Posts for tag: IV sedation

Can I take Xanax before my dental appointment to help manage anxiety?

If you are attempting to take a sedative or sleep agent prior to your dental appointment, you will need to notify the dentist IMMEDIATELY. Sedatives impair your decision making ability as well as cause issues with your ability to drive. Sedatives can also promote respiratory depression if used incorrectly and the dentist may not have appropriate training to manage your care under the influence of a sedative. Self dosing is not acceptable as the dentist needs to be making the assessment and diagnosis based on the extent of the work as well as the time needed. If you are taking any sedatives/sleep agents, please notify your provider immediately so arrangements can be made.

Does Dental Insurance Cover Sedation Procedures for Dental Work?

 

It varies from insurance company to insurance company and from procedure to procedure. Most dental insurance companies will cover multiple extractions under IV sedation and certain surgical procedures; however, routine dentistry such as cosmetic work and fillings are not typically covered. Insurance companies will also only cover up to a certain amount of time so if you had dental work that would take 3 hours...your insurance company may only be responsible for 1-2 hours leaving the patient responsible for the remaining time.

Talk with your dentist about your coverage and or contact the insurance company. Questions you should ask your insurance company:

 

1. Is oral, IV, or laughing gas sedation a covered service?

2. If so, are there limitations on sedation based on procedures and amount of

work that is needing to be done?

3. Is there a frequency or time duration limit on the sedation?

4. Do they require preauthorization before treatment is performed?

5. What is my financial responsbility for the sedation portion of the dental work.

What Kind of Dental Work Can Be Done Under Sedation?

 

Most dental procedures can be performed safely under sedation such as fillings, crowns, root canals, deep cleanings, extractions etc. The more important limiting factor is the amount of work that needs to be accomplished as the type of sedation will determine how much work can be completed. For example, more extensive work can be performed acceptably and much safer under IV sedation versus oral sedation or laughing gas. The type of sedation prescribed to the patient is based on medical history of the patient, level of anxiety and the amount of dental work needed!

Question: Can sedation help if I have a really big gag reflex?

 

Answer: Yes, sedation can minimize and often times completely eliminate it completely. The gag reflex refers to the response cause when the tissue in the back of the throat is irritated. There are multiple nerve endings located in the back of the throat and the "uvula", the flap of tissue that hands down in the throat and vibrates when a person says "ahhhhh". When foreign objects come in contact with this area such as impression material, filling material, cotton, the gag reflex is stimulated further producing a vomiting response. There is a great deal of variety of the intensity in gag reflex from person to person.

 

There are multiple treatment modalities to help improve or lessen the gag reflex. Topical anesthetic spray can be used at the back of the throat producing numbness or suppression of the gag reflex within seconds and up to 15-20 minutes. Nitrous oxide, aka laughing gas, can also work on the higher centers of the brain to also help with reducing gagging. If topical spray and laughing gas are not sufficient, oral and/or IV sedation can likely remove all the normal gag reflex reactions. With sedation, the muscles in the mouth and throat are more relaxed decreasing the likelihood of a gag reaction.

 

With sedation, routine dentistry, impressions, extractions, etc. can be accomplished in a short amount of time while minimizing the gag reflex often encountered in patients.

Question: Are there ways to do dentistry with out the pain or a needle or sound of a drill?

 

Answer: Yes there are, but they are somewhat limited in what they can treat. For example, to not need a needle for treatment either the cavity has to be very small or the dentist uses something called "Air Abrasion" or "Laser Dentistry". These are technologies that enable the dentist to fix cavities without using a needle or drill however they are not as effective when the cavities are deep (close to the nerve) or the tooth is sensitive.

 

I think an injection is much better for pain control and is better for eliminating the "what if I feel this". An injection can almost be next to painless and the discomfort can be controlled by

1. The strength of the topical gel

2. The manner the injection is given by the dentist.

 

I have a very simple rule...if I can't get you numb, I will not work on you that day...sometimes people just don't numb up well and it's hard to explain why but rest assured that if you are uncomfortable then I am too so I will not make you do anything that is uncomfortable! We generally have great success in getting you more than adequately numb which gives you a very comfortable, pleasant experience. Nitrous oxide(laughing gas) will often help drown out some of the sounds of the drill and also with analgesia(pain relief) during the procedure.

 

Regarding the sounds of the drill, we always play music while we are working..I don't like the sounds any better than my patients do? I love music from the 80s and 90s so there is always music in the background or we will play whatever music you like. We also play movies if you prefer to listen to a movie and if that's not enough...I might even sing or dance for you!

 

Back to the original question, the use of injections(i.e. the needle) as well as the handpiece(i.e. drill) is sometimes unavoidable no matter how gentle we are. If this is a concern, then sedation dentistry may be a great way of assisting in eliminating the apprehension/anxiety of these procedures as well as waking up and not remembering what happened.