Nitrous Oxide Sedation

Help for the Nervous Dental Patient:
Nitrous Oxide Sedation

How common a problem is the fear of dental treatment?

Looking at U.S. to 75% of the population has some degree of fear of dental treatment ranging from mild to severe, while 5 to 10 % are so fearful of dental treatment that they will not go to the dentist unless they are in severe pain.

Why are people afraid of dental treatment?

1.  Memories of bad dental experiences as a child or adult that was painful or unpleasant.

2.    Some patients have anxiety issues in other areas of their life, not just towards dental treatment. For example these patients may suffer from panic attacks or may already be on anxiety medication for generalized anxiety.

3.  Feelings of loss of control also make some patients nervous in the dental chair.  Some patients feel very vulnerable during dental appointments

Earlier we spoke about some of the reasons people do not like coming to the dentist and why some people avoid going to the dentist.  This raises the question:  can having dental treatment be a painless experience and are there things your dentist can offer you to take the fear out of dentistry?  The answer to both of these questions is a resounding yes!

Can going to the dentist be a painless experience?

Here are some things that can either reduce or eliminate pain and/or fear associated with dental treatment:

1. The first step towards a better experience is an honest, frank discussion with your dentist when you first meet him or her or at your next visit discussing your fears and/or apprehension towards dental treatment.

Some patients are too embarrassed to tell their dentist they are afraid.

I always ask new patients to tell me if they are nervous about having dental treatment and if so, what aspects of dental treatment are they afraid of.  For example, is it just the freezing?  Is it the sound of the drill or is it something else?  Telling your dentist about past unpleasant dental experiences can help them avoid triggers that made you anxious in the past.

2.  Understanding the nature of your dental condition, (that is whether you have a cavity, gum disease or an infected tooth,) and how the problem can be corrected can be helpful in reducing fear and can make your dental appointment easier for you.    You should be told how long a treatment will take, and how many appointments will be required.

During an appointment I tell my patients what we are doing during each step so there are no surprises.

Dental treatment should not be painful…however it is not a perfect science, so before I start treatment I tell my patient:

“You shouldn’t have any discomfort when we treat you today, however, if you feel anything at all or if you need me to stop what I am doing for any reason you just have to raise your hand right away and I will stop.”

And if their hand goes up I do stop.  Using this technique builds trust between patient and dentist and also gives patient a feeling of being in control while they are in the chair.

Should dental treatment hurt?  Is it truly painless?

The majority of treatments that I do in a given day are painless but there are times when my patients will raise their hand and stop me while I work.  This is the nature of dental treatment.

If you are having a treatment done e.g. a filling and you are still having discomfort, your dentist should stop right away if you raise your hand or otherwise let them know.  Usually, the sensitivity can be remedied by giving more freezing or by using special freezing techniques that deliver more anesthetic to the area where you are being treated (which occasionally may be required especially when treating the lower back teeth, i.e. the molars).

Most dental treatments can be delivered virtually painlessly and it is a myth that dental treatment is supposed to hurt.

Before the freezing, I find it helpful to use anaesthetic spray or gel on the gums, and let it sit for a full minute.  This pre-numbing can make the freezing quite painless.