This article is general information for our patients, not a diagnosis. If something in your mouth hurts, changes, or worries you, have it examined.
If your stomach tightens at the word “dentist,” you’re in large company, and there’s nothing wrong with you. Nervous patients are a large share of the people in our chairs, and most do far better than they expect — usually because of what we change before any medication, not the medication itself.
One thing first. Nothing below decides what you need. Whether sedation belongs in the picture at all — and which kind — isn’t settled by how frightened you feel; it comes from reading the whole picture together: your health history, the medicines you take, the treatment in front of you, and how you’ve handled sedation before. Any one piece can be overruled once the rest is in. Use this to understand your options, not to land on a plan — that part we work out together, in the chair.
Why the fear runs as deep as it does
Most dental anxiety traces back to something real — a rough appointment as a child, pain that arrived without warning, or a dentist who didn’t stop when asked. Studies fairly consistently put some fear of dental visits at around one in three adults, from mild unease to a true fear (dental phobia) that keeps people away for decades; roughly one in ten has fear strong enough to delay or avoid care.
One clue I rely on is what a patient flinches at, because it usually points to the fix — the needle, the drill’s sound, the smell, or lying back unable to speak. That last one matters most: lost control tends to be one of the strongest drivers of fear in the chair, which is why so much of calming a nervous patient is really about handing control back. There’s often a second layer — embarrassment about how the teeth look after years away, which keeps people away longer and lets small problems grow. So plainly: you won’t get a lecture from me about how long it’s been. Coming back after fifteen years is hard, and it earns respect here.
What helps before any medication
Telling us. That single step does more than anything else, because once we know, we can slow down, agree on a stop signal, and shape the appointment around you. Most of what settles a nervous patient has nothing to do with drugs — structure, control and predictability do the heavy lifting.
- Say it when you book. “I’m anxious about dental visits” goes on your file, and the whole team plans around it — more time, more explanation, nothing sprung on you.
- Agree on a stop signal. Raise your left hand and I stop — not “in a second,” I stop. Knowing you can halt everything takes away the trapped feeling that feeds most chair-side fear.
- Ask for breaks. A pause partway through is normal here, and a recognised comfort technique — you never have to earn one.
- Bring headphones. Your own music or a podcast gives your mind somewhere else to be and muffles the sounds patients dislike most.
- Book a morning. Less of the day spent dreading it, and less chance the schedule’s running behind.
- Start with just a conversation. Your first visit back can be an exam and a chat — no treatment, no commitment. Easing in gradually is how we rebuild trust, with adults as much as children.
- Expect me to narrate. I explain each step before it happens and show you the instrument if you want. No surprises is the rule.
For many, that list is the whole answer; when nerves still win, sedation comes in.
How sedation works, and what it isn’t
Sedation uses medication to settle your nerves while you stay conscious and able to respond — the formal term is conscious sedation. One distinction matters: sedation manages fear, while the freezing (local anaesthetic) manages pain. You still get numbed either way; sedation just makes it easier to sit through. Being put fully asleep (general anaesthesia) is a different category, done in hospitals or specially equipped surgical facilities — we don’t offer it here. We offer two options, at different depths:
| Laughing gas (nitrous oxide) | IV sedation | |
|---|---|---|
| Depth | Mild | Moderate |
| How it’s given | Soft hood over your nose | A small soft tube (IV) in a vein |
| How you feel | Relaxed and awake, sometimes a light tingle | Semi-conscious — most feel they slept through it |
| Afterward | Gone before you leave the chair | Groggy and sleepy; you need a ride home |
| What we use it for | Almost any treatment where nerves get in the way | Taking teeth out, and nothing else |
What laughing gas feels like, and how fast it wears off
Laughing gas feels like a warm, floaty calm — sometimes a light tingle — and it’s gone again a few breaths after the hood comes off. A small soft hood rests over your nose and you breathe normally through it; it delivers a mix of gas and oxygen, always blended with at least 30 percent oxygen, a built-in safety floor. Most people feel warmth and an easier mood within minutes, and you stay awake and in charge throughout — you can talk, answer, and use the stop signal as before.
What suits it to anxious patients is that it’s adjustable in real time: too floaty and I turn it down, and you feel the difference almost at once; still tense and I ease it up. The commonest side effect responds the same way — set too deep, it can leave some people queasy, which turning it down settles quickly. It clears fast, too: at the end you breathe plain oxygen for a few minutes and the gas is breathed back out, gone almost as quickly as it arrived. Most people return to their normal day, usually including driving, once we’ve confirmed the effects have fully worn off.
Two caveats. Because you breathe it through your nose, a badly blocked nose on the day makes it ineffective — tell us and we’ll rebook. And if you’re pregnant or might be, say so before we plan any sedation; we’re deliberately cautious here.
IV sedation, and why we keep it to extractions
IV sedation is moderate sedation given through a thin soft tube (a catheter) in a vein, and we offer it for one thing only: taking teeth out while you’re semi-conscious. It goes deeper than laughing gas. The sedative — usually from the benzodiazepine family — starts working soon after it enters the vein, and you become deeply relaxed and drowsy: semi-conscious, breathing on your own, able to respond when we speak. Most patients tell me afterward it felt like they slept through it, and they remember very little — these medicines blur the memory of the appointment, which for a fearful patient is often the whole point.
The trade-off is recovery. You’ll be groggy for hours, so you must arrange a ride home, and no driving, machinery or alcohol for the rest of that day. A little planning helps: no food for about six hours before, small sips of water are fine until two hours before, and wear loose or short sleeves so we can reach your hand or arm. The heaviest grogginess sits in the first few hours, and most people feel slower than usual until the next morning.
To be precise about scope: we use IV sedation only for taking teeth out — not fillings, cleanings or routine work, where the comfort measures above plus laughing gas are our approach. Extractions are where a deeper option earns its place, because they’re the appointments patients fear most. If one’s on your horizon, here’s what to expect when a tooth is taken out, and many of the extractions we sedate for involve wisdom teeth and the gum infection called pericoronitis.
Is sedation safe, and how do we match it to you?
Sedation is safe when it’s matched to your health and watched throughout — and that matching is exactly the part that can’t be done from how anxious you feel. Before any sedation we read the whole picture together: the medicines you take (sleeping pills, anxiety medicines and opioid painkillers all add to sedatives, and so does alcohol), breathing conditions such as asthma, long-term lung disease (COPD) and sleep apnea, whether you’re or might be pregnant, and how you’ve responded before. Any one of those can point one way alone and be overruled once the rest is in — some shift the plan, and a few (severe breathing disease, for one) rule sedation out, in which case I’ll tell you so rather than work around it. That judgement is the reason it’s settled in the chair, not from a fear alone.
The monitoring differs by option. With laughing gas, the oxygen-rich mix and constant adjustability mean over-sedation is easy to catch and quick to reverse. With IV sedation you’re watched continuously — a sensor on your finger tracks your oxygen, we follow your breathing and blood pressure, and you stay responsive to voice throughout. Laughing gas in particular has been used in dentistry for generations, including with children, because its footprint is so gentle.
What sedation costs, and whether insurance covers it
Cost depends on the type of sedation and the length of treatment, and coverage varies by plan. Laughing gas is usually billed as an add-on based on time; IV sedation costs more, for the medication, monitoring and longer visit. Insurance plans differ widely — some cover sedation in part, some only alongside surgical extractions, some not at all — so rather than have you guess, give our front desk your plan details and we’ll check with your insurer first. If you’re covered under the Canadian Dental Care Plan, ask us about that too. Don’t let cost uncertainty be one more reason to stay away.
When to call us
Call when avoiding the dentist has started to cost you — a tooth you’re ignoring, a problem getting bigger, visits you keep cancelling. The real damage anxiety does isn’t in the chair; it’s in the years of postponement, where a small filling quietly becomes a root canal or an extraction. When you call, you need one sentence: “I’m anxious about dental visits.” We hear it every week, and it changes how we plan everything — length, time of day, whether sedation joins the conversation. You won’t be talked into anything; a first visit can be nothing more than a look and a chat.
If any of this sounds like you, please reach out — book a visit or call us. Dental anxiety is common, and it’s workable; we see Barrie patients through it all the time. This guide is part of our Adult Patient Information library, where you’ll find the rest of our guides on extractions, healing and everyday dental problems.
