Dr. Nammy talks about people who have anxiety about the dentist, and how sedation dentistry can help these people to relax and feel more comfortable getting dental work done, which can lead to improvements in both dental and overall health.

John Maher: Hi, I’m John Maher, and I’m here today with Dr. Nammy Patel, founder of Green Dentistry in San Francisco, California, helping patients recognize the vital connection between dental health and whole body health, and author of the best-selling book, Age With Style: Guide to a Youthful Smile and Healthy Living. Today our topic is sedation dentistry. Welcome, Dr. Nammy.

Dr. Nammy Patel: Hi, John. Thank you for having me. I’m so excited to talk about sedation dentistry, because it is such a great resource for patients who are scared of coming to the dentist.

What Is Sedation Dentistry?

John: Yeah, a lot of people are nervous about going to the dentist. They think it’s going to hurt, maybe they haven’t been in a while, and they’re afraid of getting scolded by the dentist, or that sort of thing. So, talk a little bit about what sedation dentistry is, first of all.

Dr. Nammy: Sedation dentistry is, in our practice … There’s multiple ways that you can do sedation dentistry. There’s something as simple as nitric oxide. There is a Valium, which is my preference. It’s a small pill that you take just to help relax. It’s like having two glasses of wine, and you’re very comfortable.

There’s also general anesthesia, which is where they put you completely under; it’s like what you would do if you went through open-heart surgery. In dentistry, that’s not what we’re really talking about. We’re talking about the basic procedures, which are really taking a Valium a majority of the time, so that way you feel really comfortable and dentistry can be done. You take a little nap, you wake up, you’re feeling fine.

It’s a pill, so there’s no needles involved or anything like that, and it’s very comfortable for patients. I find that patients come back saying, “Oh my gosh, that was the best sleep I’ve ever had. I’m so glad we were able to get all the dental work done in one day.” And it’s just like that feeling that we get, like “thank God it’s over, and I was able to get through it.”

And it’s really wonderful because it also helps us feel that we can conquer going to the dentist. Not only are we able to get through the experience, it actually gives us motivation to continue to keep going, which is really nice.

Sedation vs Novocaine

John: So is the sedation different than if you have to do a procedure on your mouth or your gums and you’re numbing the gums with Novocaine or something like that? Is that different than the overall sedation that you’re talking about?

Dr. Nammy: Novocaine is a local anesthesia. So that means it just helps you not feel the pain. We always do anesthesia to make sure the patient is comfortable and you are pain-free. Now, sedation is just to help the anxiety. So it helps calm our nerves and it just helps us be more relaxed and puts us in a little sleepy state, so that way we are able to get through the actual procedures being relaxed.

Is Sedation Dentistry Right For You?

John: Right. So when is sedation dentistry the right choice for a patient? And how do you know before you get a patient in the chair that you’re going to go ahead and use sedation?

Dr. Nammy: So the number one reason why there is fear is because there’s absence of trust. So one of the first things I do is that, when I sit down … or actually a bad experience, I take that back. There’s two reasons. Number one, a bad experience, and that leads to an absence of trust. So one of the things that I do with patients is I always interview them first and I always like to get to know them. What occurred? When did it happen? If you had a bad experience, I want to know a little bit more about it, just so that I can ensure that we’re taking the necessary steps to make sure you are super comfortable during the visit. And if it’s noise of bothers you, we have noise cancellation headphones. If it’s you get cold, we have blankets that we can give you. We have aromatherapy to help calm the nerves.

The main reason we have all these things is really to build the first step, which is a foundation, which is just trust. If we have trust, then we have everything. If trust is broken, that’s when fear sets in. So the first step, regardless of sedation or non-sedation, we always sit down and build an honest relationship and say, “These are my expectations.” And I can say I can deliver them or not. I’ll be really honest about what to expect. What is it that you should do? What you should not do. You figure out this treatment plan. You go through the finances. You make sure that all of that stuff is ironed out of the way and you’re educated. And then we start the process and we get, “If you’d like sedation, we’re more than happy to do that for you, because it’s really as simple as taking a small pill that just helps you relax.”

Personally, I have a lot of fear of going to the dentist. So when I have had to have surgical procedures done on my teeth, I would take a sedation pill. They would put me to sleep, so that way, I wouldn’t know what’s happening, how it’s happening. It would just be done, and I am done with the process and I can focus on healing. So that has been my mode of treatment. I find that with patients who are extremely phobic or extremely scared, it works really, really, really well, especially for a longer procedures.

If we’re going to do surgical procedures, it’s just so much better to be relaxed during the entire visit. And then you wake up, it’s done, it’s comfortable, and you just focus on the healing process. And never during that time you ever are thinking, “Is this going to hurt?” Because you already know that you’re comfortable.

Different Types of Sedation

John: Right. Are there different options that I have as a patient or different types or levels of sedation?

Dr. Nammy: Yes, absolutely. There are different types of sedation. So the first one is called the Iatrosedation, which is more of communication. And I usually use a lot of NLP techniques to see if we can go back to our younger selves when we’ve had the negative experience to see if we can change them. So that’s the first level that we can do.

The second would be nitrous, so it would be a gas that just helps you calm the nerves.

Third would be like the Valium, where we would give you a pill.

The fourth would be an IV sedation, where there would be a needle that goes into your vein, and then you would get a stronger medication that helps you relax.

And then the fourth one is the actual general anesthesia, which we rarely use in dentistry.

John: Right. That’s where you’re actually put to sleep, right?

Dr. Nammy: Yeah. Well, when we actually say sedation, we’re really saying it’s none of that scary stuff that you have to worry about not being able to wake up or anything like that. And the risks with IV sedation and general anesthesia, it gets really high. But with the Valium, it’s the best because it’s so…a lot of times Valium is prescribed for people with sleeping problems, and it helps them sleep through the night. So the dosages that we’re using are so safe that nobody ever has to worry about passing on, when they’re sedated this way, and it’s safe sedation. I think the better word to use with this is really called safe sedation versus real sedation.

Effects of Sedation

John: So are there any lasting effects after having sedation done or anything like that? Or you said that there’s such a low dose, that it probably wouldn’t have any lingering effects afterwards. Right?

Dr. Nammy: Usually the lingering effects that people feel are usually, “I feel so much better. I had the best sleep ever.” And typically, yeah, it really is. It really just helps people sleep better and you wake up rested. You feel comfortable and you’re making sense of what occurred, but it’s really nice because you really don’t feel or remember much of the process.

John: Do you recommend after somebody has sedation done that they have somebody else drive them home, that sort of thing, or what’s the procedure after it’s all done?

Dr. Nammy: I do. I prefer that somebody picks you up. In our practice, if you don’t have anybody who’s able to pick you up, we actually take you home, which is fine. We want to just make sure you’re safe and you’re comfortable. And any extra step we can take in order to make sure that you feel safe and comfortable, we’re happy to do. Sedation is just one of the adjuncts we have in order to make you feel more safe and comfortable. But most important is really building that relationship, knowing that you have somebody you can trust, knowing that somebody is going to have your back, make sure that they can do everything in their power to help you. That’s priceless.

John: Right. All right. That’s really great information. Dr. Nammy, Thanks again for speaking with me today.

Dr. Nammy: Thanks, John.

John: And for more information about Green Dentistry, visit the website at sfgreendentist.com or call (415) 433-0119.