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ROBERT THEIN,
DDS, ABOI, ICOI

Which Dental Sedation Should I Choose?

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I need to have a dental crown placed. I’m seriously nervous about this. This is my first cavity and my first crown all in one. My dentist said if I’m super nervous he can use dental sedation to help. I don’t know what to expect for this procedure and I can’t figure out which type of sedation to choose. I’m either going to get nitrous oxide or oral conscious sedation. He said he offers both and I need to just pick which one I’d like. The problem is I can’t figure that out. Do you have a recommendation?

Amy

Dear Amy,

This is a great question. Let’s start with your procedure so you have an idea of what to expect when you go in. I’ll explain it without the sedation first and then we’ll go over the two options your dentist mentioned.

Your dentist will give you some numbing medication. It’s it is a topical anesthetic. Once you are numb he will remove the decay and remove enough structure from the tooth to fit the crown over it.

You didn’t mention if he’s doing a traditional crown or a CEREC crown. If it’s a CEREC crown, it will be milled right there during your appointment. He’ll bond it on and you’ll go home with your permanent crown. If it is a traditional porcelain crown, then you’ll be provided with a temporary crown and the permanent one will be created in a lab. Then, when it is ready your dentist will bond it on. It’s a fairly simple procedure. However, dental anxiety can even make the simplest of procedures seem larger than life.

Which type of dental sedation you choose will depend on how distressing the procedure seems to you.

Dental Sedation with Nitrous Oxide

woman with dental sedation nosepiece for nitrous oxide

This is the mildest form of sedation. Your dentist will place a nosepiece on you, such as the one pictured above, and turn on the nitrous oxide gas. This used to be dubbed laughing gas. It doesn’t make you silly. However, it will give you a floaty relaxed feeling.

If mild anxiety is what you are dealing with, this is a fantastic solution. It will relax you enough to calm you while the dentist does the procedure and the topical anesthetic will keep you pain-free. Once your procedure is over, the dentist will switch the gas to oxygen and you’ll be ready to get on with your day. There are no real restrictions and you can return to your duties for the remainder of your day if you’d like.

Dental Sedation with Oral Conscious Sedation

Woman asleep in the dental chair

This is for patients with more severe anxiety. It’s much stronger. You’ll take a pill before your appointment, but it will keep you pretty relaxed. You’ll be too relaxed to drive yourself to and from your appointment. Your dentist will require you to have someone to be your driver as well as stay with you throughout the day until you are lucid and steady on your feet again.

You will not be able to just get on with your day with this particular type of sedation. It’s too strong for that. Plan on binging on Netflix, reading your favorite book, and napping throughout the remainder of your day.

This blog is brought to you by La Crescenta Dentist Dr. Robert Thein.

Sedation Dentist Did Work without Asking and Billed Me

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I have avoided the dentist for years. They terrify me. I knew I needed to see one at some point but couldn’t bring myself to do it. I did some research about people like me with a phobia of dentists and learned about dental sedation. I thought I’d try it hoping it would be my solution. I had a consultation with the dentist and signed a consent form for the work I needed done. I felt like I may have stumbled onto something to get my oral health back in order. The day of the appointment came and everything was fine. Then, the next day I received a phone call. The dentist found some additional things he could work on while he was repairing what we agreed to and they’d like me to send the payment for the additional work. I was shocked. I told them I didn’t agree to that work so I certainly didn’t think I should be paying for it. They said if I didn’t remit payment by the time my permanent crowns were ready they wouldn’t be able to bond them on. Can they do this?

Amanda

Dear Amanda,

Woman asleep in the dental chair

The Right Sedation Dentist Can Change Your Life

This is unacceptable. It’s also unethical. A dentist is never supposed to do work on a patient without their approval. You can’t give your approval while under the influence of dental sedation. Here’s my first suggestion. I want you to talk directly to the dentist. If he is an honest doc he’ll understand your concern and not bill you for the work done without approval. They should also bond your dental crowns on.

If they give you a problem with either one of those things, let them know you’ll be going to the dental board and a lawyer, if necessary. That should be enough to sober them.

Don’t Let this Sour You on Dentists

I think you were remarkably brave with your dental anxiety to take the steps you did to get treatment. Please don’t let this frighten you from continuing on the path of good dental health.

It sounds like the sedation itself was a success and you were able to get an anxiety free appointment. It was the next day that threw you for a loop. There’s bound to be a bad egg in every profession. You just happened to hit on one your first go back.

I don’t want you going back to that particular practice. They’ve already proven themselves untrustworthy. However, don’t give up on your health. Instead, I’d like you to look up some other sedation dentists in your area. But, don’t stop there. After that, I want you to check their reviews. You can often find reviews on sites such as Yelp! or Google Reviews.

This will allow you to see what other patient’s experiences have been with them.

This blog is brought to you by La Crescenta Implant Dentist Dr. Robert Thein.