The business end of dentists is always moving forward as new surgical techniques are developed and new equipment becomes available. When it comes to our more nervous patients Marylebone, a mix of psychology and drug developments is changing their experiences.

Management in the practice

What is often underappreciated by those not suffering with dental aversons is that the spiral of symptoms are not amenable to reason. And that the same patients when not under pressure will in principle completely agree with the need for treatment, and will seek it out. But they will still be gripped with the symptoms of runaway anxiety and catastrophizing.

Local numbing vs general sedation

There’s been a change in general dental practices relating to those with phobias. Linking to general sedation and a greater emphasis being put on local numbing. Nitrous oxide was commonplace up until very recently. A patient’s consciousness was altered during the procedure. They often had memory impairment of the procedure due to the laughing gas and experienced the associated numbing sensation. That fell out of favour with options that do not affect the central nervous system becoming popular as they are safer to use,  and do not cause respiratory depression (a slowing down in the breathing rate). 

They were replaced with local numbing agents like novocaine and later lidocaine, which are injected directly into the area where they are required and stop any sensation. Though both novocaine and lidocaine are slight stimulants increasing people’s heart rates and breathing rates, they are a much safer option. But they can be a trigger for a lot of anxious patients who find the increase in their heart rate to be significantly disturbing and a sign of a panic attack or anxiety spiral. This lacks the calming effects of general sedation that nervous patients Marylebone need.

Conscious sedation

Conscious sedation is a return back to the general anaesthetic techniques. With the development of new drug solutions this can now be performed without respiratory depression. Also conscious sedation does not involve losing consciousness only reaching a state of great relaxation and having no memories of the procedure after sedation subsides, leading to it being referred to as Twilight sedation. 

When patients are under Twilight sedation, they can still respond to requests and are extremely calm and compliant. This makes it particularly important that you have a responsible escort with you and do not make any long-term decisions when under Twilight sedation. Also the use of heavy machinery or driving is not recommended within 24-hours of administering.

Costs and benefits

When medical decisions are being made, it often comes down to a cost. As any procedure has its drawbacks, many clinics will only provide sedation which is strictly necessary for performing a procedure painlessly. But we understand with our nervous patients Marylebone has a need for a calming form of sedation and without which many patients or simply not engage in care even something as simple as a filling.

If you or one of your family members suffer from a dental aversion and you would like to find out more about how we can help you in the clinic, please feel free to get in contact either over the phone or email.