This is a linkpost for https://metavee.github.io/blog/misc/2023/12/09/things-youre-allowed-to-do-at-the-dentist.html
Things You're Allowed to Do: At the Dentist
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I have a terror of people sticking sharp things inside my head. Like most phobias, it is an exaggerated fear of something actually dangerous. On two occasions, I have been overcome by fear, leaped off the dentist chair, and cowered in the corner of the room. That’s only happened twice in forty years, so I think my self control is pretty good.
f you dislike having needles driven into your head (as I do) you can ask for topical anesthesia. They put some anesthetic goop on a cotton ball and put it against the tooth that they want to numb. It takes about five minutes to numb the tooth.
I don’t always get this when I ask for it; topical anesthesia is not feasible to use for all procedures. But it usually works.
Dissociative anesthesia may be available. It’s a drug they give to you in advance. It does a weird thing: you’re conscious, it still hurts, but you don’t care. It interrupts the circuit somewhere between the pain and the aversiveness. It also gets rid of the fear response. The time in the chair becomes a boring interlude of no particular importance. If you drive home, you need someone else to drive you, because you’re not thinking straight.
I haven’t had good results with taking a tranquilizer before hand; it’s still subjectively very unpleasant.
I've used two different benzodiazapenes at the dentist with very different results. Halcion is great, I hadn't realized just how traumatic each visit was until Halcion made it stop. But Xanax suppressed my coping mechanisms more than my anxiety, so it made it worse.
Doesn't dissociative anesthesia cause amnesia? If so, how could you know that you were hurt but felt indifferent to it?
Different people react differently to different drugs. Also, amnesia isn't usually all or nothing, it's a gradient of fuzziness of memory. Midazolam (Versed) is often given to patients prior to anesthesia to relax them, and can inhibit memory formation. For me, I had an adverse reaction to it, and it gave me a panic attack, but also left me unable to voluntarily move or speak. So I just laid there, eyes wide and staring in horror until they finally gave me the true anesthesia. Blech.
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1Circa 2008, I don't think we had great methods for detecting such cases, so I'm curious how your surgeons realized that you were awake. And there's a term for that state in the literature: Inverse-Zombies. That happens about 0.13% of the time with some anaesthetics. And surgeons paid less attention to this stuff until about 1.5-2 decades ago, and you'd get some cases where people were awake, paralyzed and in pain. Some proportion of those had PTSD.
Perhaps you misunderstood my story. With surgery, they usually give a 'relaxant' (which can also inhibit memory formation) before the anesthesia which actually puts you asleep. In my case the anesthesia worked normally. The 'relaxant' had the perverse effect of giving me a panic attack and temporary inability to intentionally move or speak. A few minutes later, they gave the anesthesia and I went unconscious as per normal.
1A few minutes later, they gave the anesthesia and I went unconscious as per normal.
You mean, you remember nothing after a few minutes into the anesthesia and so you assume you went unconscious as normal, despite the previous abnormality.
After all, as you said, it's not like you could talk or make any kind of voluntary movement which might indicate to observers unaffected by anesthetic memory loss that you were conscious...
True! I have no evidence either way beyond that point of the anesthesia being administered. I don't have any traumatic memories beyond that point though, so I feel good about it.
It has some other negative side effects, rare for it to be serious, but possible. So it really is just better to 'toughen up' in this case.
I had nitrous oxide once at a dentist. It is a dissociative anesthetic. It may have caused something like selective amnesia. I remember that the dentist was drilling, but I have no clear memory of pain associated with it. It's a bit hard to evaluate exactly what it does, but it definitely has some benefits. Maybe the pain seemed too distant from me to be worth my attention?
1The slow drill hurts less but takes more time than the fast drill. You may want to ask the dentist to use the slow drill when it starts hurting.
Oh yeah, I love nano-hydroxyaptite japanese toothpaste. I've been buying it from Amazon for years.
I once had a really hot female dentist and basically everything she did to my teeth was mentally fine even if it was objectively painful. It's a really strong effect.
Something to bear in mind when choosing a dentist.
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