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Shelley Shearer: Fearful dental patients have more sedation options than ever to help defeat anxiety

Nervous at the thought of sitting in a dentist’s chair? Anxiety-ridden due to COVID-19 exhaustion? Millions of Americans share the same fears and anxiety. But modern sedation dentistry offers multiple ways to ease any hesitation about visiting a dentist. The usual candidates for some sort of sedation fight a gag reflex problem, have extra-sensitive teeth, harbor extreme anxiety, maintain a low threshold for pain, need a great deal of dental work done or are chair squirmers.

Here are the ways you can defeat anxiety and maintain your smile — and composure — this fall.

Most dental offices offer various levels of dental sedation aimed at minimizing dental fear. Much depends on the level of fear and anticipated stress.

The levels of sedation include:

Dr. Shelley Shearer

Minimal Sedation

This is when you are deeply relaxed, but fully conscious during the procedure. You are responsive to all verbal commands and completely remember your treatment once out of the chair. Patients who opt for minimal sedation desire the intense relaxation, but still have their wits about them. One way dentists employ minimal sedation is through an oral sedative such as Valium, taken about an hour prior to the procedure. It makes you drowsy and calm, and you can possibly drift off into a brief sleep. It’s a relaxing way to turn anxiety into the feeling you get when watching a sunset or ocean waves. Many dental offices can also provide the lull of music or sounds of nature for pure relaxation during the procedure.

Upside: The feeling of pure relaxation

Downside: It may not be strong enough for the most anxious patients; dentists can’t always predict which dosage will work best; someone must drive you home.

The other popular minimal sedation technique is through breathing nitrous oxide, affectionately known as “laughing gas.” Patients breathe the nitrous oxide combined with oxygen through a mask placed over the nose. Even if you are a bit claustrophobic, the phobia shouldn’t last long. The gas creates a state of euphoria; it’s easier to concentrate on taking your dog for a walk than it is to be cognizant of what the dentist is doing.

Upside: Oblivious to the sights, sounds and smells of the procedure; wears off quickly; no needles used; you can drive yourself home.

Downside: A close watch must be kept on the amount of nitrous oxide provided to ensure the heart rate is not effected; some are too claustrophobic; possible nausea or brief mental confusion can occur

Moderate Sedation

With moderate sedation you feel drowsy and sleepy and can respond to some commands, but will not remember much about the procedure. This is produced by intravenous (IV) sedation. Much advertising has surrounded IV sedation in recent years as fearful patients want to be “knocked out” during the treatment. Sedative drugs are received through a vein, working quickly. The dentist can adjust the amount as needed.

Dentists require additional training to perform IV sedation and many have opted to receive the credentials in order to offer this popular sedation method. The use of it has been hailed as a God-send for the most fearful dental patients. They sleep comfortably during the procedure, especially when a great deal of work needs to be done such as wisdom teeth extractions and the insertion of full-mouth dental implants.

Upside: Offers the best control of the amount of drugs entering one’s system; provides a deeper level of sedation; other drugs can be quickly used to counteract too much sedation; multiple procedures can be performed at once saving time and money

Downside: More expensive than other methods; some patients fear needles; longer recovery time

Now that you know about the options, there is no reason to avoid a dental visit. The decision to choose minimal over moderate sedation depends on the individual patient’s degree of dental phobia and the length of the procedure. Be sure to discuss options with your dentist so you can select the method that is perfect for you…and your smile.

Dr. Shelley Shearer is a graduate of the University of Louisville Dental School and Founder of Shearer Family and Cosmetic Dentistry in Florence, the largest all-female dental practice in Northern Kentucky.

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