How Patients with Panic Disorder Can Go to the Dentist

If you suffer from panic disorder, I think it is quite scary to go to the dentist. Since there are even people without any health issues who dislike the dentist, it is normal for someone with panic disorder to feel uncomfortable with it.

However, if you do not go to the dentist for a long period, the oral hygiene environment will deteriorate, increasing the likelihood of developing other diseases. How can patients with panic disorder manage to go to the dentist?

Preventing panic attacks with anti-anxiety medication

One measure that can be considered first is the method of using anti-anxiety medication to prevent panic attacks from occurring.

Basically, anti-anxiety medication has the effect of suppressing symptoms like nausea and hyperventilation that are prone to occur at the dentist. Therefore, it is recommended to take anti-anxiety medication as a dose about an hour before your dental appointment.

As for a specific medication, I think lorazepam is the best. It takes about an hour for lorazepam to take effect, but if you administer it sublingually, it will take effect in about 15 minutes.

Sublingual administration means placing the medication under the tongue for a certain period, allowing the active ingredients to be absorbed directly through the blood vessels under the tongue.

By using this sublingual administration, you can use it not only as a preventative measure to stop an attack from occurring, but also if an attack has already started.

I have also used anti-anxiety medication sublingually when I had an attack shortly after my dental examination began.

Because sublingual administration allows the medication to take effect in a much shorter time than taking it normally, the attack subsided in a little under 10 minutes.

Even if an attack occurs, you can gain peace of mind knowing that you have the medication.

Undergoing intravenous sedation at the dentist

Also, it seems that some dental clinics offer sedation by administering anti-anxiety medication via an intravenous drip. Doing this allows you to undergo dental treatment or cleaning while almost asleep.

However, a drawback of this method is that it is often not covered by insurance, and it frequently costs nearly 20,000 yen for a single treatment. I think that paying tens of thousands of yen for one dental treatment is too much of a financial burden.

Furthermore, since the medication administered via intravenous injection is likely a benzodiazepine-based anti-anxiety drug like midazolam, I think it would be easier and cheaper to just take anti-anxiety medication orally.

It is true that with intravenous anesthesia you can sleep, so the sense of fear would be reduced, but since you have to go to the dentist regularly, it would cost a lot of money if you were to have intravenous anesthesia every time.

In that case, I think it is better to consult with your psychiatrist about your fear of the dentist and have them prescribe a dose for you. For that dose, you could choose an anti-anxiety medication that provides solid sedation and makes you slightly drowsy.

I wrote earlier that lorazepam is good, but I think hypnotic drugs like Depas are also good. Depas is highly addictive and I cannot recommend it to many people, but if you really struggle with dental treatment and want to use anti-anxiety medication orally, Depas could be one option.