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any suggestions how to stay calm while having dental work done


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I am having an extraction which I'm very nervous about.  I always worry I will have to cough, swallow, sneeze or go to the bathroom while dentist has his hand in my mouth.  I get the feeling that the dentist doesn't understand dysautonomia. I'm a little worried about bleeding but again dentist doesn't seem to have any worries.  Also fainting due to low blood pressure.  I don't want sedation but I will take something to help calm me down.  This will not be an easy tooth removal.  thanks for helping.

Anyone have words of wisdom for a coward?

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Don't feel bad about being afraid of this -- you've never done this before, and many people find the unknown to be scary.  Nothing wrong with feeling that way at all!  DO try to remember that people have teeth removed every day, sometimes on the decks of ships, sometimes by hockey pucks. ;)   Don't worry about the oral surgeon.  No doubt they've been bit many times over the years and will have developed very quick reflexes. 

I had an impacted wisdom tooth removed a few years back, and even with my numerous medical issues, it went very smoothly. The actual procedure, from the moment the drill went into my mouth to the last stitch, took less than 10 minutes. It was easier than many of the regular fillings I've had over the years, honestly!

First, make sure you know your triggers and fears and communicate these to the oral surgeon. Bring records.  Spend time with them in a consult appointment where no work will be done, just evaluating what needs to be done and what your and your body's issues are.  In my case, their anesthesiologist decided he liked his medical license, therefore no sedation nor anesthesia for me.  Instead we did local lidocaine WITHOUT epinephrine/adrenaline in it.  This was key.  

Second, plan for recovery.  They had me get all sorts of pain meds beforehand, and we had those filled and already at home.  Also get home set up for it with the foods you'll be able to eat, plenty of things to keep you happy and amused, and build your 'nest' to recover in, as you're going to want to sleep.  I was proactively taking ibuprofen from the start of the procedure and did so for the next 2 days but didn't feel anything.  Not sure if it was the ibuprofen or if it really was that painless.  Either way, that was all.  

Despite my health issues, the whole process was surprisingly easy. The only hiccup was an initial mix-up with the lidocaine (they used with epi instead of without) but once we corrected that and we waited 90 minutes for my vitals to return to normal, everything went smoothly. They kept me sitting mostly upright during the removal, which helped since I don’t do well lying flat. The drill they used had a low RPM, so no high-pitched whine, just a bit of vibration. The tooth was out in a few minutes, followed by some cleaning and stitching. Probably 3-4 minutes to get the tooth out, 5 minutes to do the clean-up and stitching.  Not much blood. 

After that, my fiancé drove me home. I felt tired, so I slept for a few hours.   I woke up late afternoon and was up for a few hours, ate some light foods, then by nightfall I was ready for sleep and slept soundly throughout the night.  

Because of my health issues, they had me on a patient monitor at home for the first few days, BP, pulse/SpO2.  I also had to wear my medical helmet with a chin/jaw guard continuously for the first few days, then slowly less and less over time to where it was just for high-risk things (climbing stairs, etc.) until things healed up and my jaw bone reminieralized.    Even at that, the second day I felt good enough and was going stir crazy, so we drove around for awhile before getting ice cream.  

If all else fails, circle a week out on the calendar from the procedure and remind yourself it'll all be over by then, probably much sooner.  

I was honestly shocked at how well everything went and how much easier it was than a regular filling.  

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Thanks for your reply.  I'm glad things went as well as they did for you.   I'm more nervous when it's a dentist I haven't been to before.  I don't trust them to really listen to me.  Seems no one in my area has ever heard of Dysautonomia.  Thanks again!

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Some academic articles on the subject:
https://sci-hub.st/https://pubmed.ncbi.nlm.nih.gov/16637478/

https://sci-hub.st/https://www.autonomicneuroscience.com/article/S1566-0702(18)30032-8/fulltext  (a bit technical, but don't let the jargon scare you...it sounds much scarier than reality)

At least in the USA, dentists (and doctors) vary widely in quality and level of care. Don't be afraid to shop around.  It's a hassle, but when you find a good one, it's worth it.   

I once had a dentist write up $20k+ (in 2004 dollars) of work that I "needed" to have done.  I was shell-shocked and called a friend I was helping in dental school. I spoke with his attending and they had me send up the x-rays.   The professor called me within an hour and told me to NEVER go to that dentist again.  Possibly one root canal needed, but that was it. 

When I went shopping, I came across another dentist who was absolutely terrified to work on me, insisting that any work done be at a hospital.  Nope.  My current dentist was afraid of me initially, but had me evaluated by his own GP, read up on the condition, and we've come up with guidelines.  

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