meds on an empty stomache and I got really sick later.
I don't remember if I drove myself home, but I don't think I did.
I 100% recommend nitrous if you're having work done. If you can get heavier stuff, I say go for it. Makes things so, so much better.
posted by TooFewShoes at 10:56 PM on April 24, 2011 [4 favorites]
The assistant came in and put the little nose cover on my face, turned the gas on, asked if I was comfortable, and left. She came back in a few times and asked how I was feeling. The first time I'd started to get a little nauseated so she adjusted the oxygen to nitrous ratio. The second time she came in I told her I was getting a little freaked out that I wasn't feeling the gas yet, so I asked her to turn it back up and that I'd deal with the nausea. The nauseated feeling never came back.
She came in a third time and I was a little giggly. Apparently that meant the stuff was working. I had asked that they not put any of that pink numbing gel on my gums until after I was high because the taste makes me more anxious. When I got giggly that's when the doc came in and gave me the numbing gel. More waiting.
After a while (time starts to not matter) the dentist came back and asked how I was doing. I don't remember what I said, but I think it was some lame attempt at a joke. He gave me a shot and I felt it. I was upset, so they turned up the gas and left me for a little while longer.
Doc came back, gave me more shots and I didn't feel it. The rest of the procedure is kind of fuzzy.
At one point I kind of dozed off and dreamed that I was eating baby carrots. In reality I bit down on the dentist's fingers. Hard. I woke up when he yelled. He even had to take a minute and leave the room. I felt terrible and tried very hard to apologize to everyone (with a mouth full of all kinds of equipment.) I tried to sit up and the assistants had to hold me down. The dentist came back and said it was all a part of the job but that I "sure got him good." The assistant put a little block in my mouth after that to make sure it wouldn't happen again. (When I went in for my root canal I warned them and they put the block in from the get-go.)
After I was all done the nurse turned off the nitrous and gave me pure oxygen for awhile. The dentist came back and went over my after-care instructions. I must have been out of it still because I didn't hear him tell me not to take the pain meds on an empty stomache and I got really sick later.
I don't remember if I drove myself home, but I don't think I did.
I 100% recommend nitrous if you're having work done. If you can get heavier stuff, I say go for it. Makes things so, so much better.
posted by TooFewShoes at 10:56 PM on April 24, 2011 [4 favorites]
I had sedation dentistry -- Halcion + nitrous. It was great. I remember taking the initial Halcion, I remember walking to the dentist, I remember the nitrous mask . . . and literally I barely remember anything else. It was 8+ hours, I looked like i'd been punched in the face from the inside when i was done (LOTS of work was done), I remember nothing at all. Apparently I sneezed for about 8 straight minutes in the middle, but I have no memory of it.
With that kind of sedation, you need a babysitter for the rest of the day. Halcion interferes with your ability to write to long-term memory, so you're the guy from Memento for 12-18 hours or so. This is kind of a downside, but for me, it was completely worth it. COMPLETELY.
posted by KathrynT at 11:14 PM on April 24, 2011
With that kind of sedation, you need a babysitter for the rest of the day. Halcion interferes with your ability to write to long-term memory, so you're the guy from Memento for 12-18 hours or so. This is kind of a downside, but for me, it was completely worth it. COMPLETELY.
posted by KathrynT at 11:14 PM on April 24, 2011
My neighbor avoided the dentist for 25 years and had awful teeth ... what it took to get him to go was a heart attack and the cardiologist telling him dentistry was mandatory for the sake of his heart. (In fact his teeth/gums were in such bad shape, and mouth issues can have such a direct effect on the heart, that it involved arrangements between doctor and dentist and so on so he could have the work done safely.)
Anyway, he had to go for four or five sessions to get things squared away, after not going for 25 years, and had twilight anesthesia. He had to reschedule the first session like three times before he finally got up the courage to go, and only the thought that he would literally die made him do it at all. After the first session he was enthusiastically on board because he couldn't remember a thing and the discomfort afterward was totally manageable. He even had some cosmetic work done after all the required work was done AND has been going in for yearly (though not twice-yearly) cleanings. All sedated. Still too scared to go to a "regular" dentist, but adores the sedation dentistry. (Well, that doesn't sound quite right, but you know what I mean.) It's a bit of a process since he has to take off work and his wife has to drive him, but he thinks it's absolutely worth it. He usually goes on a Friday so he can take an afternoon appointment, only miss a half-day of work, and recover into Saturday. (Flip side of that is, harder to call the dentist in an emergency, but he's just doing cleanings now.)
posted by Eyebrows McGee at 3:30 AM on April 25, 2011
Anyway, he had to go for four or five sessions to get things squared away, after not going for 25 years, and had twilight anesthesia. He had to reschedule the first session like three times before he finally got up the courage to go, and only the thought that he would literally die made him do it at all. After the first session he was enthusiastically on board because he couldn't remember a thing and the discomfort afterward was totally manageable. He even had some cosmetic work done after all the required work was done AND has been going in for yearly (though not twice-yearly) cleanings. All sedated. Still too scared to go to a "regular" dentist, but adores the sedation dentistry. (Well, that doesn't sound quite right, but you know what I mean.) It's a bit of a process since he has to take off work and his wife has to drive him, but he thinks it's absolutely worth it. He usually goes on a Friday so he can take an afternoon appointment, only miss a half-day of work, and recover into Saturday. (Flip side of that is, harder to call the dentist in an emergency, but he's just doing cleanings now.)
posted by Eyebrows McGee at 3:30 AM on April 25, 2011
One of my wisdom teeth broke and I lived with it for like a week before I worked up the courage to do anything. Much like a bunch of previous posters they gave me nitrous and then something in an IV. The nitrous didn't really do much for me and I am terrified of needles so when they went to put the IV in it was pretty bad. Also they couldn't find a vein and stabbed me with the needle about a dozen times (literally, about four in each hand and four in my right elbow). While I was sitting there shaking and crying and wide awake, which sucked. But once the IV went in I was out. The nurse woke me up after it was all over and I tried to fall back asleep and complained that it was the first good sleep I'd had in a week, at which point she told me if I was making that much sense then I was certainly enough recovered to get out of the surgical room. My grandmother drove me home. I would totally do it again in the same circumstances, and the pill option that some people are talking about sounds pretty awesome.
posted by anaelith at 4:31 AM on April 25, 2011
posted by anaelith at 4:31 AM on April 25, 2011
If you are afraid of the procedure sedation will help with the physical discomfort, but not the psychological one -- both my extractions were scary business to me. One tip i can give you is: make sure you eat well and appropriately before the procedure, or risk fainting. I would also avoid doing it early in the day, but that's just my metabolism i guess.
posted by 3mendo at 4:42 AM on April 25, 2011
posted by 3mendo at 4:42 AM on April 25, 2011
I had nitrous (I think) for extractions. I was fairly alert the whole time, but just woozy. I tend to close my eyes whenever I'm getting dental work, and then open them when there's a lull to look around to see what's going on. I remember doing this once with the nitrous, and seeing this thing that looked like a huge-ass wrench hovering over my face while the oral surgeon was doing something with the other hand for a sec. And thinking "oh, that is not pleasant. I shall close my eyes again." All in all, it made me woozy and made time go by really fast. What took about 30 minutes, felt like 5. A few months ago, I also had the first stage of a dental implant under only local anesthesia. Having been through a bunch of dental work in the past 2 years, I'm not really anxious about anything anymore, but having local anesthesia and drilling into my FREAKIN' JAWBONE kind of scared the crap out of me. But I didn't feel a thing. Once things were underway, looked like things were going as planned, and the oral surgeons started throwing out weird compliments like "what nice looking bone you have! you bone looks beautiful!" I calmed down, and it was actually kind of cool to be completely alert during the procedure.
posted by raztaj at 4:46 AM on April 25, 2011
posted by raztaj at 4:46 AM on April 25, 2011
My son has had to have a lot of dental work done, and was TERRIFIED of the dentist. Sedation dentistry added significantly to the cost. The last couple of procedures were done under Halcion, nitrous oxide, and of course novocain, and he did OK. You could always try that route and have the dentist stop for the day if you can't handle it then arrange for sedation denistry. Choosing the right dentist is important.
posted by Daddy-O at 5:43 AM on April 25, 2011
posted by Daddy-O at 5:43 AM on April 25, 2011
There's a huge difference between nitrous and sedation dentistry.
I had massive dental work done (I'll spare you the details) after years of neglect. I was in the chair for nearly 8 hours, I remember the first ten minutes and the last ten minutes, the rest is lost forever. I felt NO pain during the procedure, no anxiety, no fear (after the first ten minutes).
You'll need someone to drive you home, you won't be able to function clearly for a few hours (I tried to take the keys from the wife, insisting I could drive, although I couldn't walk a straight line).
posted by tomswift at 6:31 AM on April 25, 2011
I had massive dental work done (I'll spare you the details) after years of neglect. I was in the chair for nearly 8 hours, I remember the first ten minutes and the last ten minutes, the rest is lost forever. I felt NO pain during the procedure, no anxiety, no fear (after the first ten minutes).
You'll need someone to drive you home, you won't be able to function clearly for a few hours (I tried to take the keys from the wife, insisting I could drive, although I couldn't walk a straight line).
posted by tomswift at 6:31 AM on April 25, 2011
I had my wisdom teeth out with a little IV sedation 20-some years ago, and although i was not sedated enough to forget the procedure, it was not unpleasant at all. On the other hand, I have never been bothered by getting dental work done and so was not very anxious about it in the first place. Now I am on the other end of the process and do a lot of sedation and (mainly) general anesthesia for kids getting dental work done (Parents: don't send your kids to bed with a bottle no matter how much they fuss!)
First of all, sedation is a broad, imprecisely defined term, so you need to find out exactly what your dentist offers. This PDF from the American Society of Anesthesiologists describes the different levels of sedation and is the standard most healthcare providers use when talking about sedation. As you can see it ranges from mild sedation with an awake patient to full-blown general anesthesia with the patient completely unconscious. Most sedation regimens incorporate a benzodiapine (a drug like Valium or Versed) that often produces amnesia, so even if a person does not remember their procedure they may still have been awake. Somewhat counter-intuitively general anesthesia is actually safer than deeper levels of sedation. This is because for an actual anesthetic there is supposed to be a qualified anesthesia provider who is not involved in the procedure and whose job it is to monitor the patient's airway, vital signs, and so on. When getting moderate or deep sedation it is possible for the person providing the sedation to inadvertently overdo it and put the patient into a deeper level of sedation than intended, so having someone who can handle the deepest levels of sedation and anesthesia is desirable.
Good luck; you should do well. If you would like more information on this topic, feel free to ask me here or via MeMail.
posted by TedW at 6:57 AM on April 25, 2011
First of all, sedation is a broad, imprecisely defined term, so you need to find out exactly what your dentist offers. This PDF from the American Society of Anesthesiologists describes the different levels of sedation and is the standard most healthcare providers use when talking about sedation. As you can see it ranges from mild sedation with an awake patient to full-blown general anesthesia with the patient completely unconscious. Most sedation regimens incorporate a benzodiapine (a drug like Valium or Versed) that often produces amnesia, so even if a person does not remember their procedure they may still have been awake. Somewhat counter-intuitively general anesthesia is actually safer than deeper levels of sedation. This is because for an actual anesthetic there is supposed to be a qualified anesthesia provider who is not involved in the procedure and whose job it is to monitor the patient's airway, vital signs, and so on. When getting moderate or deep sedation it is possible for the person providing the sedation to inadvertently overdo it and put the patient into a deeper level of sedation than intended, so having someone who can handle the deepest levels of sedation and anesthesia is desirable.
Good luck; you should do well. If you would like more information on this topic, feel free to ask me here or via MeMail.
posted by TedW at 6:57 AM on April 25, 2011
I'm a veteran of horrible dental experiences and now the proud owner of a lifelong dental phobia which I deal with through the miracle of Xanax plus an iPod playing loud music.
I've had IV sedation for wisdom teeth and other things -- it's fine, but it knocked me out totally. With the Xanax, I just feel sort of cheerful about the whole thing, and I find it preferable to the full knock out.
It might be useful to consider how many times you're going to need to do it. If you have a one-off eight hour long hell appointment than a nice long knock-out might be up your alley, but if it's the sort of thing where you need five different appointments to accomplish the whole thing you might opt for an anti-anxiety med because it's ultimately less disruptive to your life.
posted by A Terrible Llama at 7:26 AM on April 25, 2011
I've had IV sedation for wisdom teeth and other things -- it's fine, but it knocked me out totally. With the Xanax, I just feel sort of cheerful about the whole thing, and I find it preferable to the full knock out.
It might be useful to consider how many times you're going to need to do it. If you have a one-off eight hour long hell appointment than a nice long knock-out might be up your alley, but if it's the sort of thing where you need five different appointments to accomplish the whole thing you might opt for an anti-anxiety med because it's ultimately less disruptive to your life.
posted by A Terrible Llama at 7:26 AM on April 25, 2011
Nitrous, ftw!
I had nitrous for my wison teeth, as well for a couple of cavities down at the gum line. It's the only way to go.
posted by Thorzdad at 7:41 AM on April 25, 2011
I had nitrous for my wison teeth, as well for a couple of cavities down at the gum line. It's the only way to go.
posted by Thorzdad at 7:41 AM on April 25, 2011
I have also had Halcion. Good stuff. I was told to take it an hour before my appointment, and to have someone drive me to and from the office. At the time, I didn't live that far my dentists office, and was convinced I'd be fine enough to walk after taking the halcion. It's a good thing my dad insisted on driving me, because he's convinced if I'd walked he'd have found me curled up on the sidewalk asleep. By the time I was at the office I was very sleepy, and it sort of felt like I was drunk. I barely remember the procedure, but it involved having two root canals done. My dad picked me up from the appointment, bought me a milkshake, and took me home where I slept the rest of the afternoon.
I'd do it again in a heartbeat. My current dentist is only offering me Ativan for some work I need done. It's probably sufficient, but I don't think I'll ever do anything other than a minor cleaning without some sort of sedation again. I have major issues staying frozen, and removing the anxiety that comes with "is it wearing off? is it wearing off? oh god, can i feel that? etc etc" is worth its weight it gold.
posted by cgg at 7:42 AM on April 25, 2011
I'd do it again in a heartbeat. My current dentist is only offering me Ativan for some work I need done. It's probably sufficient, but I don't think I'll ever do anything other than a minor cleaning without some sort of sedation again. I have major issues staying frozen, and removing the anxiety that comes with "is it wearing off? is it wearing off? oh god, can i feel that? etc etc" is worth its weight it gold.
posted by cgg at 7:42 AM on April 25, 2011
Response by poster: Ah, guys, how can I begin to thank you for these overall quite reassuring answers... I had a ton of dental work done in Ye Olde Country, where pain management mostly boiled down to the dentist saying, "let me know if it starts to hurt a lot and we can stop for a couple of seconds." This new world of amazing drugs sounds lovely.
posted by onepot at 7:52 AM on April 25, 2011
posted by onepot at 7:52 AM on April 25, 2011
Please make sure sedation dentistry is covered by your dental insurance--no providers in my area who advertised it were covered. It would have been very helpful for me, but I couldn't afford to pay out of pocket for it.
I've advised this before--think about your personality type and how you react to drugs before you take anything that messes with your mind. I took nitrous when I got my wisdom teeth out (they should have put me to sleep, and my dentist was horrified when she found out my oral surgeon didn't, claiming she didn't think they even did it that way anymore). I will never take it again. It made me nauseous and paranoid, and I started laughing at a small child screaming in the next room and felt terrible about it but couldn't stop. I also hate the smell of rubber like few other things, and the mask to administer the nitrous reeked of it, which increased the nausea. Once I thought about it, it made perfect sense--I don't like being unable to control my own mind and reactions (which is why I've never had more than two drinks at one go and never touched an illegal drug) AND I have a touchy equilibrium, so the nitrous was a very bad fit.
On the other hand, my dentist gave me a prescription for diazepam (valium) before I had a root canal two weeks ago. I take antidepressants and have no problems with mood medication, and that did help. You'll have to get someone to drive you if you go that route (I actually thought I could have managed to drive myself home and back, but my husband told me I was dippier than I thought and really should not have!). If you can't get full anesthesia or twilight, I'd recommend anti-anxiety drugs.
Also, if you can find a dentist who advertises a specialization in dealing with fearful patients, that's helpful.
posted by dlugoczaj at 8:15 AM on April 25, 2011 [1 favorite]
I've advised this before--think about your personality type and how you react to drugs before you take anything that messes with your mind. I took nitrous when I got my wisdom teeth out (they should have put me to sleep, and my dentist was horrified when she found out my oral surgeon didn't, claiming she didn't think they even did it that way anymore). I will never take it again. It made me nauseous and paranoid, and I started laughing at a small child screaming in the next room and felt terrible about it but couldn't stop. I also hate the smell of rubber like few other things, and the mask to administer the nitrous reeked of it, which increased the nausea. Once I thought about it, it made perfect sense--I don't like being unable to control my own mind and reactions (which is why I've never had more than two drinks at one go and never touched an illegal drug) AND I have a touchy equilibrium, so the nitrous was a very bad fit.
On the other hand, my dentist gave me a prescription for diazepam (valium) before I had a root canal two weeks ago. I take antidepressants and have no problems with mood medication, and that did help. You'll have to get someone to drive you if you go that route (I actually thought I could have managed to drive myself home and back, but my husband told me I was dippier than I thought and really should not have!). If you can't get full anesthesia or twilight, I'd recommend anti-anxiety drugs.
Also, if you can find a dentist who advertises a specialization in dealing with fearful patients, that's helpful.
posted by dlugoczaj at 8:15 AM on April 25, 2011 [1 favorite]
(Please note--I'm not discounting nitrous out of hand for everyone! My husband, who has a much different attitude about/experience with mind-altering drugs, finds nitrous enjoyable and helpful at the dentist, and I have a friend who has such anxiety that she gets it when she has her teeth cleaned! I'm just saying that if you know about your own attitudes and reactions that can really help shape your choice--I didn't think about that going in for the wisdom teeth, but I should have.)
posted by dlugoczaj at 8:20 AM on April 25, 2011
posted by dlugoczaj at 8:20 AM on April 25, 2011
There are a lot of answers here but thought I would just put in my experience. I had all 4 wisdom teeth removed (impacted completely to the side, infected and awful) via Nitrous Oxide. Turns out, I am highly allergic, yippie. As far as they can figure, a mixture of my anxiety, my anti-anxiety meds and the fact that I am allergic, I had a very bad reaction. Like a bad trip off LSD or something. I had very, very scary hallucinations, heard scary things and felt a terrible chill and pain. It was so bad that I had to go on new meds afterwards, had nightmares for months etc. Got over it eventually by just forcing into my head that it was nothing more than a bad trip. First time back to the dentist afterwards I took a small dose of xanax and now I just go. I've only had a filling since and I just stayed awake.
That being said, I have had anesthesia via IV for 3 colonoscopies, 2 lapraoscopies and another procedure (all TKO anesthesia except for 1 twilight) and I do wonderfully with those. I personally think that anesthesia is comforting. I'd do it in a heartbeat.
My whole point isn't to make you nervous, just to let you know that if you are on any meds at all, ask the dentist first if it is okay to take laughing gas or if you could have a reaction. Laughing gas, imo, is the most evil thing about a dentist. Oh and on that note, I have an appointment today for a filling and a cleaning. Hurrah!
posted by ForeverDcember at 8:21 AM on April 25, 2011
That being said, I have had anesthesia via IV for 3 colonoscopies, 2 lapraoscopies and another procedure (all TKO anesthesia except for 1 twilight) and I do wonderfully with those. I personally think that anesthesia is comforting. I'd do it in a heartbeat.
My whole point isn't to make you nervous, just to let you know that if you are on any meds at all, ask the dentist first if it is okay to take laughing gas or if you could have a reaction. Laughing gas, imo, is the most evil thing about a dentist. Oh and on that note, I have an appointment today for a filling and a cleaning. Hurrah!
posted by ForeverDcember at 8:21 AM on April 25, 2011
I've never had nitrous, but I take 2mg of Ativan before every dentist appointment and I can barely remember a thing afterward. It's doing a lot to help me get past my severe dental phobia.
When I had 4 wisdom teeth out (2 impacted, one partial, one erupted) in January they took me into the operating room, sat me in the chair and covered me with a warmed blanket, gave me a tiny cup of liquid Versed, and the next thing I remember I was being led to the car by my mom.
I had some sort of IV sedation because I remember the hole in my arm - but I was out when they put in the needle. Which was nice because my needle phobia is worse than my dental phobia. But I have absolutely no memory of ANYTHING that happened between the Versed and getting in the car afterward.
posted by elsietheeel at 9:16 AM on April 25, 2011
When I had 4 wisdom teeth out (2 impacted, one partial, one erupted) in January they took me into the operating room, sat me in the chair and covered me with a warmed blanket, gave me a tiny cup of liquid Versed, and the next thing I remember I was being led to the car by my mom.
I had some sort of IV sedation because I remember the hole in my arm - but I was out when they put in the needle. Which was nice because my needle phobia is worse than my dental phobia. But I have absolutely no memory of ANYTHING that happened between the Versed and getting in the car afterward.
posted by elsietheeel at 9:16 AM on April 25, 2011
Nitrous made me cry the last two times I tried it, a reaction the dentist said wasn't terribly unusual. It's just not for me.
I don't know why I found it so unpleasant but two possible reasons: feeling drugs kicking in makes me anxious; maybe the YOU WILL RELAX NOW moment broke down some of my protective barriers that I maintain so carefully for my stressful life.
posted by The corpse in the library at 9:37 AM on April 25, 2011
I don't know why I found it so unpleasant but two possible reasons: feeling drugs kicking in makes me anxious; maybe the YOU WILL RELAX NOW moment broke down some of my protective barriers that I maintain so carefully for my stressful life.
posted by The corpse in the library at 9:37 AM on April 25, 2011
Joining late: I had nitrous when I was facing my first drilling-and-filling in several years, as well as a filling that needed to be removed and replaced. I get anxious about needles in my gums, so I sprung for nitrous (which, thankfully, my insurance covered.)
It didn't do anything. I was still very alert and anxious. I asked for more. They gave me more. I was still very alert and anxious. I asked for more. They gave me more. I was still very alert and anxious, but we were running out of time and they didn't give me more. I felt the needle in my gum even after the numbing cream, and while I bore the drilling and the noise and the generally uncomfortable procedure well enough, I was very alert and anxious throughout.
This may be my wonky biochemistry. I can drink strong tea all day and night with no problems getting to sleep afterwards. The one time I ever had Valium, I dozed off and hallucinated that I was choking to death. The one time I had Dexedrine, I fell asleep. I've had twilight sedation via injection for other medical procedures, and I stayed chirpy, alert and talkative throughout.
The only thing that seems to work on me as advertised is full-fledged general anaesthesia. I go out like a light and recover quickly with no nausea or other ill effects. So really, a lot depends on your individual biochemistry.
posted by maudlin at 1:25 PM on April 25, 2011
It didn't do anything. I was still very alert and anxious. I asked for more. They gave me more. I was still very alert and anxious. I asked for more. They gave me more. I was still very alert and anxious, but we were running out of time and they didn't give me more. I felt the needle in my gum even after the numbing cream, and while I bore the drilling and the noise and the generally uncomfortable procedure well enough, I was very alert and anxious throughout.
This may be my wonky biochemistry. I can drink strong tea all day and night with no problems getting to sleep afterwards. The one time I ever had Valium, I dozed off and hallucinated that I was choking to death. The one time I had Dexedrine, I fell asleep. I've had twilight sedation via injection for other medical procedures, and I stayed chirpy, alert and talkative throughout.
The only thing that seems to work on me as advertised is full-fledged general anaesthesia. I go out like a light and recover quickly with no nausea or other ill effects. So really, a lot depends on your individual biochemistry.
posted by maudlin at 1:25 PM on April 25, 2011
Nitrous is pretty cheap. Because I have had some bad experiences I take nitrous for routine cleanings. Insurance covers nitrous in many situations but not for routine cleaning. I pay $30/pop to get gassed for the duration, it's worth every penny.
posted by crazycanuck at 10:33 PM on April 25, 2011
posted by crazycanuck at 10:33 PM on April 25, 2011
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posted by Forktine at 9:28 PM on April 24, 2011