Root canal tx - diazepam didnt work?

[firstchoice]

Hi
Phobic about dentist and having root canal tx.
GP gave me a 2mg diazepam tablet (and a 2nd one to take if the first didn't work). I weigh 19st.
I took the first, no effect, so took 2nd as instructed. no effect.
had panic attack in chair and work needed stopped.
dentist told me to ask gp for 'something else'
what do I ask for pls?

(there are no specialist dental clinics for phobics around here and I don't have time for cbt type work as next apt on Friday).

Be grateful for any suggestions.

Can you not be referred to get sedated properly? I have had it done for a wisdom tooth extraction and a root canal.

My dentist does sedation. Would that be an option? I needed someone to cone with me as I would be able to drive afterwards.

It was wonderful if fairly expensive, but I wasn't aware of anything until it was all finished. I would highly recommend it if you can find a dentist that does it.

Good luck.

It is nhs work so they don't offer sedation
dentist said she could offer 5mg diazepam but she doesn't think it will be adequate.
It is a waste of her time, I will have to go back a third time now as she could hardly get any work done. I was very but she said it was a clearly phobic reaction.

someone was suggesting paracetamol recently,
why not try 10 mg diazepam?

As a dentist, these things come to mind....

1. that dose might not be enough in a person of your size.

1. I am very nervous giving oral sedatives. It's hard to say how fast they will wear off, you cannot top them up, and it won't help you to cope with treatment longer term. You need another responsible adult to help you home (you should not drive) and look after you afterwards, you should not be responsible for anyone else (including children) during this time.

1. How much dental pain are you in? If not much, I'd be looking at postpoing treatment and finding an alternative dentist who can use proper IV sedation. This does not need to be at a specialist clinic, just done by a competent practitioner with correct facilities.

1. If you are not in much pain, is the tooth dead? e.g. with absolutely no sensation to heat or cold, an obvious gum boil? if so, root canal treatment is potentlally painless, even without an injection....

1. Is this root canal that needs doing likely to work or is it going to end up being removed anyway? If the latter, I'd maybe cut my losses and have it removed, assuming it's not a front tooth.

1. And finally, once this is sorted, or even before... find a dentist who is interested in anxious patients, not necessarily a specialist, who is recommended by a friend. It doesn't sound like your current one is one of these! The way NHS dentistry is at the moment, this may mean paying privately.

It sounds like a difficult situation, and Bonzo is right that you need a more long term approach. Personally I don't feel it's fair of the dentist to ask you to get something from your doctor. Your GP shouldn't be prescribing for dental procedures, this is why dentists are able to prescribe. If the dentist wants the help of your GP they should ideally talk to each other directly to find a way forward. Most GPs wouldn't be prepared to prescribe strong seditives they can't monitor, and most dentists would want to know what seditives a person has taken before they treat them.

HI Bonzo77

thanks for your reply.
I did tell gp my weight as I wondered if it would be enough too.
I didn't drive, and did have H home to help with children and could again.
Dental pain?
Due to decay showing on xray (but no pain) I had an old white filling removed and I a deep and large amalgam filling put in about 8 weeks ago. It is very painful and certainly very bad for temperature changes. even cold morning air / warm tea is painful. Despite using a sensitive paste I am still not able to eat on that side of my mouth. Dentist said it is 'because it is sitting on the nerve and because it is amalgam so root canal work only alternative'.
I was tearful entering the room. I understand that the treatment will be relatively pain free but I cannot seem to control my fear anyway. It is mostly of having my mouth open for extended periods and being powerless rather than pain.
Dentist needed to give 6 injections - 3 along top gum (it is a top left molar) and 3 in roof of mouth before finally I was numbed up. (2 exploratory drills before then were painful, mind you).
I am okay(ish) with injections (legacy of repeated IVF...).
The dentist then used a rubber sheet over my mouth for infection control. She had explained this to me but I became very panicky very quickly and they had to stop and bring me a brown paper bag to breathe into etc.
Dentist said she could offer 5mg of diazepam and gp could also so I could take 10mg but maybe it is not the dosage but that particular drug that doesn't 'work' for me?
ChrisPeaNuts:
That's interesting - I hadn't thought of that.
I know I don't seem to respond to sedation in a 'standard' way as I remember a problem with my C-sections (1st doseage not high enough, 2nd went too high and probs breathing).

Hi first choice, i too have dental phobia. And I can also say that if that nerve is not dead, then root canal will be painful without decent local anaesthesia. I have tried diazepam, ie Valium and I find that my anxiety doesn't let it work - it's like the adrenaline over rides the effect. Disclaimer. I am not a doc.

My last root canal in no was done using halcyon, 2 mg I think - it is much stronger than Valium and also you don't remember really what happens, it's all a bit hazy. They also used promethazine, think that is phenergan so no sickness and increases the effect of the halcyon and finally a painkiller but I've forgotten that, sorry. I hsve also used Xanax which works quite well, but I found the first combo wears off quicker , I always felt a bit forgetful for a couple of days after Xanax whereas I recovered quite quickly with the other. 2 mg Valium ain't going to do it if you are really anxious. More like 10 to 20 mg but it's really not as effective as some other drugs. Sure, I know it's not addressing the problem, but I don't care. Just get it done whilst I pretty much don't know. I can't stand drilling, injections in my mouth, etc etc. but I did manage a reshape of a tooth week with drilly smoothing thing and no drugs. Good luck. I know how you feel. Also, when I had treatment using the drugs I had blood pressure monitoring and pulse meter thingy.

Had to fly for work last week. Was given 2mg of diazepam, didn't work. Neither did 5mg or 10-12mg. I am under 8 stone.

Doctor did consider beta blockers but was worried because my blood pressure was normal.

thanks, itshotinperth.
It is really hard isn't it?
dentist said 3 big nerves to teeth. couldn't measure depth with pinger machine thingy (technical term!) and so not sure how deep yet. Aaargh. Two more hour long tx at least. I am grateful for decent treatment, don't get me wrong, and the actual dentist is calm, kind and seems to know her stuff but I am just wiped out today.

whisperingshadow
I have a friend who is very petite like you.
she was once given 12mg diazepam and it had NO effect on her, although other prescription drugs act normally.

My gp told me that diazepam dose did not depend on body weight but was related to the level of anxiety. I took 2 tablets (I think 5 mg each) before an MRI but panicked at the last minute so took another one - so 15 mg. I am only about 8 stone. It did work (I was away with the fairies) but wasn't enough to make me sleep or anything (I am very afraid of scanning machines!).

Ah. Treatment again on Friday.
2x5mg tablets diazepam.
No effect.
Maybe this just doesn't 'work for me'?
3 more treatments so would like to find something that does

Lorazepam is more effective for severe anxiety.

i was offered 'sedation' due to my dentist phobia. Turned out to be 10mg of Temazpam. I was still petrified with fear, but in a jittery kind of way. It did nothing for me. I wish I'd just down a couple of triple vodkas before hand.

Feel for you OP

I was given 4 diazepan to take before second but last tooth taken out. I'm normal weight - ended up so spaced out that I tripped on a kerbstone and had a massive black eye/egg sized bruise on my head. On the plus side I hardly noticed the tooth being taken out .

I changed dentist as I felt that they shouldn't have prescribed such a high dose. Tooth pain so another tooth needing taking out - Scotland so no intravenous sedation except through dental hospital. Dentist started work, was very calm and talked me through it, still hurt and I panicked so he gave me more local injection and waited longer. Then when he actually did remove the tooth I didn't even really feel it.

Might be worth looking to change dentist to one who is recommended as being good for those with anxiety. Massive hugs though, dental work is no fun.

2 x 10mg diazepam not enough. it really doesnt work for some people. is first generation sedative and there are much better options. please insist on something better. just remembered the other drug i took - demerol. the combination of halcyon, promethazine and demerol worked a treat. used it x 2, recovery was much quicker than taking xanax ( i hate that drug) - I'm sorry, its so hideous and thankfully I was in the US and didnt have to fight to get the sedation needed for complicated root canal treatment.

I hope you do get enough sedation to work and its all over soon.

bonzo77

don't know if you are still around but if so, as a dentist, can I ask-

I've now had my 'root canal' but when I went back today for the first appointment for a crown the dentist wouldn't do it as the tooth is still quite sensitive. She said she 'hadn't been able to get ALL of one of the roots'. She suggests a standard metal filling now, rather than a crown 'in case it has to be drilled through in future'.

Eeek. Now feel have gone through RC for nothing? and will still end up with sore tooth and ugly metal filling
Would you agree that the best course is to fill over the sensitivity rather than apply a crown?