SEDATION
DENTISTRY
What
is Dental Phobia?
Ambling along
an innocent-looking road, you pass a sign for a dental surgery.
Immediately, your heart starts racing, you can feel the heat
rising to your face, and you become shaky and nauseous. Argggh,
not yet another reminder of the dreaded D-word - better cross
that road and face the other way! Is that you? You may be one
of the many people who suffer with dental phobia!
So what
IS dental phobia?
A "phobia" is traditionally defined as "an irrational
severe fear that leads to avoidance of the feared situation,
object or activity" (even though the Greek word "phobia"
simply means fear...). Exposure to the feared stimulus provokes
an immediate anxiety response, which may take the form of a
panic attack. The phobia causes a lot of distress, and impacts
on other aspects of the individual's life, not just their oral
health. Dental phobics will spend an awful lot of time thinking
about their teeth or dentists or dental situations, or else
spend a lot of time trying NOT to think of teeth or dentists
or dental situations. Which is pretty hard in today's society,
which is saturated with ugly reminders such as toothpaste commercials.
The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV)
describes dental phobia as a "marked and persistent fear
that is excessive or unreasonable". It also assumes that
the person recognizes that the fear is excessive or unreasonable.
Conclusion? The DSM-IV criteria were obviously not decided upon
by a representative group of dental phobics.
Having said
that, there is a new revised version coming out soon, so maybe
the definition will have changed. You might be interested to
learn that DSM-IV's predecessor, DSM-III, defined homosexuality
as a mental disorder... I'd hazard a guess that most dental
phobics would object to being labelled as suffering from a mental
disorder.
This is not
to say that dental phobia cannot co-occur with psychiatric disorder
- of course it can. Dental phobia appears to be more common
in people who suffer from another psychiatric disorder, notably
Generalized Anxiety Disorder, agoraphobia, depression, and emetophobia.
Research suggests that about 20% of dental phobics have a concurrent
psychiatric disorder. The main problem in defining "dental
phobia" is that there isn't just ONE type of dental phobia,
but many types - some rational, and some which seem more "irrational".
Bracha and others
(2006, HI Dental Journal) have suggested that the term dental
phobia is typically a misnomer, for much the same reasons I'm
outlining here (you can find the abstract of their article at
the bottom of this page).
Whether the
fear is "unreasonable", "excessive", or
"irrational" is debatable... certainly not if you
end up in the hands of the wrong dentist! Which, incidentally,
is one of the reasons why people end up as dental phobics in
the first place...
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The
difference between anxiety, fear and phobia
A distinction
has been made between dental anxiety, dental fear, and dental
phobia.
DENTAL
ANXIETY is a reaction to an UNKNOWN danger.
Anxiety is extremely common, and most people experience some
degree of dental anxiety especially if they're about to have
something done which they've never experienced before. Basically,
it's a fear of the unknown.
DENTAL
FEAR is a reaction
to a known danger ("I know what the dentist is going to
do, been there, done that - I'm scared!!"), which involves
a fight-or-flight response when confronted with the threatening
stimulus.
DENTAL
PHOBIA is basically the same as fear, only much
stronger ("I know what happens when I go to the dentist
- there's no way I'm going back if I can help it. I'm so terrified
I feel sick"). Also, the fight-or-flight response occurs
when just thinking about or being reminded of the threatening
situation. Someone with a dental phobia will avoid dental care
at all costs until either a physical problem or the psychological
burden of the phobia becomes overwhelming.
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SEDATION
DENTISTRY - Pain Free Dentistry
Sedation dentistry allows you
to be sedated just enough to be pain free and unaware of the
treatment, as if you were relaxing. That is why it is normally
referred to as conscious sedation dentistry. So if you have
sensitive teeth, a fear of dentists, have a bad gag reflex,
hate needles, or have limited time to spend on dental care at
the dentist, Sedation during dentistry procedures can help you.
Whatever the
case may be sedation by your dentists can help you be more anxiety
free during your dentistry treatment. Your dentist's ultimate
goal is to make your visit to the dentist a relaxing and enjoyable
one. Since you are completely comfortable, relaxed, and pain
free your sedation dentist can do years of dental treatments
in one or two dental visits.
With sedation
your dentist can restore sore gums to good dental health, fix
a chipped tooth, replace crowns or dentures, whiten yellow or
stained teeth, and more. All
pain free.
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Sedation
Dentistry
Conscious Sedation
What is Conscious
Sedation ?
Conscious Sedation is defined
as a minimally depressed level of consciousness that retains
the patient's ability to independently and continuously maintain
an airway and respond appropriately to physical stimulation
and verbal command and that is produced by pharmacological
or nonpharmacologic method or combination thereof.
Sedation Dentistry, sometimes
called Relaxation Dentistry, refers to the way dentist's manage
Pain and Anxiety during dental appointments.
Unlike General Anesthesia
where a patient is completely unconscious, asleep, and unable
to respond, patients under Conscious Sedation, are able to
respond to commands and breath on their own.
There are actually 14 different
ways that sedation drugs can be administered. There are 3
primary ways that Sedation is administered in the Dental Office:
1. IV Sedation
also known as Deep Conscious Sedation is usually used by Oral
Surgeons and dentists with specialized training and special
certification. With this type of sedation, medications are
administered directly into the blood stream. The greatest
advantage of IV Sedation is that if someone is not sedated
enough, the doctor can administer more medication and the
effects are instantaneous. IV Sedation is not used commonly
in most dental offices because of the specialized advanced
training required and the requirements for certification by
the State Board of Dentistry. The drugs used for IV Sedation
are more effective then the same drugs taken orally. There
is a more profound amnesia associated with this technique.
2. Enteral
Conscious Sedation "Orally Administered Sedation",
sometimes called "Sedation Dentistry" is administered
by taking a pill. All body functions remain normal and the
person is able to breathe on their own. The patient will often
fall asleep. Some degree of amnesia is common. The disadvantage
with this method of sedation, is that the level of sedation
for each person is not predictable.
3. Inhalation
Conscious Sedation, Nitrous Oxide/Oxygen Sedation also known
as "laughing gas". This is the most frequently used
sedation method used in dentistry. All bodily functions remain
normal and the person is able to breathe on their own. The
patient will often fall asleep and experience some degree
of amnesia about what happened during their dental appointment.
Inhalation Sedation has been used my dentists for many years.
The 2 most common types of
Sedation (Sedation Dentistry) used by General and Restorative
Dentists who utilize sedation are:
