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IV sedation doesn’t work for me

Hi Dr. Pinder,
I’m sorry I seem to boomerang right back here after every treatment failure. I did finally consent to the IV sedation and my dr compromised and agreed only to use midazolam. Two hours later the work still couldn’t take place as I remained too aware and combative when he came near me. He wants to do the work under GA at a surgery Center and I do not. I think it is excessive and unnecessary and really scary to be in such a large environment with so many strangers I don’t know or trust.
I believe their therapy may be helpful but a. How much does a session typically cost and do they really help people!? Have you any contact info for people in the US with an interest in working (not overly medicating) phobics?

Thanks for your time and always generous reply. 

Hello
If midazolam sedation does not work sufficiently then there really is no choice but to progress to a different level of sedation , or general anaesthesia .
I have an anaesthetist in for my patients ( a dr ) who gives a cocktail of propofol , midazolam , and sometimes a different variant .
But I have had patients who we have managed to treat , but even when sedated it has been extremely difficult . They have been what is called ‘ failed sedation ‘ cases before they came to me .
It seems that their dental trauma is so deep , that their unconscious mind , when sedated can still tell them that they are in a dangerous place and therfore not be able to co-operate with the treatment .
What you are asking for is not possible , and you have already with courage tried the lesser sedative option and it hasnt worked for you .
Its not the dentists fault , and I can tell you that it can be extremely stressful , and the dentist possibly also feels that he has failed and would not want to try again something that didnt work for you .
What he is suggesting is something that is the same pathway as here in the UK .
We cant do GA in practice , so people have to be referred to a hospital and its vey difficult to get treatment under GA , other than for extractions .
There may be therapists ( properly qualified psychologists ) who could work with you to do some CBT , and there are some universities who have departments and programmes for patients like yourself ( dental schools ) It may be that there is one in your area , Im not sure where you live ?
Just some suggestions , but if you could afford the GA , then perhaps its not excessive or unecessary if thats the only way you can get to where you want to be
Kind Regards
Jenny

Answer provided by: Dr Jennifer Pinder Retired
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