Baton Rouge Dentist

Am I immune to anesthesia or do I need a new dentist?

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I don’t know what is wrong with me, but every time I have to get a cavity filled at the dentist, they can never get me numb. I really don’t like going to the dentist anyway, so when I have to get a filling, it is terrible. They do one shot and wait. They do another shot and wait. It’s not fun. Is it me? Am I just immune to the anesthesia? Is it my dentist? Does he not know what he’s doing?

Cal

Dear Cal,

You didn’t mention much about your past experience at the dentist, except that you don’t like to go. If your past includes some kind of traumatic experience at the dentist, that experience could be playing a part in why you have a hard time getting numb when you have dental procedures.

There are cases when anxiety and stress prevent novocain from working correctly. Why still isn’t completely understood. It may be muscle tensity, the body’s chemistry, or some other factor, but the numbing action of the novocain doesn’t complete or it wears off very quickly.

Sedation dentistry to the rescue

If you feel that anxiety and stress describes you, sedation dentistry may be a good avenue for you. Sometimes starting with nitrous oxide, or laughing gas, can help you relax enough for the novocain to work properly. Nitrous oxide alone is enough for some patients to be able to get their dental work done comfortably. If you still aren’t comfortable, you can try conscious sedation dentistry. You would take some medicine to help you relax before your appointment, but you don’t sleep. You are just very comfortable, so much so that you may not even remember the appointment.

If you haven’t had a bad experience in the past that would lead you to feel anxiety and struggle for novocain to work, it may not be a bad idea to try a different dentist. There are dentists who are especially good at gentle dentistry.

This post is sponsored by Dr. Ryan Perry in Baton Rouge, LA.

Why can’t my son’s dental work all be done in one appointment?

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We had a regular visit with my son’s pediatric dentist today. It was very frustrating. We were told that my son not only has to have several cavities filled, but he also needs to get caps on a couple of teeth. The frustrating part is that the dentist won’t just sedate my son and get it all done in one appointment. I have to bring him back several times over several weeks. Why? Is the dentist just trying to make more money off of me than he’s going to anyway?

James, Hyde Park, MA

Dear James,

Boy at the dentist's office

By stretching the work your son needs to be done over several appointments, it may seem that the dentist is trying to pad his pocketbook. As adults, we are often able to use sedation dentistry to get a lot of work done quickly and in the most comfortable manner. Unfortunately, that’s not always the best scenario with children and your son’s dentist may feel such.

It’s not a standard practice for most pediatric dentists to use sedation on children. Some think that when people are sedated during an appointment, they are asleep. This isn’t true. The medication used for sedation helps a patient be very calm and relaxed, so much so that they may not even remember much about the appointment, but they aren’t asleep. Dentists need their patients to be able to follow simple commands.

Why not use sedation?

Sedation does deal with medication, and with any medication, there may be side effects. Although patients under sedation are closely monitored, it’s not always recommended for children.

Another reason sedation isn’t routinely used is that pediatric dentists are used to treating children. It’s not unusual for their patients to feel scared or nervous, or for their patients to have considerable work to be done. Most likely your pediatric dentist has experienced your son’s same scenario several times and knows from experience how to get the work done in the safest, most comfortable, and reasonable way. Unfortunately, this isn’t always the most convenient way or the cheapest.

Speak to your son’s dentist before the work on his teeth begins and ask questions. He may be willing to work with you to create a treatment plan you are comfortable with or that is affordable. If you are still concerned, you could always get a second opinion for your son’s care.

This post is sponsored by Dr. Ryan Perry a family dentist in Baton Rouge, LA.

Broken tooth must be pulled – do I need an oral surgeon?

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I lost a filling in one of my molars a few years ago. I lived with the missing filling for quite a while, but then the tooth broke, and it got too painful to ignore. I had a root canal treatment done, but never went back in for the dental crown placement, because I just can’t handle that much time in a dentist’s office. The temporary filling fell out about six months later, and I learned to work around the tooth, but recently it has become really painful again. I know I have to go back in, but I can hardly stand the thought of it.

I saw a dentist and he told me the tooth is infected, and that there really isn’t enough of it to save. He said that it has to be pulled, and that the condition of the tooth means they will have to cut both gum and bone. He said it would be best to have an oral surgeon do this under anesthesia, especially given my anxiety about dental work, but that is just not in my budget. He said he COULD do the procedure under a local, but that an oral surgeon would be best.

My question is, can most general dentists competently handle this type of procedure? I don’t want to spend all that extra money to go to an oral surgeon, but every time I think about getting it done my heart pounds and my hands sweat and I feel sick. Pretty intense. I think I’ll calm down some if I think my dentist is really competent to handle this.

William in Orlando

Dear William,

It sounds like you really need to a have a candid conversation with your dentist. Either he is comfortable doing the procedure, or he isn’t, and it sounds as if he will be honest with you about that. It is also encouraging that he has acknowledged that your fear needs to be considered and handled with compassion. You could also consider seeking the services of a dentist that does sedation dentistry, which they may also advertise as gentle dentistry. Very often, the use of nitrous oxide with an oral sedative is the right combination to reduce anxiety and control pain so that the appointment is much less traumatic.

This blog post courtesy of Baton Rouge dentist Dr. Perry.

Treatment while in recovery

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I have a problem. I need extensive work on my teeth, and I get really freaked out about going to the dentist. This wouldn’t be a problem for most people, but I am on methadone maintenance for opiate addiction. The last time I tried to get  some of this work done, the dentist refused to give me any pain medication at all after I told him about the methadone. There is just no way I can face the kind of work I need done without pain medication. We are talking about multiple root canal treatments.

What should I do? I tried to have him call the doctor at the clinic, even gave hime the phone number, but he refused. Obviously I need to go to a different dentist, but how do I avoid going through this all again?

Thank you in advance for your advice and help.

Marcy in Los Angeles

Dear Marcy,

Many dentists will not risk attracting the interest of the Drug Enforcement Administration. You’ll need to find a dentist who is more concerned with being compassionate.

You need to locate a dentist who does sedation dentistry. Talk to them honestly about what they can do to help you with pain, both during and after surgery. Your instinct to have them talk to the doctor who is in charge of your methadone care was a good one–your doctor may be your greatest support in getting a dentist on board to get you the treatment you need.

The office of Baton Rouge dentist Dr. Perry support the provision of this blog.