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Patient Stories 

Root canal treatment patient, 2021

 

My patient story is a simple but happy one.

 

I was due to undergo an emergency root canal in my home county of Kent in mid-October. It had been arranged by my regular dentist in his surgery in (removed for anonymity), but to be performed by a specialist endodontist. I was extremely apprehensive, because the tooth root was infected, drilling the tooth had caused me great pain, even with local anesthesia, and no sedation was envisaged by this endodontist. 

 

In the event, at very short notice on a Saturday afternoon, my appointment with this endodontist was cancelled, because she had tested positive for Covid-19. During the weekend it proved impossible to identify any substitute specialist who might treat me prior to a family holiday in Sicily due to start the following Saturday. Even on the Monday my enquiries in east Kent proved fruitless. And my dentist had prohibited me from travelling abroad, before the infected tooth had been stabilised by an endodontist.

 

I therefore resorted to searching for a suitable endodontist with short term availability in central London. (Name removed for anonymity) and her wonderful receptionist at (removed for anonymity) came to my rescue, promising that it should be possible in addition to bring in an anaesthetist to supply sedation. This promise relieved me greatly. And to add to my comfort, not only was (name removed for anonymity) reassuring and good at explaining the procedure, but also Dr Ashraf from Sedation Solutions reassured me, told me in detail about how the sedation would take effect and took a close interest in my anaesthesia history and my feelings about undergoing sedation.

 

All went well on the day. I coped well with the anaesthetic applied, apparently, and remembered virtually nothing following the root canal. There was to be a sequel, however. The degree of inflammation on this occasion had been too great to allow (name removed for anonymity) to complete the procedure. It is hard for me to imagine how unpleasant that might have proven, if I had not been under sedation. So, two weeks after our family holiday, I returned to (removed for anonymity) for a resumption of the root canal, once again with Dr Ashraf providing sedation. And my experience was just as positive, just as successful.

Root canal treatment patient, 2022

 

I have always had a strong gag reflex.  This has caused problems when dentists have needed to treat teeth deep in my mouth.  This came to a head when I needed root canal treatment.  The dentist put a rubber dam over my tongue and after only a few seconds I had a violent gag reflex.  I was consequently referred to an orthodontist working with a sedationist.

Prior to the appointment, I was asked to complete and return some administrative forms which was straightforward, and to pay in advance.  At £300 per hour, in addition to the dentist’s fees, this was a not inconsiderable extra cost.

At the start of the appointment, I met the sedationist who was very reassuring and explained carefully the procedure and what would happen.  He gave me the opportunity to ask any questions but I found his explanation to be very complete.

In the dentist’s room, the dentist explained his side of proceedings.  In addition to the sedation, but separately from it, he would administer a local anaesthetic into the gum by the tooth being treated.  The sedationist checked my blood pressure, having fitted a cuff round my bicep in order to be able to monitor it during the procedure.  He unrolled my sleeve on the other arm and found a vein in my wrist into which he introduced a small cannula.  All I felt was the tiniest of pinpricks.  A few minutes later when everything was ready, the sedationist announced that he was starting the sedation.  

I was watching him and then the next thing I knew was that the dentist was standing in front of me.  I looked at him and said “When are you going to start?”  He replied “I’ve finished!”  I had been completely unconscious up to that point.  [Other times when I have been under sedation, I was conscious of what was going on, but completely relaxed.  Afterwards, I had had the impression of ‘being under’ for around ten minutes, when in fact it had been over an hour.]

After the procedure, I only felt slightly groggy but the staff were very careful with me ensuring that I came to no harm.  After about half an hour, my wife took me to a restaurant around the corner for a light meal and thence drove me home.  At some later stage, I had a light headache, easily contained with a paracetamol.  I slept well over night and took things easy the next day.  The day after that, I felt completely back to normal other than a slight soreness around the tooth which had been operated on.

Having sedation had made the whole episode an anxiety-free experience.  I would recommend it to anyone who is nervous or who has a strong gag reflex.  The extra cost is significant, but in my case I felt it was worthwhile.

Root canal treatment patient, 2022

 

I have always had a strong gag reflex. This has caused problems when dentists have needed to treat teeth deep in my mouth. This came to a head when I needed root canal treatment. The dentist put a rubber dam over my tongue and after only a few seconds I had a violent gag reflex. I was consequently referred to an orthodontist working with a sedationist.

Prior to the appointment, I was asked to complete and return some administrative forms which was straightforward, and to pay in advance. At £300 per hour, in addition to the dentist’s fees, this was a not inconsiderable extra cost.

At the start of the appointment, I met the sedationist who was very reassuring and explained carefully the procedure and what would happen. He gave me the opportunity to ask any questions but I found his explanation to be very complete.

In the dentist’s room, the dentist explained his side of proceedings. In addition to the sedation, but separately from it, he would administer a local anaesthetic into the gum by the tooth being treated. The sedationist checked my blood pressure, having fitted a cuff round my bicep in order to be able to monitor it during the procedure. He unrolled my sleeve on the other arm and found a vein in my wrist into which he introduced a small cannula. All I felt was the tiniest of pinpricks. A few minutes later when everything was ready, the sedationist announced that he was starting the sedation.  

I was watching him and then the next thing I knew was that the dentist was standing in front of me. I looked at him and said “When are you going to start?” He replied “I’ve finished!” I had been completely unconscious up to that point. [Other times when I have been under sedation, I was conscious of what was going on, but completely relaxed.  Afterwards, I had had the impression of ‘being under’ for around ten minutes, when in fact it had been over an hour.]

After the procedure, I only felt slightly groggy but the staff were very careful with me ensuring that I came to no harm.  After about half an hour, my wife took me to a restaurant around the corner for a light meal and thence drove me home. At some later stage, I had a light headache, easily contained with a paracetamol. I slept well over night and took things easy the next day. The day after that, I felt completely back to normal other than a slight soreness around the tooth which had been operated on.

Having sedation had made the whole episode an anxiety-free experience. I would recommend it to anyone who is nervous or who has a strong gag reflex. The extra cost is significant, but in my case I felt it was worthwhile.

Extraction and implant patient, 2022

 

The road to my implant surgery has been a long one with a desire for me to keep as many of my natural teeth for as long as possible, but, with subsequent problems that arose I decided the time had come to have some implants. I was not prepared for the prognosis from both my dentist and my periodontal surgeon that the best way forward was to have all my remaining upper teeth removed and have a full arch implant. I am quite happy to undergo dental procedures with normal injections for numbness but the removal of a number of teeth, including two incisors, was something I did not relish. So I held back on making a decision. Fate, however, took a hand when crunching away on some cashew nuts dislodged a tooth that was already loose and some sort of decision had to be made as to how to rectify a gap in my front teeth.

 

I consulted an implant surgeon recommended by my periodontal surgeon who explained the implant process in depth. I told him my fears regarding aspects of the process, especially of having a number of teeth removed at the same time. He said that intravenous sedation, undertaken by a qualified anaesthetist, alongside the surgery would be one solution. The others being numbing injections only or oral sedation in tablet form. I opted for the intravenous sedation and was sent comprehensive details of what the sedation involved by both the practice and Sedation Solutions. On first reading I found the list of possible side effects quite daunting and worried that other conditions such as age, medical history etc might impact on my response to sedation. However, the comprehensive form detailing medical history that was required by Sedation Solutions eased my anxiety as I felt the anaesthetist would look at the information given and make a professional judgement as to what would be best for me. Sedation Solutions communicated regularly up to the evening of the surgery with regards to preparing myself for the sedation. These were concise instructions that were easy to follow. The anaesthetist also forwarded a mobile number should I have any last minute questions or concerns.

 

On the day of the implant surgery I was asked to arrive prior to my appointment time and my anaesthetist spent a good 15 minutes reviewing my information and talking me through the procedure and what after effects, if any, I could expect. He also did a thorough run through of how to spend the next 24 hours and re-emphasised the things I should avoid in that period. This conversation was very caring and went a long way towards allaying my concerns. Once the surgery and sedation began I was very comfortable and can recall very little of the whole procedure even though I was told I would be conscious throughout. On returning home with an escort I spent the rest of the day resting. I retired early and had a really good sleep! The following day I was still a little 'vague' and did very little until the evening.

 

I would not hesitate to recommend intravenous sedation to anyone who is undergoing potentially painful dental work and certainly Sedation Solutions provided an excellent and professional service.

General dentistry and extraction patient, 2022

 

It wasn't my fear of the actual dentist. It wasn't the fear of the needles or the sound of the drills and other machinery. My phobia really arose out of two things: I couldn't breathe through my nose due to a deviated septum and the unexplained sudden onset of a bad gag reflex.

 

It was my dentist who recommended intravenous conscious sedation and eventually, much against what I thought was my better judgement, I agreed to have it.

 

Approx 10 years plus later I am still using Sedation Solutions.

 

In all honesty I couldn't go to the dentist without the assistance of Andre Du Plessis, my go to sedationist. 

 

The whole process is so calming and relaxing and, before you know it, the entire procedure is over and you are slowly coming round. 

 

Prior to the procedure there are a few forms to fill out (medical, consent and payment). 

 

On the day of the procedure you will need to be nil by mouth for a number of hours before hand. 

 

Andre arrives at the surgery and in the dentist's office he will set up all his equipment. I suppose this few minutes alone with the dentist also gives them time to discuss the procedure, the patient, etc.

 

I am finally called in. As Andre has already set up, then prepping me for the procedure takes no time at all. I sit in the chair upright. Andre sprays a freezing solution on my hand so I don't even feel the IV needle going in. He will start to administer the drugs via the IV. What happens next is truly magical for anyone who has any anxiety, like I do, when going to the dentist. Any anxiety, nervousness, fear or dread you might feel just gradually melts away. My body starts to feel warm, I feel completely relaxed, I very quickly appear not to care about anything and it's a feeling you can't and don't want to fight. It is just a very pleasant, calming and relaxing feeling. I had a pre-med before surgery under general anaesthetic once and it's a very similar feeling to how I remembered that. You are being put in a very tranquil place. Within seconds or maybe minutes you fall asleep. At least you think you're sleeping. You are in fact conscious throughout the whole procedure but you don't know it. Hence the name "conscious sedation". I respond to the dentist's commands but DON'T recall one minute of the procedure or what they have done. 

 

It is worth mentioning, as I am not afraid of needles, my dentist has been known to numb my mouth before Andre sedates me. As of late, however, my dentist has been more than happy to numb me once I have been sedated. This way there is absolutely ZERO discomfort to me whatsoever. Amazing.

 

My understanding is a combination of drugs are used to sedate. One of them includes a memory loss drug which is why you have NO recollection of the procedure at all. The cocktail of drugs are administered in tailored doses based on a number of factors such as your body weight, anxiety levels, length of procedure, type of procedure, etc. 

 

Throughout the procedure the sedationist is in complete control of how much sedation you are given. He can titrate (I believe that's the word used) the levels he gives you. He can bring you in and out of consciousness. If you're reacting particularly well he might lower the level of sedation he gives you. If, like me, you occasionally remain (unknowingly!!!) anxious even while sedated he can increase and deepen my sedation to relax me even further. 

 

It's probably worth noting that having a patient like me sedated makes life a lot easier for the dentist too as I won't be continuously interrupting the procedure, pushing his hand away, gagging, having to stop so I can take a breath, etc.

 

At my dentist's surgery having a crown made and fitted is a two-step process all done in one appointment. First I will be sedated while they do the x-rays and the "dreaded" impression.  My dentist has a machine in the office that makes the crown while I am in the chair. In the 20 minutes or so it takes for the crown to be made I know Andre has brought me around to a level where I don't feel like I am sleeping but in a very comfortable state of semi consciousness as I don't need to be 100% under while the crown is being made. I'm still completely relaxed and might be able to converse a little but clearly drifting in and out of the very calming state I am in. When the crown is ready to be fitted Andre will increase the dose to put me back under again while the dentist completes the crown fitting procedure.

 

Once the procedure is over and the sedationist stops administering the drugs I very quickly come round and wake up. 

 

It is seriously the most incredible feeling to know I can go to the dentist and have whichever procedure is required and NEVER GET ANXIOUS ABOUT IT AND BEST OF ALL DON'T REMEMBER A THING.

 

The most inconvenient thing about having sedation is having someone come to pick you up and escort you home following the procedure and the fact that you might feel a little drowsy for the next few hours. But sometimes not. A small price, I think, to pay for such an unbelievable service. 

 

Treatments I have had under sedation include root canal, crowns, extractions, apicoectomy, implants, gum and bone grafts and at the same time my dentist has managed to take x-rays while I am under in addition to impressions which, for me, are one of the worse things to endure when I can't breathe through my nose and I have a bad gag reflex!

 

No longer do I need to be afraid of going to the dentist or suffer while going through any procedure I might require. Sedation, for me, was literally lifesaving and knowing that over the years I have developed a trusting relationship with my sedationist Andre (who also understands me as a person and my sedation requirements), it is almost a pleasure to go to the dentist knowing I will have no anxiety. Before using Sedation Solutions - in a million years I NEVER thought I would have said that.