Sedation Dentistry Archives - West Seneca Dentist

Best Dentist for Terrified Patients

Posted on December 19, 2024 by writeradmin.

I was trying to find the best dentist for my situation. I have horrible, debilitating dental anxiety. It has kept me from getting my teeth cared for the way I want to. I’ve decided I need to be proactive and there MUST be a dentist out there who can help someone like me. I did a search on two review sites for “Best Dentist for Fearful Patients”, but none of the reviews had anything to do with dental anxiety. How do I find the right dentist?

Angela

Dear Angela,

I am glad you wrote. I know exactly how to help you here. First, let me say that it is awesome that you are moving forward trying to get your oral health taken care of even though you have severe anxiety. One of the definitions of courage is being afraid and doing it anyway. You are demonstrating that right now.

As you’ve discovered, these review sites are great for things like plumbers or hairdressers, but for things like specifics in dental care they do not do as well. They rate the dentists by the number of stars they get. Those reviews may have nothing to do with the care of the dentist or the specific need you have. You’ll get things like, “The staff is great!” Or “They get you in and out on time.”

If you’re looking for something specialized, like an expert cosmetic dentist or, as in your case, someone good with fearful patients, it is hard to get the right information.

The Right Dentist for Anxious Patients

You will find that the dentists who are the most compassionate with anxious patients are sedation dentists. They understand that you can’t always just will away your fears. They also don’t judge. You’re likely behind on your dental work and they don’t judge or give grief.

Plus, they can provide you with a medication that is so strong that, if you wanted to, you could sleep through your appointment. There are several levels of sedation. In your case, I am going to recommend you use oral conscious sedation. This is administered by a pill but is really strong. In fact, you will need someone to drive you to and from your appointment.

Dental sedation changes people’s lives. You will find you will be able to quickly get caught up with your dental work.

This blog is brought to you by West Seneca Dentist Dr. Carl Embury.
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Resistance to Novocain

Posted on September 24, 2024 by writeradmin.

I have a mouth that is a complete mess. Most of that has to do with my inability to tolerate my dental care. I have a ridiculously high tolerance to novocain. It has made every dental appointment a bit of a nightmare. As a result, I have avoided the dentist like a plague and only seem to go when there is a dental emergency. If I continue this pattern, I’m going to lose more teeth. Do you know what causes this resistance and whether or not there is some way to deal with it so I can get the care I need?

Stacey A.

Dear Stacey,

When someone has a high resistance to Novocain, it is usually a sign that they have dental anxiety. This is a common issue, but the devastation it brings to those who have to deal with it are rather serious. The good news is that there is a solution for what you are dealing with.

The anxiety will cause your metabolic system to kick into overdrive. When that happens, your body will burn off the medication you’ve been given faster than it would under normal circumstances. This is why you are having a hard time with the Novocain working for you. The solution is for you to relax enough so that the medication stays in your system long enough to do its job.

I know. You’re probably laughing right now. Relax? At the dentist? Sure. That’s likely.

So, here is that good news which I promised earlier. If you see a sedation dentist, they can provide you with a medication that can relax you enough for your medication to work. Unless you are having major work done, I would start with the lowest level of sedation—nitrous oxide.

It sounds like you need a lot of work done at the moment. In that case, I would do something a bit stronger, such as oral conscious sedation. this is sometimes called sleep dentistry because it is so strong that you can sleep right through the procedure if you want to.

This will allow you to catch up on all of your oral healthcare. You will no longer be going from one dental emergency to another.

This blog is brought to you by West Seneca Dentist Dr. Carl Embury.

Sinus Perforation After a Tooth Extraction

Posted on January 9, 2024 by writeradmin.

I am hoping you can help me. I had a tooth extracted and the dentist ended up perforating my sinus cavity. They did not tell me that about the perforation until the next day. I wasn’t even aware this could happen, though when I asked them about that they insisted I gave them informed consent. Several days after the procedure my nose started popping. I called the office and they said to take Sudafed. By the next morning I had a 102-degree fever. They called me in an antibiotic, but my fever did not go away and soon my left eye started hurting. A week later I went back in and they removed some pieces of bone. They could see an infection in the back sockets and gave me a stronger antibiotic. Two weeks later and I was still in pain and had an infection. They finally recommened an oral surgeon that suggested I see an ENT. I was sure that they needed to close up this hole because whenever I do my gargling (which I normally do daily), parts of it is coming out of my nose green and slimy, so I asked to see the oral surgeon so I could speed things up. I’ve been missing work and am out of sick days.
While waiting for the oral surgeon appointment, my antibiotics ran out and I ended up with another sinus infection. I called my family doctor and explained my situation. He called in ANOTHER antibiotic. When I went to see the oral surgeon, he poked around with a Q-TIP and told me it is healed up and there’s nothing to worry about. I will admit to being puzzled because of the symptoms I am having and the pain I am in. That annoyed him and he snapped at me saying, “I told you it was healed. You should be happy, not questioning me.” I’m out of sick days, still have a fever and am in terrible pain. I can barely eat. What do I do? Also, I checked on my informed consent because I didn’t remember them telling me any of this would be a possibility. It turns out my informed consent does not have a date or even my signature; just a note that says, “Reviewed with patient. Unable to sign due to sedation.” Can they give me information when I’m out of it and call it consent?

Adriana

Dear Adriana,

I’m going to start with your last question first. No, they cannot get “informed consent” when you are under the influence of dental sedation. When you are not lucid, you cannot give consent to anything. They should have gone over everything with you before any sedation became a part of the equation.

This dentist has made several mistakes, which I’ll go over in a moment. Before I do that I want to make sure you understand it was totally inappropriate for your oral surgeon to talk to you that way and, given your condition, I question his motives. This dentist recommended him and I suspect he was worried that if he pointed out this dentist made some mistakes that he worried he would not get any more referals. I would see that ENT who will be able to help you, but pick your own. Don’t go to anyone this particular dentist is recommending.

Call your dentist and tell him that he needs to cover all the expenses you’ve incured getting this repaired as well as any follow up expenses directly resulting from this. If he gives you any trouble, let him know you’ll be contacting a lawyer. That statement will trigger him contacting his malpractice insurance, who will likely advise him to settle.

Mistakes Made By Your Dentist

Not getting informed consent from you, which we went over earlier.
A poorly executed extraction that resulted in a large sinus perforation.
Bone fragments left in the perforation site.
Neglecting to start treatment of the perforation immediately after the event.
Neglecting to even tell you about it until the next day. This is important because blowing your nose could have done more damage.
Not giving you the correct anitibiotic the first time around.

Show this post to an attorney if it comes to that.

This blog is brought to you by West Seneca Dentist Dr. Carl Embury.

Is It Possible to Avoid General Anesthesia with Wisdom Tooth Extraction

Posted on September 23, 2023 by writeradmin.

My daughter is 20 years old and needs to have her wisdom teeth extracted. One of them is partially under the bone. Our dentist has not given us much information on this and just said to schedule the appointment. I’m assuming that some type of sedative has to be used. Does she need the type of sedation that they do in hospitals during surgery or is there a less scary one?

Cassie

Dear Cassie,

Bear in mind that I have not examined your daughter myself or seen any diagnostics, so I don’t have all the information. However, unless your dentist said their were some complicating factors other than just being partially under the bone, then I don’t think she will need anything more than oral conscious sedation.

Oral conscious sedation is administered by a pill but is still very strong. She will likely just sleep through the entire procedure. However, she is still conscious and can stay awake if she really wants to. Most people just prefer to sleep.

I am not too worried about the bone issue. At your daughter’s age, the bone is still pliable. There is not much cementum accumlation on the roots of the teeth at this age either. She’s actually in a sweet spot when it comes to extracting wisdom teeth.

As I am sure you know and why you expressed concern, there are added risks with general anesthesia. If she doesn’t need it, and I really don’t think she does, then you will be fine with just getting the oral conscious sedation. If you are still concerned, you can look for a dentist who is associated with DOCS, which is the Oral Conscious Sedation Organization. They provide special training for dentists. This will ensure your daughter is in the safest hands.

This blog is brought to you by West Seneca Dentist Dr. Carl Embury.

Help! Novocain Doesn’t Work on Me

Posted on May 23, 2023 by writeradmin.

Every single one of my dental appointments are a complete torture session because Novocain just doesn’t work on me. As a result, I have been avoiding the dentist. However, I am worried about my dental health and have noticed some decay. Can you please help me? Is there another type of option to Novocain. My dentist insists it works for everyone but me. I feel very uncared for at this point. I can’t be the only person this happens to. If I can’t find a solution, I fear I’ll be in dentures before I hit 30.

Penny

Dear Penny,

You are certainly not the only person to deal with this. The good news is there is a great solution. That being said, I do not think you are with the right dentist to help you. He doesn’t seem compassionate and doesn’t understand what is happening to you. Given your highly negative experiences with dental appointments, it is natural for you to have a significant amount of dental anxiety.

One thing to be aware of is that when you have dental anxiety it impacts the effectiveness of your Novocain. This is why it hasn’t worked for you. The great news is that there is a solution. You need to see a dentist who offers dental sedation, preferably oral conscious sedation. This is administered by pill and will completely relax you, which in turn enables the Novocain to do its job. Most people are so relaxed that they end up sleeping through their appointments.

The one downside to the complete relaxation is you will need someone to drive you to and from your appointment and stay with you at home until you are lucid and steady on your feet. This is mostly to prevent you from falling if you get up to go to the bathroom. I’d plan on a nice day of bingeing your favorite shows.

A secondary benefit to this type of sedation is it allows you to get more work done at each appointment. This means you can catch up on all that dental work much sooner than would otherwise be possible.

Give this a try and I’m confident you’ll find it will change your life.
This blog is brought to you by West Seneca Dentist Dr. Carl Embury.

Will Insurance Cover a Sedation Dentist?

Posted on February 7, 2023 by writeradmin.

I need to have my wisdom teeth extracted, as well as have two fillings and one dental crown placed. My dentist suggested I see a sedation dentist to have the wisdom teeth done and then return to him for the remainder of the work. Is it possible a sedation dentist can just do all of it so I can get it all done at once or will I need to go to two separate offices? Also, will insurance cover the sedation?

Bethany

Dear Bethany,

These are great questions. Let’s start with will a sedation dentist be able to do all of it. A lot of that will depend on whether or not you are going to an oral surgeon for your wisdom teeth removal or a general dentist. Oral surgeons are typically not able (or willing) to do the general dental work but they will do the wisdom tooth removal. They also will have an anesthesiologist present, which your insurance will cover, at least in part.

If you go to a general dentist, they can do all the work, but whether or not your insurance will cover it depends completely on your plan. Most dental offices have a business manager who is well-versed in what insurance companies will or will not cover. You could set up a consultation with them and see what information they can give you on your specific insurance plan.

Dentists offer a variety of dental sedation options. I recommend looking for someone who offers oral conscious sedation. This will relax you enough that you will completely sleep through the procedure. The caveat to that is you will need someone to drive you to and from your dental appointment, as well as stay with you for a few hours at home until you are lucid and steady on your feet. I would plan on relaxing on the couch for he majority of the day and maybe binging some of your favorite shows.

Whether or not a dentist will do all of it at once, will depend on the extensiveness of the work you need to be done. When you do your consultation, you can go over all of that, and the dentist will advise you on what will be most useful to you.

This blog is brought to you by West Seneca Dentist Dr. Carl Embury.

Dental Sedation for a Recovering Addict

Posted on August 17, 2022 by writeradmin.

I am in a pickle. I need an extensive amount of dental work. I will need some pain meds to deal with things and would like to have sedation during the procedure. Here’s the problem I am facing. I am a recovering drug addict. I am on methadone, but it is monitored at the clinic I attend and I have a doctor and a counselor. I offered to give them their numbers and permission to access my medical records, but the dentist still doesn’t want to give me the medication I need. Is there anyway I can get help with this?

Luke

Dear Luke,

You are in a tough spot. While most dentists are compassionate, they’re also afraid of the Drug Enforcement Administration (DEA). There were a few cases where some case agents were overly keen and some dentists, who were just trying to be compassionate, lost their licenses. The stories got around to other dentists and some overcorrected out of fear.

What you need is to find a dentist whose compassion overrules their fear. I would start by calling around to sedation dentists and explaining your situation. I truly believe if you are persistent you will find one. If you use something like oral conscious sedation this will enable you to catch up on your needed dental work even faster.

Depending on what drug you were on, your teeth may need some cosmetic work. Meth is especially hard on teeth. In fact, it is often called meth mouth. If you decide to have dental work done after you are caught up on the health necessities, choose the dentist carefully. Cosmetic work is not taught in dental school and they will need post-doctoral training.

This blog is brought to you by West Seneca Dentist Dr. Carl Embury.

Should She Trust This Dentist?

Posted on February 6, 2022 by writeradmin.

I am going to be completely upfront and say the situation I am in is my fault. I tend to avoid the dentist because of the anxiety I have. My experiences at the dentist have not been pleasant. I hope you won’t take offense at that, especially because I am going to ask you for advice! Haha. OKay, so I’ve had the pain that comes and goes for a couple of weeks but when it is there it hurts like the dickens. I looked up emergency dentist so I could get in right away. This dentist did an x-ray and found a cavity on a tooth that already had a filling. He said the cavity is so large that only 10% of the tooth is viable. He’s scheduled me to have the tooth extracted and then wants to do a dental implant. This idea terrifies me. Would it be stupid to get a second opinion? By that, I mean am I just putting off the inevitable? Or, does it make sense to get a second opinion?

Lydia

Dear Lydia,

I actually think a second opinion is a good idea here. The diagnosis the dentist who you saw gave you is suspect for a couple of reasons. First, if you had decay that significant, your dentist (or you) would not need an x-ray to see it. In fact, your filling would have fallen into the cavity and there would be a large gaping hole. Additionally, a tooth that far gone would have started hurting months ago, not a couple of weeks.

When you get your second opinion, make certain you don’t tell the second dentist anything the first dentist said or even who he is for that matter. This is called a blind second opinion and will protect you from one dentist trying to cover for another one who is a friend.

A Word About Your Dental Anxiety

The anxiety you feel at the dentist is quite common. The good news is I have a solution for you. I’d like you to find a dentist who offers dental sedation. This will allow you to have positive experiences at the dentist. You can get your work done both anxiety-free and pain-free. If you need a lot of work done, which you might if you’ve avoided the dentist for a while, the best option is oral conscious sedation. This will allow you to sleep through your appointment while the dentist gets a lot of work done. Before long, you’ll be all caught up and find that the dentist is not so scary after all.

This blog is brought to you by West Seneca Dentist Dr. Carl Embury.

Why Couldn’t My Dentist Get Me Numb?

Posted on June 15, 2021 by writeradmin.

I had to have my very first cavity taken care of and it did not go well. I was nervous going in and now I don’t know if I can go back. He gave me seven different shots and still couldn’t get me numb. He refunded my money and said we’d try again in a week. Will that make it any better just waiting a week? I’ve never had a filling so I don’t really know what to expect.

Melanie

Dear Melanie,

No, just waiting a week will not change this, UNLESS the dentist changes something that he is doing. I have seen scenarios like this and I can tell you there is a solution. When a patient has trouble getting numb, it is often because they have dental anxiety. Many people don’t realize this, but dental anxiety can cause your metabolism to burn off your numbing medication. You mentioned you were nervous going in. That may have made it difficult for the numbing medicine to be fully effective. Then, when you felt pain as he started, your anxiety probably went through the roof, making it even harder to get numb.

Here is my recommendation. You need to find a dentist who offers dental sedation options. Under normal circumstances, just a little nitrous oxide would be enough to calm your nerves and enable the medication to do its job. However, given your last experience, and without any previous experiences to compare it to, my suggestion is you get oral conscious sedation.

This is administered by pill, but believe me when I tell you that pill is STRONG. So strong, in fact, that you will need someone to drive you to and from your dental appointment, as well as stay with you for a time afterward to ensure you are lucid and steady on your feet before you are left on your own. This will enable you to get that tooth taken care of without any pain and any anxiety. I want you to do this as soon as possible, because the earlier a cavity is dealt with, the less invasive the treatment procedure is. The longer you wait, the greater chance of it turning into a tooth infection, which is considered a dental emergency.

This blog is brought to you by West Seneca Dentist Dr. Carl Embury.
Click here to read about Mercury-free Dental Fillings.

Informed Consent with Dental Sedation? Nope

Posted on November 26, 2020 by writeradmin.

Can you advise me? I went in to get one tooth extracted and another crowned. I am a bit of a baby when it comes to dental work, so I had dental sedation. When I got home they called to see how I was and told me that they had to extract the second tooth, rather than place a dental crown on it. Then, the next day I was having some pain in my sinuses and called them. That’s when they informed me the second, unplanned, extraction perforated the sinus a little. I have had multiple complications since, including a massive infection and the need to go to an ENT for extraction of bone fragments. I want them to pay my medical care. They’re refusing on the grounds that I consented. But, I have no recollection of giving consent to the second extraction. Where do I go from here?

Alicen

Dear Alicen,

There are some real problems with the treatment you have received. First, if you were under dental sedation, you were unable to give informed consent. Period. It is poor form on their part to try to claim that. Second, the extraction technique wasn’t correct because it led to a sinus perforation which included bone being left in the cavity. Third, they didn’t inform you of the perforation until two days later. That likely led to your infection.

I’d give your dentist one more chance to make this right, which would include them paying all your follow up medical care. If they refuse, my suggestion would be to let them know you will be contacting an attorney. That should sober her. If it doesn’t, her attorney and malpractice insurance certainly will. They will tell her to settle. If you end up going to court, you’ll likely get more than just the medical expenses.

Hopefully, she will smarten up and do the right thing. If not, you’ll have to follow through. I am sorry this happened to you. I hope it doesn’t discourage you from further care.

You didn’t mention what they replaced your teeth with, if anything. It will be important to have a replacement or the remaining teeth will begin to shift or tip into the empty space. If at all possible, you should replace the missing teeth with dental implants. These are by far the best tooth replacement option available. They are the most like having a healthy natural tooth.

This blog is brought to you by West Seneca Dentist Dr. Warren Krutchick.