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I NEED Pain Free Dentistry

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Can you help me? My mouth is a mess and I really want to get them fixed, but my dentist has never been able to get me numb. Every appointment is excruciating. Are there different medicines to get patients numb that my dentist can try? I’ve been socializing because everyone is wearing a mask and I don’t feel as embarrassed? But, this won’t last forever and I’ll have to take my mask off at some point. I want a smile I am not trying to hide.

Bennie

Dear Bennie,

Woman covering her mouth

You don’t have to hide your smile

Yes. I can help you. The problem isn’t the numbing medication. In almost all cases when a patient has trouble getting numb, it is because they struggle with dental anxiety. There is an unusual reaction that happens. When some patients are nervous, their body burns off the numbing medication before it can do its job. When you have had bad experiences at the dentist, it is normal to have some added anxiety the next time you go.

The solution to this is to find a dentist who offers dental sedation. Sedation dentists have differing levels of medication that can help to relax you. While most sedation dentists offer two levels of dental sedation, nitrous oxide and oral conscious sedation. Dr. Imam offers a third deeper level known as I.V. Sedation.

In your situation, I would recommend starting with the middle level, oral conscious sedation. It will completely relax you and enable you to get more work done in each sitting. In fact, most patients sleep through their procedures using this medication.

Once you get your teeth and mouth healthy, then you can look into the aesthetics of your smile. I would look for a cosmetic dentist, especially one who offers a digital smile design. This will allow you to see your smile before you settle on what work will be done.

This blog is brought to you by San Antonio Dentist Dr. Imam.

Afraid of the Dentist and Want a New Smile

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I have terrible teeth. This is mostly my fault because I am pretty afraid of the dental chair. Is there a way to get my teeth healthy without feeling like I am being tortured? I have a horrible time getting numb. Once I get my teeth in order, I wondered how painful getting porcelain veneers will be.

Janessa

Dear Janessa,

woman asleep in the dental chair

You are not alone in your fear of the dental chair. Many patients go through something similar. The good news is there is a solution. Believe it or not, your dental anxiety is why you have trouble getting numb during your procedures. Not all dentists know this. What you need is something that helps bring down your anxiety level. When you’re relaxed, your numbing medication will become much more effective. In order for this to happen, you need to see a dentist who offers dental sedation options.

There are basically, three levels of dental sedation, which you can read about on the link directly above. What I’m going to do here is recommend you use the second level, called oral conscious sedation, when you have a great deal of work to do in one sitting. This is strong enough that you will need someone to drive you to and from your appointment, as well as stay with you for a few hours after the appointment until you are lucid and steady on your feet. Most patients sleep through their appointment using this.

You will find this will change your life and allow you to get your oral health back in step much faster simply because you have more work done in each sitting.

Getting that Beautiful Smile

Once your teeth are healthy, you’ll be ready to make them beautiful. To do that, you’ll want to go to an expert, artistic cosmetic dentist. Make certain you check out their smile gallery to see that you love the results they get. It’s also helpful if you go to a dentist who offers a digital smile design. That way you can see your smile before the work is done.

Porcelain veneers are the right procedure for a smile makeover. They aren’t painful. The only enamel removal is about the depth of your fingernail. A dentist will use a local anesthetic. After you experience dental sedation, you likely shouldn’t have the same problems getting numb. If you’re worried, you could always get the first level of sedation, known as nitrous oxide. This relaxes you, but you are still completely lucid and able to get on with your day immediately following the procedure. This is useful because you want to be able to enjoy your gorgeous new smile.

This blog is brought to you by San Antonio Cosmetic Dentist Dr. Imam.

Would an Oral Surgeon be a Better Option for an Extraction?

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I am going to be upfront that I’m not the best patient and know the situation I am in is entirely my fault. Several years ago, I had a filling fall out on a tooth. I avoided seeing the dentist, but there must have been an underlying infection because before too long I was in a ton of pain and unable to function. I finally bit the bullet and went to see the dentist. He did a root canal treatment. I was supposed to come back for a crown, but the root canal appointment almost did me in so I didn’t go and they didn’t follow up. Now the tooth is reinfected and so far gone that I had to go back. He said the tooth can’t be saved and has to be extracted. I sort of expected that but am now in a panic. Would I be better off having this done by an oral surgeon who can knock me out?

Lacey

Dear Lacey,

woman asleep in dental chair from sedation

Anxiety can be crippling and there are a lot of people who suffer from dental anxiety. While you can see an oral surgeon, I don’t think it is necessary for a reason I’ll share with you in on in a moment. Oral surgeons are considerably more expensive. So I want to give you a satisfactory alternative What you need is a dentist who can work with you, without judgment, to give you an anxiety-free and pain-free experience. My suggestion would be to see a sedation dentist.

How Dental Sedation Helps

There are three levels of sedation. Almost every dentist offers the lowest level— nitrous oxide. This is a gas that is dispensed through a nose piece that allows you to breathe in the gas and relax. It’s a mild form of sedation and you’ll be back on your feet and ready to get on with your day as soon as the procedure is completed.

In your situation, I would actually suggest the second or third levels of sedation. They are for patients with higher anxiety. The second level— oral conscious sedation— is administered by taking a pill. Fewer dentists use this but it is strong and worth the trip to another dentist. Because of its strength, you will need someone to drive you to and from your appointment as well as remain with you for a few hours after your appointment, until you are lucid and steady on your feet. Some patients call this sleep dentistry because you are very likely to sleep through your entire appointment.

The strongest form of dental sedation— I.V. Sedation, is available through only a small amount of dentists. Both Drs. Imam & Schroder do have it available, along with the advanced training necessary to administer it.

Another Consideration with Tooth Extractions

Whenever you lose a tooth, it is important to replace it as soon as possible. Leaving a space open for very long will cause the nearby teeth to shift or tip into the open space. This will throw off your bite, eventually leading to TMJ Disorder, along with a lifetime of jaw pain and migraines.

The best replacement is a dental implant. It will be like having a healthy, natural tooth in your mouth again.

This blog is brought to you by San Antonio Cosmetic Dentist Dr. Imam.

Why Couldn’t My Dentist Numb Me?

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I had a tooth which was only partially dead but needed to be extracted. My dentist tried several times to get me numb and just couldn’t. The appointment was excruciating. He apologized and decided he’d reschedule me and we’d try again. He didn’t charge me for the first appointment. I’m a bit nervous about going back after the first experience. Have you seen this before? Is there a solution?

Cody

Dear Cody,

man holding his jaw in pain in need of a dentist

I have good news and better news. Yes, I have seen this. Even better, I know the solution. Many dentists do not realize that anxiety actually speeds up your metabolism briefly. That results in you burning off the anesthetic much sooner than you otherwise would be capable of doing under normal circumstances. This is why your dentist couldn’t get you numb. He’d inject the medication, your anxiety took off, which in turn burned off the anesthetic. Each time it didn’t work your anxiety went up making it burn off even faster. At that point, there would be no way for your dentist to get you numb. I am glad he showed enough compassion to stop, as I’m sure you are as well. Some dentists would have callously just pushed through, which is one of the reasons so many people have dental anxiety to begin with.

The Solution to Dental Anxiety

Because your dentist wanted to do research on this, I don’t think he will be offended by you showing him this blog post. The best solution for patients with anxiety is dental sedation. In some cases, just using nitrous oxide is enough to relax some people. Others, however, have such severe anxiety that nitrous isn’t enough.

In those cases, you need oral conscious sedation. This is administered by a pill. It is STRONG. It will be necessary for someone to drive them to and from your appointment. You will be in no condition to drive. Additionally, they’ll need to stay with you for a few hours after your appointment until you are lucid again and steady on your feet.

This blog is brought to you by San Antonio Cosmetic Dentist Dr. Imam
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