oral conscious sedation Archives | Williams Family Dentistry

Burning Mouth Syndrome or Zirconia Allergy

Posted on April 30, 2025 by writeradmin.

I had a zirconia crown placed. Not only was the appointment itself a bit of a nightmare, but ever since the appointment I have had burning in my mouth. It reminded me a bit of when I was on chemo, only without the sores. My dentist said there are no allergies to zirconia so he doesn’t believe that is the problem. I’ve been to two different ENTs. The first one ruled out acid reflux, but could not figure out what was going on. The second one thought it might be burning mouth syndrome, but said we don’t know the cause of it. Is it possible they’re all wrong and this really is an allergy? I need more dental work, but am terrified to move forward without knowing what the cause of this problem is.

Evelyn

Dear Evelyn,

I don’t think it is wise of your dentist to say there are no zirconia allergies. The human body is very unique and even when something is very biocompatible, like zirconia, there could always be someone whose body doesn’t deal well with it. There was a dentist who wrote about some zirconia allergies, but while he posted about it, there is no documentation on the case itself. This makes me wonder if it is just something he heard about instead of witnessed.

You could go to an allergist to get checked for a zirconia allergy, but I am leaning toward agreeing with the second ENT that you are dealing with burning mouth syndrome. While it has been said there is no known cause for this, there have been clear signs that it is related to dental anxiety. Many patients who’ve experienced these symptoms also documented either having dental anxiety to begin with or a traumatic dental appointment that led to the anxiety. As you’d mentioned a traumatic appointment, this makes me think that would be the most likely cause for you.

The good news is that there is a solution to this. My suggestion is that you avail yourself of dental sedation for your needed dental work. I think your anxiety is going to be too high for simply using nitrous oxide. Instead, I’d like you to use oral conscious sedation. If your dentist does not offer that, then I would switch to someone who does.

You have needed dental work and you don’t want to end up with a dental emergency because of your past experiences. Using oral conscious sedation will relax you enough that you could even sleep through the appointment if you wanted to. It can completely change your life.

This blog is brought to you by Lexington, KY Dentist Dr. James E. Williams.

Can’t Stand Going to the Dentist

Posted on October 31, 2024 by writeradmin.

Please don’t take this the wrong way, but I cannot stand going to the dentist. I know you are just doing your jobs, but if feels like you are just trying to hurt people. Every single dental appointment I have have ever had has been excruciatingly painful. My dentist said it is because I have a high tolerance to Novocain. Because of this I haven’t been to the dentist in a while and I am starting to get concerned about my oral health. Is there any way to get the care I need without feeling like I’m being tortured by a psychopath?

Stanley

Dear Stanley,

I’m not offended. In fact, I understand what you are going through. Even better, I know the solution. It isn’t as much that you have a high tolerance for Novocain as it is that your dental anxiety, which is justifiably real given your experiences, is burning off your numbing medication.

The solution is to see a sedation dentist. They can provide you with a medication that will completely relax you. Once you are relaxed, then the numbing medication will work to its full effect. There are levels of sedation that you will read about on the page I linked to. Normally, I would suggest that someone start with the lowest form of sedation. Instead, given all that you have been through, I would like you to use oral conscious sedation.

This is strong. Really strong. In fact, you will need someone to drive you to and from your dental appointment as well as stay with you afterward until you are lucid and steady on your feet. The side benefit is that whatever dentist you end up with will be able to get significantly more work done at each appointment than would normally be possible. You will be able to catch up on your dental work significantly faster than you would otherwise.

The sooner you get your work caught up the better because it gives you a greater chance at saving the maximum amount of teeth. If, by chance, there are teeth that you cannot save I would highly recommend that you replace them with dental implants. These are the closest to having your own natural teeth in your jaw bone again.

This blog is brought to you by Lexington, KY Dentist Dr. James E. Williams.

Terrified to Get My Wisdom Teeth Out

Posted on September 28, 2024 by writeradmin.

I am 18 years old and my mother wants me to get my wisdom teeth out. I’ve never had a problem with my teeth and have never even had to have a filling. Two of the wisdom teeth are impacted but are not bothering me. Is it really necessary to have these removed? Technically, I’m an adult now even though I still am in my last year of high school so I’m guessing no one can make me do this. I just want to understand why my mother thinks it is so important. She keeps saying not to wait until it is too late and this way she’s paying for it. But, I’m the one living through it. Why is this a big deal? If I’m being honest, I will have to admit I’m terrified of having to have them out. All of my friends who have to have things like root canals and such say it is absolutely miserable.

Tara

Dear Tara,

Let’s start out with the adult thing. You are not technically an adult. You are an adult. The good news for you is that I’m noticing something really positive in the way you are handling this. What you are not doing is saying, “I’m 18 and you can’t make me.” Instead, you are doing something very wise and asking, “Why is this important?”

First, let me alleviate your fear. When you have your wisdom teeth out, you should be getting dental sedation, usually oral conscious sedation. This is a very strong medicine taken by pill that will make dental work much easier on you. In fact, you will be so relaxed and comfortable that you will be more likely sleep through the procedure than anything else. The only downside to this is that you will be a bit loopy. Because of that, you will need someone you trust to drive you to and from the procedure as well as stay with you until you are lucid and steady on your feet. Other than that, it should be smooth sailing.

Why Remove Impacted Wisdom Teeth?

If your wisdom teeth are impacted, at some point they are very likely to develop an infection. So, your next question should be, “Why not wait until that happens?” Great question!

You are currently at the perfect age to have your wisdom teeth extracted. The bone is very pliable and there is hardly any cementum at the roots. As you get older, that changes. With those changes, comes an increased risk for serious complications. By the time you hit 30 your chances double. But, then the risk chances double much faster. I’d say about every 5 years.

While, 30 may seem like a long way away for you now, in reality you will blink and suddenly you’re 30. Life moves much faster after you graduate high school. Plus, each year the bone and cementum change to make the procedure a tiny bit more challenging. Having your wisdom teeth extracted now prevents all of those possibilities.

A second issue is control. If you wait until there is a dental emergency, you have very little control over when you get to go in and make arrangements for everything. Doing it before there is a problem means you have the contol.

You also have the bonus of getting your parents to pay for it. Once you are graduated and out of the house, then you will no longer have that benefit. Take my advice. Use their money and get this done while it is simple.

This blog is brought to you by Lexington, KY Dentist Dr. James E. Williams.

After Three Appointments, My Dentist Still Can’t Get Me Numb

Posted on June 29, 2024 by writeradmin.

I have a serious problem. I’m dealing with a rather challenging tooth infection that needs to be treated. I’m currently living off of antibiotics and pain killers, but these will not last forever. Unfortunately, even though I have had three different appointments with my dentist, he has been completely unable to get me numb enough to get any treatment done. I’m about to the point where I’m going to see an oral surgeon in order to get the tooth removed, but I was hoping to save the tooth. Do you know why I cannot go numb? At each appointment, he has given me a minimum of five shots of Novocain and none of it them has worked.

Any help you can offer will be greatly appreciated.
Avery

Dear Avery,

I am sorry that you have had these experiences. This probably hasn’t made your desire to go to the dentist any better. Bear in mind I have not examined you, however, I believe I do know what is happening as well as a solution for the problem.

Most people are at least a little anxious when it comes to going to the dentist. That anxiety drives up your metabolism. In some patients, this results in it reducing or, in more extreme cases, completely burning up any effectiveness of the numbing medication. This is very likely what is happening to you. Then, the more bad experiences you had with it the higher your anxiety got.

I am going to suggest that you see a sedation dentist. They can provide you with a medication that will help you to relax, thereby getting the numbing medication to do its job. There are different levels of sedation available, the lowest is nitrous oxide and when your procedure is over, you can go right back to your day with no problems. However, given your recent experiences, I feel you are going to need something stronger. I would try oral conscious sedation. This is very strong. So strong that you will need someone to drive you to and from your dental appointment as well as stay with you for a few hours after your appointment to ensure that you are lucid and steady on your feet. The good news is that you will be so relaxed that, not only will you have an anxiety-free and pain-free dental appointment, but you are very likely to sleep through your entire appointment.

I would consider your situation a dental emergency. Don’t stay with this dentist. Get to one who can give you sedation so you can get the treatment you need before this becomes a life-threatening situation.

This blog is brought to you by Lexington, KY Dentist Dr. James Williams.

Dental Sedation for Wisdom Tooth Extractions

Posted on March 21, 2024 by writeradmin.

My twenty-one year old daughter has an impacted wisdom tooth that is a bit under the bone. I am worried about this procedure and don’t want her in a ton of pain, but am also worried about the idea of her going under anesthesia. Is there a type of dental sedation that will work for her that is strong enough for her to not be in pain while still not being anesthesia? If that is the only option I’ll understand, but want to avoid it if I can.

Daphne

Dear Daphne,

I can tell that you are a good mother and are worried about your daughter. The good news is that she will not need to use general anesthesia. Nothing you have mentioned indicates there is anything overcomplicated about your daughter’s case. She is also at the perfect age for these extractions. Her bones will still be pliable. Plus, there will not be any cementum accumulation on the roots of her teeth. By the time she turns 30, her chances of complications will double. They’ll double again every few years.

To keep her out of any pain during the extractions, I recommend you see a dentist who offers sedation dentistry, specifically oral conscious sedation. This will be administered by a pill. However, it is STRONG. You, or someone else equally trustworthy, will need to drive her to and from her procedure as well as stay with her for several hours until she is lucid and steady on her feet.

I hope this helps to put your mind at ease. Doing the wisdom tooth extractions now will save a potential dental emergency from happening down the road when she will also be at a much greater risk for complications.

This blog is brought to you by Lexington, KY Dentist Dr. James E. Williams.

A Procedure Where It Was Almost Impossible to Get Numb

Posted on August 31, 2023 by writeradmin.

I recently had a tooth extracted. It was my bottom, left back molar. I think my dentist called it tooth #18. I have three major concerns that I need to ask someone other than my dentist about. First, it took multiple shots to get me numb. I lost count at 13 and was just crying by them. Is this normal? Second, a few days after the extraction, a bone spur appeared at the site. I wasn’t thrilled with the deal of going back to the dentist after the extraction, but it hurt so much any time someting even brushed it (including my tongue) that I had to. It took the dentist about 30 minutes to deal with that. Now, about eight days later, the extraction site has a sharp ridge. It’s also still painful for me to swallow and eat. I don’t even try to smile anymore. I think I’ve lost confidence in this dentist and I don’t know what to do about this ridge or even if any of this experience was normal.

Mary

Dear Mary,

You have definitely had a rough go of things. Let’s start with the problem getting numb as this will impact every dental appointment you have. I highly doubt your dentist missed the tooth area that many times. The underlying issue more likely lies in a dental anxiety issue combined with your dentist not understanding how that impacts your ability to get numb.

As your anxiety goes up, it gets harder and harder for your body to stay numb. This is because your metabolism jumps up during that anxiety and burns off the numbing medication. This is why it was so difficult for you to get and stay numb. Now for the good news. There is a solution to this.

Pain Free Dental Procedures

My suggestion is you go to a dentist who offers dental sedation. In some cases, all you need is nitrous oxide. This is a mild form of sedation that relaxes you. It is sometimes called laughing gas because of the floaty feeling it gives you. It has the benefit of allowing you to immediately get on with your day because, once the procedure is over, they switch the gas to oxygen and you are back to normal in just a few moments.

Some patients have such a high anxiety level, however, that they need something a bit stronger. If you are in that camp, my suggestion is oral conscious sedation. This takes a little more preparation. While it is administered by a pill, this pill is so strong that you will need someone to drive you to and from your appointment as well as stay with you at home until you are lucid and steady on your feet.

Your Other Questions

The bone spur puzzles me. I don’t have a lot of information about it. What I can say is that dentists should try their best to remove any loose pieces of bone, etc. As for the sharp ridge, I have more information. When the tooth is first removed, the socket will have a sharp edge to it. You didn’t notice it because the gum tissue is over it and a bit swollen. As it heals the gum goes back to normal size and the sharp edges are then on the surface. If it is causing you a problem, your dentist can smooth it or clip it.

I hope this helps.
This blog is brought to you by Lexington, KY Dentist Dr. James E. Williams.

Can Novocaine Make You Tremble?

Posted on June 30, 2022 by writeradmin.

A friend of mine had to have a crown placed and they gave her novocaine. She said it caused her to shake and tremble. I’ve never heard of that before. Could she be allergic to this? If so, is there an alternative?

Percy

Dear Percy,

You seem like a good friend who cares to be writing on her behalf. While there is some Epinephrine in Novocain, I do not think there is enough of it in the medication to cause the reaction you are describing. In fact, there is more Epiniephrine in her body naturally than she would have received during treatment. The most likely cause of her reaction is dental anxiety. She may not even realize she is dealing with anxiety. The good news is there is a solution which can completely relax her at all future dental appointments.

Your friend will need to find a dentist who offers dental sedation. There are different levels of sedation and I always recommend using the lowest level necessary. If all she needs to do is get a bit relaxed before her appointment, nitrous oxide may be all she needs. This is administered by a nose piece and has the benefit of allowing her to drive herself to and from her appointment as well as go about her day as she normally would when things are completed.

If her anxiety is too strong for that, then she will require oral conscious sedation. This is administered by a pill. However, it is really strong. In fact, it is so strong that she will need someone to help her get to and from her dental appointment as well as stay with her for a few hours afterward until she is steady on her feet again.

Let your friend know about these options and I doubt she’ll have that kind of reaction again.

This blog is brought to you by Lexington Kentucky Dentist Dr. John Weaver.

Worried About Having My Wisdom Tooth Extracted

Posted on March 14, 2022 by writeradmin.

I have a wisdom tooth in my jaw that has a pretty good cavity and is partially impacted. My other wisdom teeth are fully impacted but don’t have any problems. My dentist said I need to see an oral surgeon to have it extracted because of my age (I’m 37), which he says puts me at risk. He also mentioned that there is a risk of nerve damage. I’m not a comfortable patient under the best of circumstances, but now I’m terrified of this procedure. Help me understand how serious this is and is there a possibility I can not have the tooth removed at all?

Sienna

Dear Sienna,

I wish these impacted wisdom teeth of yours had been extracted when you were in your late teens to early twenties. At that age, everything is quite pliable and super easy to remove. As you age, the bone gets thicker as the roots fully form. The older you get the more difficult the extraction. I would not wait for the other ones to bother you before having them extracted. It will only get more complicated the longer you wait. As for the one with decay, it does need to come out. You don’t want to wait for an infection to develop, which can turn into a dental emergency.

As for the potential for nerve damage, that is only a real risk if the tooth is impinging on the nerve. Surgeons always tend to overstate the risk because they want to avoid any possibility of a lawsuit if things happen with a nerve beyond their control. Just make sure whomever you see gets some good 3-dimensional x-rays. This way he can work around any nerves.

I did want to address a different type of nerve issue, however. You mentioned you were not the most comfortable of patients. I want to suggest that you see a sedation dentist for any further dental care you need. Having something like oral conscious sedation when you need any work done will greatly improve your feelings toward the dentist. You will finally be able to have anxiety-free/pain-free appointments.

This blog is brought to you by Lexington Dentist Dr. John Weaver.

Pain Free Dental Care for Recovering Addicts

Posted on January 19, 2022 by writeradmin.

I spent over a year in the hospital because of a hit and run. After I was released, the pain was hard to deal with and I developed an opiate addiction. I’ve since been working hard to get past that and am in an outpatient treatment program that uses methadone maintenance as I learn to deal with the pain that I will have the remainder of my life. One of the things I wanted to improve was my appearance and the health of my teeth. I need a lot of work thanks to the time in the hospital and recovery afterward. The appointment I went to required a root canal treatment that was excruciating and he refused to give me any pain medication due to the fact that I’m an “addict”. I had offered to give him the number to my program counselor and let him discuss my progress in depth, but he treated me like I was unworthy of his time. I do want to get my oral health in order and would love to have a smile I am proud of, especially since so much of the rest of me is scarred from the accident. Do you know how I can find a dentist with enough compassion to not expect me to suffer?

Andrea

Dear Andrea,

I am so sorry for all you have been through. I am equally sorry for the way you were treated at the dental office you went to. It sounds like he’s had bad experiences in the past and is taking it out on you. You are in a tough spot. One of the things you will run up against is the fear many dentists have of the DEA (Drug Enforcement Administration). An overzealous agent can destroy a dentist’s career and practice. Some dentists have been closed down simply for being compassionate. As other dentists hear these stories, it makes them wary of ending up in the same boat.

Your best option is to call around to different sedation dentists. They tend to run more on the side of compassion. Explain your situation as you did to me. I feel certain you will find someone willing to help you. If your counselor okays it, you will find that you can get more work done at each appointment with oral conscious sedation. That would be my recommendation to you because you can get caught up on your dental care faster.

This blog is brought to you by Lexington, KY Dentist Dr. John Weaver.

Burning Mouth Syndrome or Zirconia Allergy

Posted on December 31, 2021 by writeradmin.

I have a hard time at every single dental visit. This last one was no different. I had two zirconia crowns put on. Since then, I have had horrible try mouth and my mouth, tongue, and throat have been burning. I’ve been to the doctor and two ENTs. All have said there is no acid reflux and were baffled. The last one mentioned the possibility of burning mouth syndrome. I’ve asked about the possibility of an allergy to the zirconia but they all insist that no one is allergic to zirconia. I don’t know what to do?

Grace

Dear Grace,

I get annoyed when dentists or other practitioners say there is “NO” chance you can be allergic to something. The human body is remarkably unique for each individual and saying that no one can be allergic is short sighted at best.

That being said, your symptoms are consistent with burning mouth syndrome. While we don’t know the actual cause, there is a consistent connection with patients who report these symptoms. Each of them has a pattern of both dental anxiety and traumatic experiences at the dentist.

You will want to do something to help with the dry mouth, which in turn may help with the other symptoms you are experiencing:

Avoid caffeine, alcohol, and tobacco use
Drink water regularly
If you need mouthwash, make certain it does not contain alcohol. There are some mouthwashes specifically designed for dry mouth
Avoid over-the-counter antihistamines and decongestants, which will worsen your symptoms.

How to Have Positive Dental Experiences

When a patient is dealing with dental trauma, I always recommend they see a sedation dentist for their treatment. Specifically look for someone who offers oral conscious sedation. Nitrous oxide is fine for mild anxiety, but your experiences hint to me you will need something stronger. These dentists are skilled at working with fearful patients and have compassion for what you’ve dealt with.

This blog is brought to you by Lexington, KY Dentist Dr. John Weaver.