Do You Fear the Dentist? Put Pain in Its Place

When it comes to pain and fear of pain from dental treatment, you can bet on one thing. Your dentist has been trained to use an arsenal of techniques to prevent that pain and ease that fear.

Preventing pain has changed a lot over a period of years, and it continues to evolve. How can you keep pain at bay and ease your concern? One way is to take a team approach: Tell your dentist what worries you, and the dentist will tell you what can be done to help.

Local Anesthesia
Injectable local anesthesia remains the backbone of dental pain control. It prevents pain in a specific area of your mouth by blocking the nerves that sense or transmit pain. This causes the temporary numbness often referred to as a "fat lip" feeling. Injectable anesthetics may be used in such procedures as filling cavities, preparing teeth for crowns, and treating periodontal (gum) disease.1

Afraid of needles? Your dentist can apply an anesthetic gel at the injection site so the sting of a shot is often barely detectable.1

Sedation Options
Dentists use several other techniques to control pain-sometimes by themselves, but often combined with injections of local anesthesia.2 One common way to ease anxiety is the use of nitrous oxide, or so-called laughing gas. You inhale a mix of nitrous oxide and oxygen through a mask over your nose, leaving the rest of your face and mouth free. Your dentist customizes the dose of gas to your needs.2 With the low doses dentists use, you stay fully conscious and able to communicate. In fact, this method is sometimes called waking sedation.1

In some cases, your dentist can prescribe a single dose of an antianxiety medication you take orally, usually in the dentist's office. 2 For some patients, oral antianxiety medicine is all the help they need to conquer concerns about dental treatment. For others, nitrous oxide or other non-inhaled sedative drugs given in the office make dentistry easier to tolerate. The American Dental Association has guidelines for the amount of training dentists should undergo to use three levels of sedation and pain control: minimal sedation, moderate sedation, and deep sedation.3,4 The use of sedative drugs such as nitrous oxide or antianxiety drugs given intravenously is carefully controlled and requires special training.3,4


1 "Anesthesia." American Dental Association. http://www.ada.org/public/topics/anesthesia_faq.asp. Accessed 2009.

2 "Anesthesia for the Dental Visit." American Dental Association. http://www.ada.org/prof/resources/pubs/jada/patient/patient_06.pdf. Accessed 2009.


3 "Guidelines for Teaching Pain Control and Sedation to Dentists and Dental Students:? As adopted by the October 2007 ADA House of Delegates." The American Dental Association. http://www.ada.org/prof/resources/positions/statements/anxiety_guidelines.pdf. Accessed 2009.

4 "Guidelines for the Use of Sedation and General Anesthesia by Dentists:? As adopted by the October 2007 ADA House of Delegates." The American Dental Association. http://www.ada.org/prof/resources/positions/statements/anesthesia_guidelines.pdf. Accessed 2009.

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Author: Jeffrey Bramnick
Online Editor: Kate Karczewski
Online Medical Reviewer: Samuel F. Dworkin, DDS, PhD
Date Last Reviewed: 1/1/2009
Date Last Modified: 1/28/2010
The views represented by this article are that of the author and not of Delta Dental. This article is provided for information only. Please consult with a licensed dentist to discuss the best way for you to improve or maintain your oral health.

In all cases, specific group contract provisions, benefits, limitations and exclusions take precedence over oral health recommendations given here. We recommend that you contact your dental benefits carrier to determine the specific limitations and exclusions for your group.

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