Dental anxiety is very common in dental patients. Anxiety can come from many different sources. Patients also differ in degrees of anxiety. Thanks to modern dentistry, we can treat this accordingly with a high level of success.
Reasons for anxiety are as different as people, but some are more common than others. The most common source is a past bad experience. This is most often from childhood experiences before modern anesthesia and techniques. Another source is phobias of the sights and sounds of the dental office. Many patients don’t like the sounds of drills but unfortunately, they are a necessity. Some patients are simply afraid of needles, and this is very understandable.
Mild: Like reasons for anxiety, degrees also differ from person to person. Some folks are simply a bit nervous anytime they walk into a dental office. They can have slightly elevated blood pressures once they pull into the parking lot which goes down as fast as they exit the front door.
Moderate: Other patients get uncomfortable when they see a needle or hear the drill. Many patients are nervous about the anesthetics. Some patients can be so uncomfortable that they have an increased risk for stroke or heart attack due to the spike in blood pressure that anxiety can produce. Many of these patients avoid dental work altogether which only worsens their problems later
Severe: Other patients, when severe, can not sit still when the dentist is working which endangers them due to the instruments in close proximity to the face/eyes/mouth. This also makes work extremely difficult for the dentist not allowing him to do a good job.
Nitrous Oxide: “Laughing Gas” has been around for years and is very effective for mild anxiety or to help people get through the shot. It is very quick acting and will help you feel relaxed while not altering your senses or reflexes much. This is very safe and the effects wear off after breathing 5 minutes of oxygen so you are able to leave under your own supervision.
Oral Sedation: Many drugs are available to treat anxiety. My most commonly prescribed are Halcion and Ativan. They are similar but much improved than valium. They are taken the night before and 1 hour before your appointment. You will be coherent and under your own motor support, but you will be unaware of your anxiety. Your senses and reflexes will be dulled allowing you a comfortable experience in which you don’t remember as many details. You will need to be driven to and from your appointment.
IV Sedation: Drugs like Versed can be given intravenously that will sedate you to a near unconscious level. This is only used in severe cases of anxiety or when major work such as oral surgery is to be performed.