Tag Archives: Sedation Dentist

Why Fill a Baby Tooth?

Can you tell me why my dentist wants to fill a baby tooth? My son has a cavity on one of his back teeth, but this isn’t his adult tooth. As it is just going to fall out anyway, why should I spend this money and put him through the procedure?

Callie

Dear Callie,

boy smiling with a toothbrush

Nobody wants unnecessary medical or dental procedures so I completely understand your question. While some baby teeth will start to fall out soon, his back molars need to stay in until he is around 12 years of age. You don’t want this cavity to turn into a dental infection. A simple cavity is easy to treat, with little trauma. If the tooth gets infected, you will need a child’s version of a root canal treatment, called a pulpotomy.

In most cases, you will want to prepare ahead of time and possibly even arrange to have oral conscious sedation used during this procedure, so he is as comfortable as possible. If you let the tooth go, it could go downhill fast, which will mean a dental emergency. In that case, oral conscious sedation may not be an option for him which would make the appointment more traumatic for him.

What If He Loses This Tooth?

Another problem with letting the decay continue is that the tooth may become unsaveable. If that happens and it has to be extracted, you will need your pediatric dentist to place a space maintainer in that spot. This will prevent the other teeth from shifting and tipping into that spot.

Without that, the other teeth will drift. This will mean there is not correct placement left for his twelve-year-old molars and will lead to crowding. Crowding means crooked teeth and expensive orthodontics.

A little prevention now by getting this tooth filled can save you and your son a lot of expense and hassle.

This blog is brought to you by Lafayette, LA Dentist Drs. Foreman and Thimmesch.

Perforated Sinus with Tooth Extractions

Can you help advise me? I had ten teeth extracted by an emergency dentist. With one of the upper molars, he perforated the sinus cavity. He placed a compound in it to increase the clotting, but I can feel air flowing through it even when I am at rest. There is air blowing into my mouth and it feels quite weird. He also gave me a ten day course of antibiotics. Should I be concerned about this?

Emilio

Dear Emilio,

Man holding his jaw in pain

Usually, when a patient sees an emergency dentist they just get the patient out of pain and do the minimal procedure necessary than have you reschedule with your normal dentist. I am a little surprised that this dentist removed ten of your teeth in one appointment. While he was right to get the clotting started, he should also have closed the hole. Will it heal without that? Possibly, but it will take a long time and you are at risk for infection while you are waiting for the healing. In your place, I would see an oral surgeon to have them graft some bone there to close and heal the area.

Another issue I am concerned about is the number of teeth you’ve had removed. It is important that they are replaced as soon as possible. Otherwise, you will begin to lose your bone structure in those areas as well. Without that, you could end up with a condition known as facial collapse. I’m going to recommend that you have them replaced with dental implants because these will preserve your bone.

Sometimes we have found that patients who end up with dental emergencies have a fear of the dentist that keeps them away until they are in too much pain to avoid it anymore. I want you to know, just in case that is a situation you find yourself in that there is a solution. I’d like you to see a sedation dentist. They have medication they can give you which will allow for you to have a pain-free/anxiety-free appointment. Dentists who offer sedation are used to patients with anxiety and can help put you at ease.

This blog is brought to you by Lafayette, LA Dentist Drs. Foreman and Thimmesch.

Can I Take Xanax Before My Dental Appointment

I am not being melodramatic when I tell you that I am terrified of the dentist. I haven’t gone in years because of that, but now I have a tooth which is in so much pain that I can’t focus or sleep. I know I need to go see a dentist. Half my face is swollen going all the way up to my eyeballs. I’m worried, but my anxiety about going is still strong. Would it be okay if I took a Xanax before my appointment in order to help relax me?

Greta

Dear Greta,

A woman grabbing her jaw in pain, in need of emergency dental care

I am sorry for your pain as well as the fear you face when thinking about the dentist. Often, when someone has this level of anxiety, it is a result of experiencing some dental trauma earlier in their life. If you have properly prescribed Xanax, you can take it before your appointment. However, you need to let your dentist know ahead of time that you’ve taken it because it will affect what types of numbing medication he or she can give you.

Because you are in so much pain, and especially because of the swelling you are seeing, I would consider this a dental emergency. It doesn’t sound like you have a regular dentist, given your experiences. So I would do an internet search for someone who sees non-established patients in cases of emergencies. Doing a search for for an emergency dentist will help you find them.

While you are searching, I do think you should look for a sedation dentist. This could solve all of your anxiety issues and you would not even need any Xanax.

Whatever you do, please don’t put off getting the treatment you need here. The swelling that has gone up to your eye means that your infection is spreading. You do not want it to reach your brain. Then a simple tooth infection will become life threatening.

This blog is brought to you by Lafayette, LA Dentist Drs. Foreman and Thimmesch.

Dentist Is Growing Frustrated with Me

I have problems in the dental chair. I don’t know what it is but every time the dentist or hygienist comes at me with something sharp looking, I can’t help but wiggle and sometimes even have trouble breathing. I thought my dentist was understanding. We’d had a couple of appointments where he waited for me to calm down. However, at my third appointment, he said, “You’re an adult and should be able to handle this by now.” I was so embarrassed. I know I’m an adult. I know I should be able to handle this by now. But, I don’t know any solutions. Have you had patients who’ve struggled as I do?

MaryAnne

Dear MaryAnne,

Woman resting from dental sedation

I am going to tell you right off the bat that your current dentist is not going to be the best dentist for you. To be frank, he was rude and insensitive to your very real anxiety in the dental chair. Adult or not, many patients are uncomfortable in the dental chair, some so much that they can’t even go and end up only going in for dental emergencies.

I don’t know where you live, but what I would like you to look for someone who considers themself a sedation dentist. Not only will they be compassionate, instead of rude and judgmental, but they also have the tools to give you an anxiety-free/pain-free dental appointment.

What Type of Sedation is Best?

My recommendation is to start with the lowest level of sedation that is useful to you. The lowest level is nitrous oxide, which people used to call laughing gas for the floaty, happy feeling it can give you. This will relax you in the dental chair. A benefit to nitrous is that you can get right back on with your day once your appointment is completed.

For invasive procedures, I recommend oral conscious sedation. This is administered by pill. However, it is so strong that you will need someone to drive you to and from your dental appointment as well as stay with you for a few hours after your procedure until you are lucid and steady on your feet. Most people find they completely sleep through their procedure, leading some to dub it sleep dentistry.

Look for a dentist who offers these options and I think you will find your life changed.
This blog is brought to you by Lafayette, LA Dentist Drs. Foreman and Thimessch.

Numbing Medicine Doesn’t Work On My Daughter

My seven-year-old daughter developed a cavity on a back tooth, which is weird because they have sealings. I took her in for them to do the filling and they could not get the numbing medicine to work. She is in agony and ended up thrashing about. He did seven shots to no avail. He finally just sent her home without the tooth dealt with. Where do I go from here?

Maggie

Dear Maggie,

Little girl smiling in a dental chair

I am sorry you and your daughter had to go through this. It is agony watching our children suffer. The good news is I have a solution. It appears that your current pediatric dentist is not aware of the connection between anxiety and numbing medication.

If a patient is very anxious, it has the effect of metabolizing the numbing medication very quickly. Sometimes so quickly that the patient gets no benefit out of it. I feel this was what happened to your daughter. Traumatic experiences like this are what keep people away from the dentist in adulthood.

Our goals right now for her are two-fold. First, get the cavity dealt with before it blows up into something more substantial or even a dental emergency. Two, give her a positive experience at the dentist so she can feel good about her oral health care.

I want you to find a dentist who is good with children that also offers dental sedation. It doesn’t have to be a pediatric dentist. There are many general dentists who enjoy treating children and are qualified.

Under normal conditions, she would only need some nitrous oxide to relax her. However, after her recent experience, I am concerned that will not be enough. Look for someone who offers oral conscious sedation. It is so strong that she will sleep through her whole procedure. In fact, some people call it sleep dentistry for that reason. She is still conscious. This is not anesthesia. It just completely relaxes her which will allow that numbing medication to do its job.

Be aware that she will still be woozy for a few hours after that procedure. You might want to set her up a little castle on the couch and let her binge watch something like “A Series of Unfortunate Events,” which will entertain her while simultaneously realizing her life isn’t so bad.

As for her sealants. Sometimes those will come off. Make sure you have the dentist check that the others are still intact.

This blog is brought to you by Lafayette, LA Dentists Dr. Foreman and Thimmesch.

Can I get all this work done in one setting?

I’ve got a lot of dental work to get done. I have to get at least four root canal treatments, and I need to have a couple of teeth ground down as TMJ treatment. I also may need to have a dental bridge placed, though my dentist is still considering the best course of action in that case. I also need some dental bonding done on a chip on my front tooth. The problem is that I seriously freak out in the dentist’s chair.

I’d like to get this all done at once. I don’t have much time off of work, and I just want to get it over with. My question is, how much can be done in one sitting?

Frank from Escanaba

Dear Frank,

Time of treatment is determined by the patient’s ability to tolerate treatment. The placement of the teeth that need root canal treatments will affect the amount of time necessary for treatment.

The amount of treatment you need will probably require the services of a sedation dentist. This would have the added benefit of easing your anxiety. If you can’t locate a sedation dentist, or don’t want to go to one, then the length of treatment is largely decided on your ability to tolerate treatment. Your anxiety will probably lessen your ability to spend long hours in the chair, so consider this when you are deciding whether or not to go with a sedation dentist.

If you can’t locate a sedation dentist, you may want to consider going to an endodontist. A specialist will reduce the amount of time you need to spend in treatment.

This blog post created for Lafayette Louisiana cosmetic dentist Dr. Mike Malone.

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