Dental Dreams

It was every dentaphobe’s worst nightmare.

A tooth extraction gone wrong left Ginger Frank bleeding from the mouth along with a splitting headache that lasted for two months.

“The pain level was a nine out of 10,” says Frank, a 53-year-old housewife from Ft. Worth, Texas. “I was hurting constantly, and my tooth kept bleeding.”

When it came time to find another dentist to replace her missing tooth, Frank was terrified—until she discovered sedation dentistry. The fast-growing practice involves sedating fearful patients with anti-anxiety drugs and sleeping pills for everything from routine cleanings to multiple root canals.

The use of medication to make dental patients more comfortable is certainly nothing new. For decades, dentists have administered nitrous oxide, or laughing gas, to give patients a buoyant, relaxed feeling and injections of local anesthetic to numb the area around the teeth. General anesthesia is regularly used for oral surgery and more complicated dental procedures.

But in the last 10 years, thousands of dentists have been trained to administer a new generation of oral sedatives as the latest way to coax frightened patients back into their chairs. They say these drugs offer better anxiety relief than laughing gas, lack the nasty side effects of general anesthesia and leave patients with no clear memory of painful dental work.

“It relaxed me almost immediately,” Frank says of the dose of the anti-anxiety drug Xanax that she was prescribed by her new dentist, Dr. Lorin Berland, before her implant procedure. “After that I wasn’t feeling scared anymore.”

A sleep-like experience

Sedation dentistry is sometimes advertised as “sleep dentistry,” which is misleading because patients aren’t actually put to sleep.

Instead, the medications bring about a relaxed state known as conscious sedation. Patients are awake, but feel drowsy and only semi-aware. And because mild amnesia is another common side effect of the drugs, they often don’t recall their experiences at the dentist.

Perhaps that’s why sedation patients also “tend to have less pain and recover more quickly, even after extensive work,” says Dr. Michael Silverman, a Seattle-based dentist who founded the for-profit Dental Organization for Conscious Sedation, which has taught oral sedation to more than 8,000 dentists since 2000.

Who benefits?

According to Silverman, sedation dentistry most benefits the estimated 45 million Americans who are reported by the  Journal of the American Dental Association  to avoid the dentist out of dread.

Deep-seated anxiety kept Keith Beam away from the dentist for almost 20 years despite suffering from extreme pain in his mouth. “My teeth were wobbling, and I ate a lot of soft food,” recalls Beam, a 48-year-old businessman from Pittsburgh.

Patients such as Beam often have infected gums and teeth, compromising their ability to chew and digest food. Many also lack self-confidence because of bad breath or an unattractive smile. With the help of sedation drugs, however, years of neglect can be remedied in one or two long appointments, Silverman says.

“It is very gratifying to treat these patients,” says sedation practitioner Dr. Joseph Curley. “You take someone from being completely debilitated by significant pain and poor oral health, and in one day, you can turn their whole world around.”