Dental Dread

Sedation dentistry rids fear and pain.
Sep 1, 2014
Jennifer L. Boen
Steve Vorderman

The dental appointment reminder postcard has arrived. If just looking at it makes you feel anxious, you’re not alone. A telephone survey published by the American Dental Association some years ago found that 12 percent of respondents reported high dental fear; another 18 percent had modest fear of going to the dentist; and 16 percent were “dental avoiders” who had not seen a dentist in more than a year because of fear and anxiety.

Well, fear no more.

“The landscape of dentistry has changed,” says Dr. Thomas Teel of Family Dentistry & Aesthetics Inc. Even the most dental-phobic individuals can now recline comfortably in the chair while teeth are cleaned, decay is removed and multiple fillings or root canals are completed.

Of the dental avoider survey respondents, fear of pain, sometimes experienced years earlier at the dentist, was the most common explanation. With today’s improved topical and local anesthetics, as well as nitrous oxide gas, which has been used in dentistry for many years, plus oral medications that provide safe, conscious sedation, Teel says, “There is no reason for anyone to have pain anymore.”

The term sedation dentistry may elicit the image of an unconscious patient. While oral surgeons and specialized dentists sometimes use intravenous drugs that cause deep sedation or render someone completely unconscious, in general dentistry, minimal to moderate sedation options are the outpatient norm.

Inhaled through a mask over the nose, nitrous oxide relaxes the patient, even though they remain conscious. When the dental work is completed, the patient breathes 100 percent oxygen to quickly eliminate the effects of the gas, enabling the patient to resume normal activities.

Another conscious sedation option is an oral sedative. Most commonly, Halcion, similar to Valium, is taken at home prior to the appointment. With the medication’s relaxing and amnesic effects, “the patient often remembers very little about the visit,” says Teel. Patients require a driver to and from the clinic and cannot work that day. 

To ensure patient safety, individuals given oral sedation are never left alone in the office. At Family Dentistry & Aesthetics, oral sedation is used only in adults. Children who need extensive dental work are sometimes referred to pediatric dentists.

With both nitrous oxide and oral sedation, topical and injectable anesthetics are still needed to ensure the patient feels no pain, but patients are so relaxed and calm, most are unaware when the needle is put in their mouth, says Teel’s colleague, Dr. Catherine Periolat. She tells patients, “You’re in charge. If you feel anything, we will stop. We will not work on you if you’re not numb.”

Conscious sedation “allows us to do a lot at one time,” says Dr. Thomas Gilbert, the third dentist in the group. One recent patient, who avoided dental care for years, needed several root canals and 10 fillings. Gilbert did all the work in one visit, which is both convenient for the patient and efficient for the busy dental practice, which employs 19 people besides the three dentists.

When patients are relaxed, “We’re able to do better work,” Teel says. Jaws and shoulders are more relaxed, patients open their mouths wider and, most importantly, for the long-time dental avoiders, having a tranquil, pain-free experience leads to return visits and better oral health.

“Sometimes sedation is the thing that turns it around for people,” Periolat says, noting a growing body of evidence that shows a strong correlation between a healthier mouth and a healthier body overall. 

Gilbert recalls one patient, a long-time dental avoider, whose toothache eventually compelled her to seek care. She sat white-knuckled and, in her first few visits, needed every form of sedation and anesthetic Gilbert could offer. After gentle, pain-free care and building trust with Gilbert, today she needs nothing more than the usual topical and local anesthetic for a filling. 

The majority of patients don’t need or want sedation, but Teel says of sedation dentistry, “It has enabled us to help people we couldn’t reach before.” 

 

Family Dentistry & Aesthetics Inc.

Address: 4626 West Jefferson Boulevard, Fort Wayne, Indiana 46804

Phone: (260) 432-0561

Website: smilefortwayne.com

Years in Business: 26

Number of Employees: 19

Products & Services: General dentistry, including restorative and cosmetic, for children and adults.

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