Re: Need Help Local prob ... is Halcion the answer??
From: W_B (no_one_at_nowhere.net)
Date: 09/05/04
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Date: Sun, 05 Sep 2004 07:41:44 GMT
Halcion or Valium is not that expensive.
When encountering a patient with this kind of attitude ...
... punt.
Just my 2¢
W_B
On Sat, 04 Sep 2004 22:12:05 -0400, Steven Bornfeld
<dentaltwinnospam@earthlink.net> wrote:
>
>
>Emily wrote:
>> Hi,
>>
>> I have a pretty good case of dental anxiety myself. This year I had to have
>> two root canals (both with crowns) and a replacement crown, and I elected to
>> use oral sedation twice. My dentist uses nitrous oxide and novacaine as
>> well during the oral sedation.
>>
>> The first appointment, I don't remember a thing until I sorta came to while
>> they were working on the last tooth. I felt a little wince of pain (this
>> tooth had always been sensitive and hard to numb up; it was an upper tooth)
>> so made a noise and pointed, and they quickly gave me another shot (which I
>> didn't feel at all), and I dozed back off. No more pain.
>>
>> The second appointment, I was not as asleep when I arrived at the office; I
>> was very drugged up but still conscious, and when she started working on the
>> tooth (a different one), I felt a little something, again made a noise and
>> pointed, got another shot, and promptly dozed off for the rest of the appt.
>> I have only very vague memories of either appointment, and only a few bits
>> here and there, so the amnesiac aspect is there, but not complete (at least
>> for me).
>>
>> My dentist uses a combination of Halcion with one other medication I can't
>> recall now. It's incredibly expensive since she doesn't write a fillable
>> Rx, just gives you the meds. You take Valium the night before, then the
>> Halcion + other med the morning of the appointment, then someone else drives
>> you there and back. Both times I got home and napped for a couple more
>> hours after the appointments, and was pretty well wiped out the rest of the
>> day. It cost around $375 each time for the oral sedation (not covered by
>> insurance, of course), which is outrageous for three little pills, but in
>> light of my anxiety, I was willing to pay that not once but twice!
>
>
> Well, I am not prepared to say whether this fee is unusual or not. But
>you are certainly not paying $375 for "three little pills"--you are
>paying for the training, and certification of the dentist, as well as
>the knowledge in how to manage your sedation.
> Administering sedation used to be fairly uncomplicated
>administratively, but in some states (New York, for example) being
>certified in enteral and parenteral sedative use is a pretty involved
>thing. (I am not certified myself.)
>
>>
>> However, given the fact that I did feel some pain at both appointments *even
>> after a shot of novacaine and with nitrous* and had to request another shot,
>> I cannot imagine getting through the appointments on the oral sedation
>> alone. My pain tolerance is very low, though. Yours might be higher,
>> especially since you've managed to have dental drilling done with only
>> nitrous in the past (I could not do that - never ever). I don't mind the
>> shots nor the after-effects (just numbness for a few hours, nothing
>> long-term like what you've experienced). I just don't want ANY pain from
>> the drill.
>
>
> There are two issues, as you've said--anxiety and pain. If there is
>pain, the level of sedation necessary to allow treatment will need to be
>much deeper.
> Back in the dark ages of my residency, even folks undergoing dental
>surgery under general anesthesia in the operating room got a local.
>
>Steve
>
>>
>> So....I don't know what to tell you. If you didn't get the after-effects
>> from the needle, I'd say to go for the local since while you're sedated it
>> will not bother you one bit to have the shots, I don't think. I guess it
>> depends on how bad the after-effects are that you get. I wish I could say
>> you'll feel no pain with Halcion, but I can't. I know that *I* would feel
>> pain!
>>
>> Good luck!
>> Emily
>>
>> "Synergie" <wlmcdonald@accesswave.ca> wrote in message
>> news:XQo_c.58708$vO1.318709@nnrp1.uunet.ca...
>>
>>>I have very deep anxiety with dentistry... I still force myself to go,
>>>and when I have needed work, I have insisted on the use of nitrous
>>>oxide. My fear deals mainly with the needle. I won't let them give me
>>>local.... at all! Because of this, I suffered through an appointment of
>>>a very deep filling with no freezing, and only nitrous oxide. It used
>>>to work better when I was younger, almost knocking me out and making it
>>>so I didnt need any freezing. But that last appointment, I felt
>>>everything, and was too scared to let them know because I knew they
>>>would drag out the needle.
>>>
>>>Now to the present.... I need another filling fixed. I didn't want to
>>>try the nitrous again as I believe that the last dentist did not use
>>>enough percentage or something. My current dentist (and I am only
>>>switching dentists because I am in the military and we get who we get)
>>>anyway she doesn't use nitrous anyway and suggested oral sedation, more
>>>specifically Halcion. I have a prescription for .25 mg the night before,
>>>.25 mg an hour before the appt and and extra pill to bring with me in
>>>case I need it. The plan is to do the work with no local at my request.
>>>Do you think that I can handle it under the Halcion without the local?
>>>
>>>And just for background... the issue with freezing was brought on by not
>>>just fear, but also the fact that every time I ever got it when Iwas
>>>younger, my jaw would always be very sore afterward, sometimes lasting
>>>several days. The dentist would never listen to me, and always tried to
>>>say it was just because I was holding my mouth open for a long period of
>>>time. But when i switched to just Nitrous, I had no soreness after. It
>>>seems like the soreness is always located right where the injection site
>>>was. The bottom ones were the worst. I would not be able to fully open
>>>my mouth for 3-4 days and had to take mortin etc just to be able to
>>>function. Am I a complete oddball that local affects me this way?
>>>Should I just be 'biting the bullet' so to speak and live with the
>>>soreness after? Because I really am more comfortable with dealing with
>>>the pain of the drilling during the apt than 3-4 days of nagging
>>>soreness after. They think at my dentist office that I am wimp and an
>>>anommoly. I hope that the Halcion puts me out enough to deal with the
>>>pain of the drilling, and I hope it has the amnesic effect that they
>>>told me about.... I don't want to remember the appt.
>>>
>>>Please someone answer my questions... The appt is still several weeks
>>>away and I am already losing sleep over it.
>>>
>>
>>
>>
-- W_B wubbabubbazG@RBAGEyahoo.com Take out the G'RBAGE
- Next message: Sue Shelton: "surgery?"
- Previous message: W_B: "Re: Vitamin D Is Good for Your Gums"
- In reply to: Steven Bornfeld: "Re: Need Help Local prob ... is Halcion the answer??"
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