Dental Anxiety

Local anesthetic stops nerves temporarily from feeling the area of the mouth.

Local anesthesia involves injecting a medication directly into the area that the dentist wishes to numb. A dentist can perform various procedures on the affected area after injecting the anesthetic. A dentist may use topical anesthetics to dull the pain of the needle before administering it. Patients rarely will a patient feel pain at the injection site from the pricking of the needle.

Lidocaine is the most commonly used anesthetic, but other medications can also be used. All dentists use this method to perform procedures that are painful otherwise, like fillings and extractions.

Local anesthesia ensures that the patient does not experience physical pain. This is important. Other factors can disturb patients such as the sound of cracking noises from the drill or the feeling of pressure. Many patients confuse the sensation of pressure with pain, or become very anxious because of the sounds associated with dental care. Many patients opt for other forms of sedation, in addition to local anesthesia.

Rarely, a nerve can become too inflamed and numb when the patient is suffering from a severe infection. In this case, patients must take antibiotics before their procedure.

When mixed with oxygen, nitrous oxide gas helps patients relax.

Inhaling nitrous oxide is a sedative. A small mask is placed over the nasal region. The gas is mixed with oxygen to help patients relax. Many patients feel less anxious after using "laughing gases". Some people report feeling light-headed, or that their arms or legs feel heavy.

You can drive home after stopping inhaling the gas. It can be beneficial for mild anxiety, and help patients relax. The effects are similar to those of drinking two glasses of wine. This is not recommended for more complex and difficult procedures.

This type is used for major surgery and not often in dentistry.

Anesthesia is rarely used in dentistry. It must be performed by an anesthesiologist, as you will become unconscious and sleepy. An anesthesiologist is going to place a tube in your throat so that you can breathe. They will also monitor your blood pressure, heart rate and breathing.

You will be monitored and brought back to awareness after the surgery. Some people experience nausea, vomiting, chills, and a scratchy voice.

Typically, you would have to be in the hospital for general anesthesia. This type of anesthesia can be used in major surgeries such as hip or knee replacements, open heart surgery, and facial reconstructions following severe injuries.

For all general dentistry procedures, such as wisdom tooth extractions, root canals or sinus lifts, it is important to explore all other options for sedation. Only extreme facial injuries or rare complex cases will be treated with general sedation.

Also known as pill sedation, oral sedation is a technique dentists use to calm their patients down during dental procedures.

Patients who take oral sedation pills leading up to an appointment will do so in the hours before their appointment. It is important that the patient feels relaxed and calm during their dental procedure. Oral sedatives are often benzodiazepine medications, such as Valium or Xanax. These medications reduce the activity of brain areas that regulate fear and anxiety. This is a deeper form of sedation compared to nitrous dioxide and has additional side effects such as sleepiness and memory impairment.

The benefits of oral sedation:

• Easy to Administer
• It is not necessary to inject a needle into your arm to begin an IV. Instead, you will be given oral medications to take before the procedure.
• Amnesia
• Patients who receive oral sedation have little or no memory of their procedure. It is a great advantage for people with dental anxiety and fear because they won't remember much of the procedure once they leave.
• Safe
• FDA regulates oral sedatives. They are safe. These medications rarely cause complications.
• Awareness
• You will be awake and responsive even if you feel sleepy or sedated. You can still talk to your dentist and give them instructions throughout the procedure.
• Oral anesthesia can be combined with Nitrous Oxide to produce a more powerful effect.

Cons of Oral Sedation

• Unpredictable
• Oral sedatives can take up to an hour for the patient to feel their effects. The level of sedation can also vary depending on a patient's metabolism. 
• Patient Cannot Drive
• The day after taking the oral sedative medication, patients are not allowed to drive. You will need someone else to drive you to and from your appointment. The driver does not have to remain in the office during the entire procedure. However, they must arrive within 15 minutes after our call.

IV Sedation (also known as Monitored Anesthesia Care) is the intravenous administration of an anti-anxiety medication.

When a dentist inserts an IV into your vein, he administers medications through the blood. You will be in a drowsy state during IV sedation, but you can still respond to the dentist's directions. You will feel calm and relaxed. You will likely forget most of the appointment. The predictability of IV sedation makes it ideal for anxious and fearful patients. Patients often use it for complicated procedures, such as surgical extractions or wisdom tooth extractions.

If you are a patient who is afraid of needles, your dentist may prescribe an oral sedative that can be taken either the night before the procedure or the morning of it to help ease your anxiety.

Midazolam and diazepam are both benzodiazepines. Midazolam is used most commonly for dental procedures today.

Fentanyl, a narcotic drug, can be used to reduce pain and increase sedation.

Your dentist will use a local anesthetic during IV sedation to numb the work area. It does not reduce pain as effectively as a local anesthetic. Its main purpose is to induce a deep sense of relaxation and calm.

The Pros and Cons of IV Sedation

• Very Predictable
• The patient will begin to relax as soon as the IV medications are administered. The level of sedation can be adjusted as necessary throughout the procedure.
• Amnesia
• After the procedure is completed, patients will remember very little of it (if anything at all). The patient will be able to respond to questions and speak during the procedure, if necessary.
• Awareness
• During the procedure, all normal body functions such as speaking and breathing are possible. You will feel more comfortable and relaxed.
• Increase Safety
• It is simple to administer emergency medications with an established IV line. Dentists who are trained in IV Sedation have Advanced Cardio Life Support certification (ACLS), and they can administer medications if needed.
• Additional Medication (If Needed)
• If necessary, we can prescribe additional medications for common problems like swelling, nausea or infection.

Cons of IV Sedation

• Patient Cannot Drive
• The day after a patient has been sedated, they are not allowed to drive. Someone will be required to drive the patient to and from the appointment. The driver does not have to remain in the office during the entire procedure. However, they must arrive within 15 minutes after our call.
• No food or drink six hours before procedure
• Plan to avoid eating or drinking anything before the procedure. You can get nauseated and vomit if you eat or drink anything.