The history of dentistry dates back some 14,000 years to an Italian tooth treated with flint instruments. However, current archeological research indicates that Neanderthals may have used rudimentary dental tools 130,000 years ago! From those ancient eras to current times, discomfort and anxiety associated with dental treatment has no doubt been a concern. Greensboro dentist, Dr. Steven Hatcher of Triad Dentistry, shares this brief but intriguing lesson in the role of sedation in dentistry.
In the context of dental sedation, pain and anxiety are often confused. While both triggered by a primal “fight or flight” survival instinct, the actual responses are different.
Hurt originates when there is tissue injury or inflammation that stimulate pain receptors. They release chemicals that race to the spinal cord, which carries the message to the brain. The thalamus receives the impulse and forwards it to the cerebral cortex – the part of the brain that decodes messages. When the brain perceives pain, it instantly sends that message back to the site of injury, telling you to do something about it before more harm is incurred.
Anxiety is a mechanism that biologically heightens our sense of awareness, so we are better prepared to deal with potential threats. While stress is the product of external factors, anxiety is created internally by natural, neurological processes. The amygdala is a communication hub in the brain that helps to process incoming sensory signals. It alerts your brain based on emotional memories (fears) encoded in the hippocampus. Anxiety floods your system with norepinephrine and cortisol, which boosts perception and reflexes. How? By increasing heart rate to send more air to lungs and more blood to muscles.
Obviously, for pain-free dental treatment, both responses must be controlled.
An analgesic is a drug that relieves pain by blocking the communication of pain receptors and the brain. A sedative calms anxiety centers in the brain, inducing a sense of relaxation. There can be some crossover with certain medication, but the history of dentistry has proven that the most effective treatment comes from a combination of these medications.
Here are some highlights of the journey:
Local numbing adequately controls discomfort for less involved procedures such as cavity preparation for fillings, and even more extensive treatments like placement of dental implants or straightforward extractions. However, if you develop anxiety during preparation for the procedure, you are likely to unconsciously “fight” the dentist. Tensing the neck and back or clenching jaws makes treatment more traumatic than it needs to be. Oral or inhaled sedation provide emotional and physical relaxation. That lets the doctor work more efficiently, gets you out of the chair faster, and promotes speedier healing.
An individual with severe dental phobia may have difficulty seeking any treatment – even calling to make an appointment. Knowing that gentle sedation is available helps you get the care you need.
Triad Dentistry’s goal is to see each patient enjoy the emotional and wellness benefits of a healthy mouth. In addition to numbing injections, he offers nitrous oxide inhaled sedation. It is a good choice to “take the edge off” for a nervous patient, without residual grogginess, and it is safe for children, too. Oral conscious sedation is a pill that brings a bit deeper sense of relaxation. Intravenous sedation is ideal for lengthier procedures. It is a more intense level of sedation but doesn’t knock you out like general anesthesia, and it can be continually adjusted to ensure your comfort.