It is normal for some people to have apprehension about going to the dentist. Most people deal with this apprehension with little difficulty. Some people have more than a little apprehension. They’re just scared to death. Whether it’s from a past experience or some other reason, their fear often keeps them from going to the dentist for even routine care. Sooner or later, it catches up with them. A visit to the dentist becomes a feared necessity.
Fortunately, there are a number of methods we can utilize to reduce fear and anxiety.
Local anesthesia is used to eliminate any discomfort or pain associated with treatment. Local anesthetic agents block conduction along the nerve pathways so that pain is not felt. Commonly referred to as “Novocain”, the anesthetic most commonly used in dentistry is Lidocaine. Novocain was the first of the synthetic local anesthetics used. A significant percentage of the population has an allergy to Novocain and as a result, Lidocaine was developed. Lidocaine is an extremely safe and effective local anesthetic agent. It remains the number one used local anesthetic in dentistry and medicine today. Septocaine was developed a few years ago and seems to produce more profound anesthesia with half the dosage. Regardless of any other sedation techniques used, local anesthesia is also used to insure a pain free visit.
Nitrous Oxide has been used in dentistry since the 1800s. It has been called “laughing gas”, “happy gas”, or “sweet air”. It produces slight euphoria and has a calming effect. Nitrous oxide is inert and will be completely eliminated from your body about 5-10 minutes after its administration has been discontinued. The advantages of nitrous oxide are its calming effect and the ability for you to drive yourself to and from the office. Nitrous oxide is delivered along with oxygen. After the nitrous oxide administration is discontinued, the you breathe 100% oxygen for 5-10 minutes and are then ready to drive home.
For patients who experience slightly more anxiety at the dental office, oral sedatives can be administered. These are tablets taken by mouth about one hour before the procedure. Valium, Lorazepam, or Halcion are the most common anti-anxiety agents given. These medications produce a very relaxed state and reduces most anxiety. In addition, many of these medications have very good amnesia properties, meaning you may not remember much of your visit. Due to the tranquilizer effect of these medications, you cannot drive while taking them and must have someone take you to and from the office.
Moderate (Conscious) Sedation
For patients who experience a high degree of anxiety – those scared to death – moderate (conscious) sedation is the highest level of sedation we offer. We administer the sedation medications through an intravenous (IV) line in your arm or hand. We administer the right dosage for you. You will be continuously monitored for your blood oxygen saturation, pulse rate, blood pressure and heart rhythm. You will also receive supplemental oxygen. With moderate (conscious) sedation, you are awake and able to respond to commands, but are in a state of extreme relaxation. Most patients have no memory of the procedure and afterwards think that they were asleep for the entire time. Due to the medications that are administered, you must have someone bring you to and from the office.
Dr. Clark Brown was trained in intravenous moderate (conscious) sedation at Georgetown University hospital and in the United States Air Force. He has been practicing moderate (conscious) sedation since 1978 and is licensed in conscious (adult – moderate) sedation by the State of Florida’s Board of Dentistry. He maintains CPR/AED and ACLS certifications. In addition, he regularly takes continuing education classes in sedation and emergency medical management. He is a member of the American Dental Society of Anesthesiology and the Florida Dental Society of Anesthesiology.