For Those Who Fear the Dentist, Help Is Here

Jan. 6, 2007 — -- For many people, a trip to the dentist is no walk in the park. Needles, drills and other scary-looking tools of the trade make it hard to sit still while the dentist gets down to business.

Cheryl Gillespie is so terrified of the dentist, she's canceled and postponed appointments multiple times.

"Once I sit in the chair, it's like my hands grip the sides of the chair and I can just feel it in my stomach. You know my stomach just gets in a knot," she said. "There was one point that I didn't go for five years, which I'm embarrassed to say."

So when Gillespie had no choice but to get a new crown for a chipped tooth, she decided to undergo "conscious sedation" -- an increasingly popular procedure that her dentist, Dr. Jason Kasarsky, has been using for seven years.

The practice entails giving the patient -- usually one who has dental phobia, like Gillespie -- periodic doses of a sedative during dental procedures. Patients remain awake and aware of everything that's happening inside their mouths, but they're relieved of the anxiety that usually comes with the visit.

Kararsky gave Gillespie a pill of triazolam. Extremely nervous patients sometimes get a dose of nitrous oxide in addition to the pill.

Kasarsky said triazolam works by turning off or toning down receptors in the patient's brain. Even though Gillespie felt every touch, she feared nothing.

"Her legs -- they were crossed, now they're kicked back as if they're home on a couch," Kararsky said shortly after giving her a dose of the drug.

Gillespie was astounded by how smoothly the procedure went.

"It's absolutely amazing," she said afterward. "I mean, the whole time, I'd be carrying on that conversation, but I'd be very relaxed, no apprehension at all."

Sedation Not for Everyone

While the American Dental Association recognizes sedation dentistry as a very safe procedure, there's some concern about impatient or unskilled dentists who may oversedate their patients.

"If the patient is overdosed, they could lose consciousness and that could include a problem with their breathing," said Dr. Joel Weaver of the ADA.

The ADA also urges consumers to note possible side effects, such as drowsiness, blurred vision and temporary memory loss for a day or so.

Sedation dentistry isn't right for everyone.

Kararsky said people who fear dentists and are in good health -- with no or mild systemic health issues -- are good candidates for the practice.

Those with heart problems, untreated asthma, thyroid problems, or drug or alcohol abuse issues are not. Pregnant women and overweight people should also avoid sedation dentistry.

Tips for Undergoing Sedation Dentistry

Make sure your dentist has a sedation permit or license, if that's required in your state. Check your dentist's credentials with a local state dental board and make sure their practice follows the ADA guidelines.

Have a brief interview with your dentist -- ask where he or she was trained and the response plan is in case of emergency.

Be prepared to be your own advocate and find a dentist and staff who are caring. The practice you choose should have a consent form for you to sign, so you're clear on your rights and the potential side effects.