Dental Anxiety and Dental Sedation

Relaxation Techniques for Dental Anxiety and Dental Oral Sedation

Dental visits feel like this for some patients

With over 20 years experience as a practicing dentist it is very, very clear (sad but true) that dental anxiety is a very real and scary thing for quite a few people.  Few things can elicit the very severe anxiety that dentistry causes in these folks.  Last week, I wrote a blog (click here) about why people really don’t have to be afraid of the dentist, but I understand that some people need more than a pep talk. So, this week is dedicated to solutions for dental anxiety.  

·        Bring a comfort item from home – This can include a blanket, stuffed animal, favorite playlist on your iPod, aromatherapy, favorite movie (for offices with TVs), or warm compress.  As long as it is not distracting to other patients or the dental team it is probably fine to bring. Just in case, you might ask first ... Though most dental offices will welcome whatever makes you happy!

·       Get a good night’s sleep the night before your appointment- It sounds simple, but people can deal with stress and anxiety much better when they are well rested.

           Here are some In-Office (do-it-yourself) Tips ... 
                                              Oral Sedation is Discussed further below  
    Deep Breathing – This is breathing in your nose for a slow count of 3.  Holding it for 3 slow seconds, then breathing out for a slow 3 seconds, repeatedly. This breathing can help to reduce the amount of adrenaline and cortisol your body produces when it is under stress.

·        Guided Imagery and Self-Hypnosis – Try to imagine that you are in a favorite place, such as a beach, lake, Grandma’s house or anywhere you feel safe. This can be used in conjunction with relaxation and soothing play-loops on your iPod, and can be very effective.  

·        Progressive Muscle Relaxation – This is done by tensing one muscle group for 8-10 seconds and then letting the muscle group relax and release. When combined with soothing sounds and deep breathing this can be a great tool!

·        Express your concerns with your dental team – Let them know what your fears are.  Often times your dental team might have a solution that will help ease your mind.  For example, one patient I know felt more comfortable under the lead vest we use for x-rays.  

Dentistry with proper relaxation techniques or sedation

ORAL SEDATION Dentistry ... If all these suggestions don’t help then it is time discuss sedation.  Sedation is a great option for people who need a little extra help to get through their dental procedure and there is no shame in using it.  There are several types of sedation, but the two most commonly used in dental offices are conscious sedation (oral sedation) and IV sedation.

·        Conscious Sedation - is sometimes referred to as oral sedation, because it is administered orally.  Conscious sedation requires that you take a pill one hour prior to your procedure.  Technically you'll be "awake" during the procedure, but you will be so relaxed that you won’t have a care in the world.  Interestingly, after even many hours of dental treatment with oral sedation dentistry, patients don’t even recall the procedure at all or even being in the dental office.  This requires that you have an escort to drive you home and stay with you for several hours after the procedure.  When proper precautions have been taken (following rigid guidelines for patient selection and drug admnistration), Oral Sedation Dentistry safety record is safer than even IV Sedation. (per data from world renowned Dental Oral Sedation Organization - "DOCS").

·        IV Sedation – is administered through an IV.  This sedation can be administered by a sedation team either in a hospital or in the dental office, or by a dentist who has extra education and training in IV sedation.  My personal preference with IV Sedation is for a Board Certified MD to administer the Sedation (while the dentist takes care of the dentistry) -- to ensure the utmost safety. During this type of sedation you will be unconscious completely or in such a deep sedative state that you are unable to respond to any verbal commands; and would require assistance breathing.

If you have a real fear of the dental procedures talk to your dentist and come up with a plan before your appointment.  Consider treatment with a trusted and experienced oral sedation care dentist in the St Louis area.  The days of “dental horror” stories can be a thing of the past.  Sometimes the scariest step is just making that first call.  Don’t let fear keep you out of the dental chair, you are not alone - and many, many success stories are out there.  You can be one also! 

Dental Anxiety

 

Why You should NOT be Afraid of the Dentist

I often hear people complain about having to go to the dentist for their 6-month check-up.  I often wonder… Why?  Isn’t getting your teeth cleaned like taking your car to be detailed and waxed? Who doesn’t want a nice freshly polished smile?  After much thought, I compiled a list of reasons to not be afraid of the dentist.

1.     You get a chance to catch up with your dentist and the dental team!

Believe it or not, dentists have patients who cannot wait to come into the office to show off the most recent pictures of their families, tell them about their child’s honor roll, or let them know about a new grandbaby. Here is the other secret…the dental team looks forward to hearing about it! Over time they build relationships with their patients, and look forward to the chance to visit.  Sometimes those bi-annual check-ups are the only time they get a chance to say hi, hug the babies and see how big the kids are getting.

2.     Your dentist can make your smile amazing!

Dentists can help you brighten your smile with whitening, achieve a smile you have always wanted, or even straighten your teeth!  They can also give you great advice on at-home-hygiene, diet, and habits that will help you maintain that gorgeous smile! See my previous blog:  The True Value of a Smile

3.     Your dentist can save your life!

Did you know that infections that occur in your mouth can actually affect your overall health? Case in point…If your foot gets infected and is left untreated your entire well-being and life are at risk. This is true for infections in the mouth as well.  Moreover, every time you go in for a routine check-up your dentist checks to make sure there are no signs of oral cancer.  Your dentist is your ally and wants to help you!

4.     Your dentist wants to help you keep your choppers!

By seeing your dentist regularly you can minimize damage to your teeth.  Your dentist will be able to catch decay early, advise you on anything that might be damaging your teeth, and catch any other areas of concern.  Also, diagnosing and treating infections in the mouth early helps to reduce premature tooth loss and can save your life.

5.     Your dentist is there to help you!

Dentists are there for you.  They can help you with any medical concerns you have.  If you are in pain, your dentist can help alleviate that pain. You can discuss that bad breath that you are afraid to mention to anyone else.  You can talk about your fears and your dentist will understand.  Your dentist is looking out for your best interest and has a lot of training and education.  They have countless hours of formal education and hands on training, and many dentists complete a residency and keep up with continuing education annually.  They are constantly looking for new and improved ways to help meet your needs in the best possible way.  

6.     Your dentist understands you!

It seems that everyone has a horror story about a past dental visit.  Telling people you are dentist can be compared to telling someone you are pregnant.  Everyone has a horror story they need to share.  Dentists understand that your concerns are very real.  They want you to have a positive experience as much as you do. Dentistry has made amazing strides in recent years to alleviate the bad experiences that people have had in the past.  Dentists and their teams are trained to address your concerns and to make you as comfortable as possible.  Your needs as their patient are their top priority!

7.     You get a new toothbrush, toothpaste and floss!

Who doesn’t love free stuff? 

These are all reasons to NOT fear the dentist.  If you find that your dentist is not meeting your needs and you are fearful of going to him/her, then you should consider finding a new office.  There are many dentists that will address your concerns with sympathy, compassion, and patience.  Many dental offices offer sedation, relaxation tools, and a friendly face.  Don’t allow fear to keep you from taking care of your health, teeth and mouth.  Who knows…You might even make some new friends!

Snoring Solutions

Have you been told you snore?  Do others have trouble sleeping while in the same room with you, because of your snoring?  Do you wake up feeling tired and feel sleepy all day long even after getting eight hours of sleep? Do you consistently wake up with a dry mouth and a sore throat? Does shortness of breath commonly wake you while sleeping?  If you have answered yes to any of these questions your solution may be as close as your nearest dentist.  YES, I said Dentist!!!  

It is an exciting time to be in sleep dentistry!  The new advances in sleep dentistry are allowing dentists who are trained in sleep dentistry to make a difference in the lives of many. Sleep dentistry is an area of dentistry that focuses on the management of sleep related breathing disorders, which includes snoring and obstructive sleep apnea (OSA). According to the Mayo Clinic sleep apnea is, " a potentially serious sleep disorder in which breathing repeatedly stops and starts during sleep." There are three different types of sleep apnea, but the most common type is OSA.

 The most common signs of OSA are:

•  Hypersomnia (excessive daytime sleepness) 
• Waking with a dry mouth and sore throat
•  Loud snoring
• Difficult to control high blood pressure
• Insomnia (difficulty staying asleep)
• Morning headaches
• Breathing cessation while sleeping

While anyone can develop sleep apnea these are the most common risk factors: 

• Being male - Males are twice as likely to be affected by OSA
• Overweight - This is a cyclical process, because sleep apnea can cause people to be overweight, and being overweight can make obstructive sleep apnea worse. However, thin people can also have sleep apnea.
•  Large neck size - A thick neck can narrow the airway. A neck circumference of greater than 17 inches for men and greater than 15 inches for women indicates a greater risk factor for sleep apnea.
• High blood pressure
• Chronic nasal congestion - OSA is twice as likely to occur in those with chronic nasal congestion
• Being Hispanic, Black, or Pacific Islander 
• Being over the age of 65
• Family History of Sleep Apnea
• Using alcohol, sedatives, or tranquilizers
• Smoking

Sleep Apnea is a serious sleep disorder that if left untreated can lead to several chronic illnesses and even premature death.  It is estimated that untreated sleep apnea is more detrimental to a person's well-being than smoking. 

There are many ways to diagnosis and treat sleep apnea.  In the past, patients were required to sleep in a sleep clinic overnight hooked up to wires and monitors, while being observed by cameras and clinical practitioners, called polysomnography.  Thanks to advances in new technology, patients now have an at-home-sleep-study option, called oximetry.  Dental offices that specialize in sleep medicine and some physician offices have equipment that patients can take home and use while sleeping in the comfort of their home, and more importantly their beds. As you can imagine, sleeping in one's own bed and home could yield more accurate results, and may encourage more patients who are apprehensive about sleeping in a clinic to participate. Patients who choose the at-home-option simply take the data to their local physician's office to be read. If a diagnosis of OSA is made, patients now have a couple of options for treatment. It is important to note that the type of sleep study a patient chooses does not affect their treatment options.

Treatment options:

Behavior therapy - is often a first step to treating obstructive sleep apnea.  Patients are often encouraged to avoid alcohol, sleeping pills, and other sedatives that can relax the airway during sleep. 

Medications - certain medications can be prescribed that have been found to be helpful.  

CPAP device

Continuous Positive Airway Pressure (CPAP) device -  CPAP devices work by opening the patients airway with a continuous flow of air.  Patients must sleep in a mask to do this. CPAP devices are very beneficial to people with obstructive sleep apnea, but they do come with negative aspects. CPAP devices can be difficult to travel with and sleep in, and they are noisy.

Oral Appliance Therapy (OAT) -  Dentists trained in sleep disorders can  work with your physician and make an oral appliance that can be used to hold the airway open. Many patients find this more convenient and economical than a CPAP device.  

Surgery - Surgery is an option for those suffering from OSA.  However, due to the invasive nature of surgery it is usually reserved for those who have not had any success with alleviating their sleep apnea with behavior therapy, medications, a CPAP device, or OAT. 

At Plaza Health Dentistry we are trained in sleep dentistry.  If you suspect that you or someone you love might have sleep apnea call our office at 314-843-0500 for more information, or visit our website at www.stlouis-cosmeticimplantdentist.com. Your health is very important to us and we look forward to talking with you.