Dissipate your dental anxiety with sedation dentistry

This story first appeared in the April 2024 edition of Healthy You, a quarterly health publication and Gazette special section.

If you suffer from dental anxiety, you aren’t alone. You can go your whole life having positive experiences in your dentist’s chair. But unfortunately, it only takes one bad experience to make it tough to get through the clinic door.

“I find a lot of my new patients that come in are very, very anxious. They are just ashamed they have let things go or ashamed of what I might find,” said Shannon Hingst, DDS at The Dental Center in Cedar Rapids.

As a certified clinician for sedation dentistry methods, her passion lies in helping people cope with their dental phobias and avoidance of oral care. “These feelings are what I try to curtail at the very beginning, telling patients this is not a place where you should ever feel shame about what you have going on. We are here to help,” Hingst said. “We understand that sometimes life gets busy, and months or years go by, so we try to be a warm and inviting place to give that patient a different mindset towards healing and being better rather than shame and fear.”

Sedation dentistry helps ease a patient’s mind to make them more comfortable for their visit, whether it be a routine screening or more invasive dental procedures. Hingst explains the three modalities of sedation she utilizes in her practice.

Nitrous oxide gas

Nitrous oxide is commonly known as laughing gas. In a dental setting, it can be used for all treatments and is safe for the overwhelming majority of people. It creates feelings of relaxation, drowsiness and the sensation of time passing quickly. Hingst explains this is a great modality of sedation, as the gas is completely exhaled after a treatment and patients are able to drive themselves home.

Anti-anxiety medications

Anti-anxiety medications for dental work are what you might think: a higher dose of commonly used medications to treat everyday anxiety. Similar to nitrous oxide, they create a more relaxed and drowsy sensation that makes a procedure easier to cope with. It is common for patients to combine a high dose of anti-anxiety medications with the nitrous oxide gas.

Intravenous sedation

Intravenous, or IV sedation, requires more specialized training. A permit is required to do conscious or moderate sedation, but it is safe when done by a trained professional like Hingst. This type of sedation is most useful for invasive procedures like extractions. Deep sedation, a more advanced form of IV sedation, aims to treat patients who might be too unhealthy or have other risk factors that disqualify them from other sedation techniques. A certified registered nurse anesthetist (CRNA) must administer this deeper form of anesthesia.

Is sedation dentistry right for you?

Hingst stresses that each patient’s body is different and responds differently to sedation techniques. This is why Hingst has a routine 30-minute consultation for patients interested in a sedation technique. In this consultation, she goes deeper into the patient’s health and medical history, focusing on any past issues with sedation or local anesthesia and the current physical capabilities of the patient.

The largest risk factors for sedation involve breathing, so it is important to be thorough with any history of lung or breathing issues. It is when patients have a greater number of medical issues or a greater severity of certain medical issues that it would not be safe for Hingst to sedate them in her office.

Just like every patient’s body responds differently to sedation modalities, every patient has different subjective feelings towards the dentist. Hingst tries to tap into these feelings to gauge what sedation technique will be most effective. She tends to start with a simple procedure to see how it goes. From there, a rapport is established that makes patients feel more comfortable in establishing a treatment plan.

In Hingst’s experience, after several months or a year of treatment, many of her patients start backing off the pharmaceutical intervention. They have controlled their fear, and the anxiety has sometimes completely dissipated. They might have some nerves the day of, but they aren’t breaking into a sweat when they walk into the door. This is the most rewarding part of the job for Hingst.

“It’s been absolutely jaw dropping to see the transformations of people that come in, take care of the disease, the pain, the fear and rebuild. Patients who have not smiled in years are now coming in beaming,” she said.