Last May, I got two root canals, one repeat root canal, and three crowns. I am trying to catch up on dental work for my neglected teeth. I have two wisdom teeth left – both lower – one hurts and is impacted. The oral surgeon says the impacted wisdom tooth is causing neck and ear pain. She says that after she removed it, I will feel relief. For some reason, she does not want to remove both wisdom teeth while I am sedated. I told her that I do not want either of them removed if she does not take both teeth out. Neither of us is budging. Why wouldn’t she remove both teeth? Thank you. Jonah from TN
Jonah,
Dr. Lacy would need to examine your teeth or refer you to an oral surgeon for a second opinion. Without an exam, we cannot give you an accurate diagnosis. If your oral surgeon does not want to remove both wisdom teeth while you are sedated, she must have a good reason for it. Maybe there are no issues with the tooth.
But if you do not understand why the oral surgeon will not remove the tooth, it is best to speak with her. Ask for an explanation.
What Happens If You Do Not Remove and Impacted Wisdom Teeth
If you do not remove an impacted wisdom tooth, a tooth infection can spread. If you already have an earache and neck pain, they are symptoms that your body is trying to fight the infection. Lingering tooth infections can flare-up. In rare cases, they can even be life-threatening.
You and your oral surgeon disagree. So, you can schedule a second opinion with another oral surgeon. Have copies of your x-ray sent before your second-opinion appointment.
What does getting sedated at the dentist have to do with a chronic sinus problem? If your sinus issue is related to a tooth infection, a dentist can help you get the relief you need.
The Tooth and Sinus Connection
According to a January 2019 article published in the online
journal, MDLinx, chronic sinus infections are often caused or intensified by
chronic tooth infections. A tooth infection can spread into your sinus cavity.
Although you might receive antibiotics for a sinus infection, after you’ve
finished the medication, the untreated tooth infection can cause the sinus
infection to recur.
Maxillary sinusitis of endodontic origin (MSEO) is the
medical term for a sinus infection that results from a tooth infection. Usually,
the problem occurs with infection in upper back teeth.
What’s the Solution?
Your dentist will examine and x-ray your teeth. If there is an infection in your tooth, your dentist will remove it with root canal treatment. If the issue with your tooth is complex, your dentist might refer you to an endodontist, or root canal specialist.
The procedure cleans out the infected pulp (living tissue, including nerves) in your tooth—completely through the roots. Your dentist or specialist will fill your hollow tooth with dental filler material and seal it. Your dentist will protect the tooth with a dental crown. About half of all patients with MSEO who receive a root canal treatment also experience sinus relief and require no further care. If the thought of dental procedures increases your anxiety, your dentist can give you a mild sedative to help you relax.
What’s the Connection with Sedation Dentistry?
Let’s admit it. If you have a lingering toothache, you’ve
probably delayed seeing a dentist for it. Dental anxiety is one of the main reasons
that people delay, reschedule, or cancel appointments. Sedation can make the
difference you need. How does it help?
1. Relaxes You
There are varying levels of sedation available to match your
anxiety level and the complexity of the dental procedure you will receive. Nitrous
oxide (laughing gas) might be all you need to unwind, but if it’s not enough,
your dentist can provide you with a mild anti-anxiety pill to take before your
appointment. You won’t become anxious at the sights and sounds of dental tools.
2. Decreases Your Sensitivity to Pain
Your relaxed state will decrease your sensitivity to pain.
You won’t be “on alert” for a slight pinch or other sensations that you might
otherwise anticipate.
3. Helps Your Dentist Accomplish More
Sedation—your relaxed state—allows your dentist to focus on
your dental procedure. Interruptions from anxiety attacks or pauses in
treatment won’t be an issue. You’ll have a productive visit. And you won’t have
to reschedule the appointment due to anxiety.
Which comes first—the sinus infection or the toothache? It
could be the toothache, and sedation can help you get rid of both.
I need sedation dentistry for dental implants. I’m wondering whether I should go to a prosthodontist, an oral surgeon, or a periodontist to place my dental implant. Do these specialists handle sedation dentistry differently? I’m not sure what the difference is between all of these specialists anyway. I normally see a general dentist and he’s a great guy, but I guess he won’t do the actual surgery when placing an implant. He says he always refers patients out to a specialist and that he only does the crown on top. He gave me three different referral sheets and told me I could go to anyone. I didn’t really look at them while I was in the office, but now that I’m home, I see that one specialist is a prosthodontist, another is an oral surgeon, and the last one is a periodontist. How do I know which one to choose, and will each of them be willing to give me sedation dentistry?
Great question! Basically, any dentist can do dental implant surgery. And dentists who provide oral surgery offer some level sedation. From a general dentist who just graduated from dental school to a specialist—all of them can place dental implants. But if you’re going to have extensive work done, you want an expert. Statistically speaking, the doctor’s level of training and experience is the most influential factor in the outcome of dental implants.
Even some general dentists have taken extensive post-graduate training in implantology and are highly qualified to place implants. But your dentist is referring you to a specialist. So how do you choose your specialist, and will he or she be willing to provide sedation dentistry?
Which Levels of Sedation Dentistry Will Be Offered?
Most general dentists often offer nitrous oxide (laughing gas). Specialists offer higher levels of sedation, including oral conscious sedation (anti-anxiety medication in pill form) and I.V. sedation. You can call each specialist’s office and ask what levels of sedation will be offered to you.
Dental Implant Specialists Who Offer Sedation
Oral Surgeon
After finishing dental school, doctors can begin practicing right away, or they can continue school for several more years to become a specialist in one of the nine specialties recognized by the American Dental Association (ADA). They define the area as:
“Oral and maxillofacial surgery is the specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.”
Periodontist
The ADA defines this area as:
“Periodontics is that specialty of dentistry which encompasses the prevention, diagnosis, and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.”
Prosthodontist
From the ADA:
“Prosthodontics is the dental specialty pertaining to the diagnosis, treatment planning, rehabilitation and maintenance of the oral function, comfort, appearance and health of patients with clinical conditions associated with missing or deficient teeth and/or oral and maxillofacial tissues using biocompatible substitutes.”
Which Specialist Should You Choose?
Regardless of which specialist you choose for dental implant surgery, each of them will offer adequate sedation dentistry to relax you and minimize your sensitivity to pain.
Oral surgeon – Oral surgeons are trained to surgically treat diseases, injuries, and defects. In other words, it’s their job to treat damage, trauma, and malfunction. This could include:
Cleft palate
Jaw trauma
Wisdom teeth extraction
Dental implant placement
Periodontist – The periodontist description, mentions “teeth or their substitutes” and talks about maintaining health and function. Periodontists typically
Periodontal disease
Bone loss, including bone grafting
Structural problem
Prosthodontist – The description for prosthodontics says, “clinical conditions associated with missing or deficient teeth.” Prosthodontics is an entire specialty for missing tooth replacements, ranging from dentures to dental implants.
Request Consultations
We suggest that you review each dentist’s website to learn about his or her qualifications. Look for the following:
Education
Years of experience
Credentials, including state board certification, fellowship, or mastership in dental implant organizations
Published works on implantology
Patient testimonials or reviews (some might be published on external sites)
Choose at least two specialists and schedule consultations with each. This gives you an opportunity to ask questions about dental implant placement, as well as your options for sedation dentistry.
I’m wondering why I can’t get sedation dentistry for a root canal. 2 of my bottom left molars have really been hurting me. Unfortunately, I put off the dental appointment so long that I can’t chew on that side of my mouth without intense pain. Last Thursday, I had a dental appointment and the dentist told me that I now need root canals and crowns for both teeth. If I had gone to the dentist earlier, the situation wouldn’t be so bad. I was expecting the dentist to say that I only need fillings. I asked to be sedated for the procedure, but this dentist told me that he doesn’t do sedation because he is gentle and none of his patients need sedation, especially for something as simple as a root canal. My level of fear is so high that the thought of going to a dentist for a root canal is making me nauseous. Am I asking for too much? Why can’t I get sedation dentistry for a root canal? Daniel
Daniel – A gentle dentist is able to give you root canal treatment that is painless. But if your anxiety level is high, sedation dentistry can help keep you calm. Even dental fillings or cleanings can be performed with sedation.
The important thing is not to skip the root canal treatment. When the pulp, or soft tissue, inside your tooth is infected, the infection must be removed. Otherwise, the damaged pulp will cause nerve irritation and pain. At some point, the pulp in the tooth will die, and you won’t feel pain anymore. But your tooth will still be infected, and the infection can spread to the bone and to other teeth.
What Happens During Root Canal Treatment?
Your dentist will make an opening on the biting surface of the tooth. Dental tools will be used to clean out the tooth, down to the roots.
The pulp will be replaced with a dental filler material. The roots of the tooth will be sealed with a dental adhesive.
A temporary filling or a temporary crown will be placed over your tooth.
Your tooth will be shaved to allow the permanent crown to fit over it. Usually, permanent crowns are custom made in a dental lab.
Sedation Dentistry Will Help During Root Canal Treatment
Sedation dentistry is helpful during root canal treatment. In addition to helping you stay calm, it will decrease your sensitivity to pain. If your dentist is unwilling to provide some form of sedation, you can schedule consultations with at least two other dentists who will provide it.
Depending on the dentist, you will learn about three different levels of sedation:
Nitrous oxide – This colorless, odorless gas is often referred to as laughing gas. You’ll breathe it in during the appointment. When the procedure is complete, you’ll be given pure oxygen to reverse the effects.
Oral conscious sedation – In advance of your appointment, you will take commonly prescribed anti-anxiety medication. You’ll come to the office relaxed and ready for your root canal treatment.
IV sedation – Anti-anxiety medication is given to you intravenously.
For each consultation, ask the dentist what types of sedation he or she offers. Ask about safety precautions while you are sedated. You can find a sedation dentist by asking friends, family members, or coworkers for recommendations. Also, you can search online for a dentist near you. Be sure to check patient reviews.
Act promptly to prevent your infected molars from causing more problems in your bone or adjacent teeth.
This post is provided by Plano, TX female dentist Dr. Miranda Lacy. Dr. Lacy’s office is convenient to Addison, Allen, Carrollton, Farmers Branch, Frisco, Garland, Highland Park, and Little Elm.
I need to have my wisdom teeth pulled and I plan to see a sedation dentist for it. I already have a dentist and I think she’s awesome, but she won’t sedate me for the procedure. Actually, she doesn’t even provide any kind of gas or anything. I even asked her if she’d just prescribe something for me to help take the edge off during the procedure and she won’t even do that much. I’m really disappointed because I already know and trust her, but it’s her practice, and her rules, I guess. So, instead of pulling my wisdom teeth, she gave me referrals to a couple different sedation dentists. Actually, I think these guys are oral surgeons who just happen to provide sedation services as well. Anyway, I feel kind of bad saying this, but I’m not comfortable with male doctors. I’m not saying they’re bad or dangerous or anything like that. I’d just feel better if my doctor was a woman, especially if I’m going to be sedated. Again, I don’t think a male doctor would do anything bad, I just feel more comfortable with a female physician, especially for something like this.
Here’s where the problem comes in- she referred me to a couple different oral surgeons and told me I could choose one, but they’re all men. I called my insurance company to see where I could go, and then I asked them if they could tell me which ones were women. Instead of helping me, the insurance agent gave me a hard time about it saying, “Their credentials are the same. What does it matter?” Well, it matters to me. A lot. I don’t think I should be made to feel bad just because I want to see a female doctor. I’ve called around to most of the offices on my list and it looks like they’re all men. Seriously. Are there no female oral surgeons?!?
What are my options here? Is it ok that I’m insisting on seeing a woman, or am I being unreasonable? Thanks, Anonymous
Dear Anonymous,
You’re not being unreasonable at all. Some people simply feel more comfortable with a female practitioner, and that’s okay. When you’re choosing a dentist, you need to feel comfortable and know that you can trust him or her. In fact, many insurance companies that post lists of their physicians online actually allow you to search by gender for this very reason.
At the same time, you’re experiencing one of the odd quirks of dentistry. The latest stats indicate 98% of oral surgeons are men. This has been the topic of scientific research; trying to uncover why so few women get into the field and what can be done to attract more women to it. Sadly, very little has changed over the years, and it continues to be a male-dominated profession.
There’s a very real chance that there are no female oral surgeons in your area, particularly if you live in a smaller community. So, you have a couple of options.
1) Visit the office of a male oral surgeon and see if he has female staff members who will be with you during treatment. Offices usually have an assistant assigned to each patient, and the majority of assistants are female. You can also ask if the anesthesiologist, if one will be present, is female. So even if you can’t have a female doctor, you may feel some comfort by having women around you while you’re medicated.
2) Search for a female sedation dentist. It sounds like your dentist was willing to do your extractions, which means a specialist isn’t really needed for the extractions. You may be able to find a female general dentist in your area who provides oral conscious sedation.
This post is sponsored by Plano female dentist Dr. Miranda Lacy. Dr. Lacy’s office is convenient to Addison, Allen, Carrollton, Farmers Branch, Frisco, Garland, Highland Park, and Little Elm.
I am a coward at the dentist and I have a low tolerance for pain. I know I need sedation but I’m concerned about the safety. A normal person would be numbed with local anesthetic, but it doesn’t work for me. My dentist has tried numbing me 2 hours before my appointment but it has no effect. It’s as if nothing was done at all. He isn’t a gentle dentist either. So I’ve put off any serious dental work. Within the past two weeks I received a postcard in the mail from a nearby dental office. It’s a husband and wife team that practices sedation dentistry. Is this really a safe alternative? Is there any way to tell whether or not it would work on me before the dentist starts drilling in my mouth? Thanks Lizzy
Lizzy – Your case is not unusual. Millions of Americans have dental anxiety or dental phobia and consider themselves to be dental cowards. It helps to have a gentle dentist, but sometimes that isn’t enough. When the anxiety is high enough, local anesthetic either wears off very quickly or doesn’t work at all. Sedation dentistry is a safe alternative.
Conscious oral sedation uses common anti-anxiety medication to relax you. You’ll still be conscious and have your reflexes, and your vital signs will be monitored. But you’ll be completely relaxed. Some dentists use nitrous oxide to calm the patient so that the local anesthetic will be effective. Remember sedation is not local anesthetic, but it helps you relax so that the anesthetic will work. It can also help you experience less sensitivity to pain.
Sedation Dentistry Is Safe
Sedation dentistry is safer and less expensive than general anesthesia. It helps you to have a pleasant dental experience, and it’s likely that you won’t recall what happened during the appointment. It is safe. Your medical and prescription history is reviewed to determine if you are a candidate for it. During your dental procedure, your vital signs are monitored.
You can find a gentle dentist who enjoys treating fearful and anxious patients. It’s important that you get the treatment you need, so that you can maintain good oral health. Sedation dentistry can help.
This post is sponsored by Plano dentist Dr. Miranda Lacy. Dr. Lacy’s office is convenient to Addison, Allen, Carrollton, Farmers Branch, Frisco, Garland, Highland Park, and Little Elm.
I’ve spent the last 3 years with so many medical issues that I can’t manage to even see a sedation dentist about the problems that I have with my teeth due to my illnesses and medication. The countless hospital stays and doctors’ appointments have tapped out my emotions. Thankfully I am much better physically but I’m just exhausted from seeing healthcare providers. I know that my teeth need extensive work and I will have to see a dentist, but I’m just afraid. I understand that sedation dentistry is my best option, but I’m anxious about going to the dentist. I just want to get my anxiety under control before I take that step. There isn’t a lot of time for me to do this because my teeth are in poor shape and it is starting to affect my confidence. What can I do to get over this hump? Ava
Ava,
Sedation dentists don’t just give you medication so you can get through your dental appointment. They thoroughly understand dental anxiety, and they are compassionate about it. Part of their training involves seeking to understand why a patient is anxious, and that comes through communication with you.
Your experience with a sedation dentist will evolve from conversation, to education and understanding, to dental treatment. A sedation dentist makes the effort to provide a calming office environment, to hire patient staff members, and to ensure your comfort throughout the dental visit.
We suggest that you schedule appointments to speak with at least two sedation dentists—not for dental treatment—but to get to know the dentist and how he or she can help you address your anxiety. Medication is part of the solution, but so is your relationship with the dentist. When you call to schedule the appointment, explain your concerns and that your request is only for a consultation—no exam or x-rays.
You can get to know the dentist and experience the office environment before you commit to dental treatment.
This post is sponsored by Plano dentist Dr. Miranda Lacy. Dr. Lacy’s office is convenient to Addison, Allen, Carrollton, Farmers Branch, Frisco, Garland, Highland Park, and Little Elm.
I need 3 fillings replaced. I’ve had the fillings since I was 15 years old. 2 weeks ago one of them cracked. It broke a piece of the tooth off so bad that I had to go to an emergency dentist. He said I now need a crown. I am dreading this work that needs to be done. The dentist saw my anxiety level increases as he was explaining everything that needs to be done. He said that a sedation dentist might help me relax and if I wanted to I could go to another dentist who offers it. I’ve haven’t been to a dentist for about 5 months because my old dentist left his practice. Now the thought of being sedated by a new dentist and having this be the first major work done for me is making me more nervous. Is this something that insurance covers?
Whether or not insurance provides benefits for sedation dentistry depends on your individual plan and the type of sedation offered. Some procedures are billed to dental insurance, and others are billed to dental insurance. In advance of your procedure, the dental office can contact your insurance companies to determine if any benefits are provided. Keep in mind that it is unlikely that insurance will cover the entire cost, but some benefits might be provided.
If sedation dentistry is used during an appointment with an oral surgeon, an anesthesiologist might be present to administer it. The insurance will likely provide some benefits for the sedation, which is often referred to as twilight.
Sedation at a dental office for general procedures is usually nitrous oxide or oral conscious sedation. Anti-anxiety medication is given for oral conscious sedation, and insurance generally doesn’t cover it.
You can search for experienced sedation dentists who use different levels of sedation, depending on your procedure and anxiety level. Ask about each dentist’s training, credentials, and experience. Schedule a consultation with two or three sedation dentists and get a feel for how you are treated as a patient. If you are comfortable with the dentist and his or her office environment, it might be easier to trust the dentist with giving you medication to help you relax.
Remember that you will still be conscious during your appointment and able to respond to the dentist’s questions, and to let the dentist know if you are experiencing any discomfort. Your vital signs are monitored throughout the procedure.
Ensure you are comfortable and have enough information about sedation dentistry and your dental procedures before you schedule an appointment to have your dental work completed. It help your appointment to go smoothly.
For the average person getting cavities filled might not be a problem, but it’s a problem for me. I need something to sedate me or relax me before my dentist’s appointment. I have never had cavities before, and I hate going to even the nicest, most gentle dentist. Now I have 2 cavities that need to be filled. I am going with composite and I know that takes longer than silver fillings. My question is can I take maybe a Benadryl or something for the fillings even though it’s a simple and quick procedure? Will Benadryl affect anything the dentist will do or put in my mouth? I got a suggestion to drink alcohol before the appointment but that doesn’t sound like a good idea to me. What is something safe for me to take before the dental appointment? Manuel
Manuel – Yes, you can be sedated for the simplest of dental procedures. But you shouldn’t try to sedate yourself with Benadryl, alcohol, or by any other means. If you are anxious or nervous, a sedation dentist prefers that you be relaxed before your appointment. If you can’t relax, the dental treatment and your visit won’t be productive. But leave the sedation to your dentist.
A sedation dentist uses nitrous oxide (also referred to as laughing gas), conscious oral sedation (mild, anti-anxiety medication), or IV sedation to help you relax during a dental procedure. The levels of sedation offered varies with the dentist and his or her training. All are common, safe means of helping patients relax.
Many patients cancel dental appointments because of their anxiety. Some patients actually refer to themselves as dental cowards or dental phobic. Speak with your dentist about your concerns and your desire for sedation. If he or she doesn’t offer a level of sedation adequate for your needs, you can consider finding a dentist who does.
Your comfort level with a dentist can contribute to or decrease some of your anxiety. If you need to find a dentist who practices sedation, we suggest that you schedule a consultation first to ensure you are comfortable with the office environment, staff members, and dentist.
This post is sponsored by Plano dentist Dr. Miranda Lacy.
Is sedation dentistry like anesthesia during outpatient surgery? I’ve received a few postcards from new dentists in the area who do sedation. My dentist doesn’t offer it at all, but I am not attached to him because I’ve only been going to the practice for a year. I like him, but I feel no commitment. I think my anxiety at the dentist would be much better if I got sedation so I am thinking of making the switch. Before I get talked into it I would just like more information on how it works. Is sedation like anesthesia? Thanks Kerry
Kerry,
The main difference between sedation dentistry and general anesthesia is that with sedation dentistry you are awake. There are different levels of the treatment, depending on your level of anxiety. A sedation dentist may offer some or all of the levels.
The levels of sedation are nitrous oxide, oral conscious sedation, and IV sedation. The treatment makes you drowsy. Some patients actually fall asleep through the dental procedure, including tooth extractions, root canal treatment, dental crowns, or whatever treatment they are receiving. Since you won’t be unconscious, you will be able to respond to your dentist’s questions and commands throughout your procedure.
Sedation dentistry relieves a lot of anxiety before, during, and after your dental procedure. Often just the anticipation of a dental appointment can make you nervous. Your sedation dentist will speak with you about the cause of your anxiety. He or she will match your anxiety level with the procedure being done and determine whether you need nitrous oxide, oral conscious sedation, or IV sedation.
After your dental appointment, you will still be drowsy. Like outpatient surgery, you will need transportation and need to take the rest of the day off.
We recommend that you visit at least two sedation dentists. The levels of sedation offered can vary, so you may want to find a dentist who offers at least two levels. Before you receive any dental treatment with sedation, the dentist will review your medical history to ensure you are a candidate for it. Ensure you are comfortable with the dentist first before you receive sedation. Your trust in his or her qualifications will give you confidence in the dentist during your appointment.