Implants and Your Health

Fear of the dentist and implants under sedation

Most people who have put it off for years are not afraid of pain but of two things: losing control and being judged

Some of the people reading this page may not have been to a dentist for more than ten years. The reason is usually not laziness; it is a bad experience in the past, the feeling of losing control in the chair or embarrassment about the state of their mouth. All three can be managed, and all three have known solutions. On this page we explain where the fear comes from, the sedation options and the point people confuse most often: the difference between being put to sleep and sedation.

Short answer

Fear of the dentist is common and can be treated. Managing it involves three steps: communication and handing control to the patient, removing pain completely and, if needed, sedation. Sedation is not being put to sleep; you stay conscious and can answer questions, but you are relaxed and usually do not remember the procedure. General anaesthesia is a separate procedure and needs a suitable setting and an anaesthetist.

Most common source: A bad past experience, losing control, embarrassment
What sedation is: Conscious and relaxed; you usually do not remember it
Is sedation being put to sleep?: No; general anaesthesia is a separate procedure
Who you need with you: Someone to take you home

Medically reviewed by Bilge Ilgın, Dentist · ImplantologyLast reviewed 2026-09-06

Where the fear comes from and how it is overcome

Fear of the dentist ranges from mild unease to losing sleep at the thought of the appointment. It rarely has just one source. The three reasons people describe most often are a painful experience in the past, the feeling of losing control while lying back in the chair, and the fear of being judged for the state of their mouth. Each of the three has its own solution, and none of them is solved by saying 'don't be afraid'.

A painful experience in the past has nothing to do with dentistry today. If you went through a procedure years ago without being numbed deeply enough, your brain carries that experience into the present. With the methods used today, the area is first numbed with a surface gel, the anaesthetic is given slowly, and the procedure only begins once the numbness has been tested and found to be enough. In other words, pain is the part that can be controlled most.

The feeling of losing control is a separate matter, and its solution is not technical but a question of how things are done. Explaining the procedure from the start, saying how long it will take and agreeing on a hand signal reduce this feeling markedly: when you raise your hand, the procedure stops. This simple agreement shows the person lying in the chair that they are the one in control, and for many patients it removes the need for sedation altogether.

The third, and the least talked about, is embarrassment. Most patients who have not been to a dentist for a long time think they will be judged for the state of their mouth, and that thought makes them put it off even longer: the worse the mouth gets, the harder it becomes to go. Let us say this plainly: resolving exactly these situations is our job. A mouth where treatment has been put off for years is an ordinary case for us, and nobody is lectured about their past.

Sedation comes in when these steps are not enough, or when the patient prefers it from the start. The point people confuse most often is this: sedation is not being put to sleep. You stay conscious, you answer questions and you breathe on your own; but you are deeply relaxed and usually do not remember the procedure. Your sense of time changes; a procedure lasting hours feels very short to the patient.

General anaesthesia, on the other hand, is a completely separate procedure: you are unconscious, your breathing is supported, and it needs an anaesthetist and suitable equipment. It is rarely chosen for dental treatment and only comes into consideration in certain circumstances. What people describe as 'having dental work done while asleep' usually means sedation; confusing the two leads people to arrive with the wrong expectations.

Which method for whom

The distinction below is the framework for the decision you make together at the consultation. Sedation is not a requirement; it is an option.

The tooth can be saved

People whose anxiety can be managed through communicationFor a large proportion of patients, explaining the procedure, agreeing on a hand signal and taking breaks is enough. The advantages of this route are clear: no extra medication, no need for someone to accompany you, and a return to normal life the same day.
Anxious patients who will benefit from sedationFor patients who lose sleep at the thought of the appointment, whose heart races in the chair or who have stopped a procedure halfway through in the past, sedation changes the picture completely. It also makes it possible to complete long sessions in a single sitting.
People with a strong gag reflexFor patients who gag while impressions are being taken or while work is done at the back of the mouth, sedation may be the only way to make the procedure possible. This is a reason unrelated to fear, but with the same outcome.
Patients with a long session plannedIn full-mouth plans, surgery can take a long time. Sedation lets both the patient and the team get through it in comfort; for the patient, hours pass like minutes.

Saving it is unlikely to hold

People who cannot arrange for someone to accompany themYou cannot drive after sedation, and it is not appropriate for you to go home on your own. If there is no adult to take you, sedation is not given that day; this is not a rule that can be bent.
People with certain general health conditionsSleep apnoea, advanced heart or lung disease, some medicines and pregnancy all have a direct bearing on the decision about sedation. This assessment is made together with the opinion of the doctor responsible for that condition.
People who cannot follow the fasting instructionsYou are asked not to eat for a certain time before sedation. If this instruction is not followed, the procedure cannot go ahead that day. For conditions where fasting is not easy, such as diabetes, a separate plan is made.
People who think sedation is the only answerSedation does not treat the fear; it manages that session. If you want to build a lasting relationship with dentistry, being able to have later, simple procedures without sedation should also be a goal. A good plan keeps this in mind too.

How it works, step by step

For a patient who is afraid of the dentist, the process does not start with an examination but with a conversation.

1
Talking first, then the examination
At the first appointment, you can simply talk without any procedure being done. Explaining what you are afraid of, what you have been through in the past and what helps you feel at ease is the first step of the plan. Asking for a conversation without sitting in the chair is an ordinary request.
2
Explaining the procedure from the start
What will be done, how long it will take, what you will feel and what sounds you will hear. Uncertainty is the strongest factor in making fear worse; a procedure that has been explained is much easier to get through than one that has not.
3
Agreeing on a hand signal
When you raise your hand, the procedure stops. This simple agreement gives the control to you, and on its own it markedly reduces anxiety for many patients. Sticking to the agreement matters just as much as making it.
4
Removing pain completely
The area is first numbed with a surface gel, the anaesthetic is given slowly, and the procedure begins only once the numbness has been tested. If you feel anything during the procedure, you say so and more anaesthetic is given. Pain is not something to be negotiated.
5
Preparation if sedation is planned
Your medical history and medicines are reviewed, you are told how long to fast, and you are asked to arrange for someone to accompany you. During the procedure, your pulse and oxygen level are monitored.
6
The procedure and afterwards
Under sedation you stay conscious but relaxed; you usually do not remember the procedure. Afterwards you are given time to rest, and you go home with the person accompanying you. That day you do not drive, make important decisions or drink alcohol.

Options to help you relax

The options below are listed from the lightest to the most advanced. Most patients never need the higher steps.

Communication and an agreement on control

Explaining the procedure, a hand signal, breaks and music. The lightest route, and the one that works most often. It needs no medication, and you return to normal life the same day.

Local anaesthetic given properly

Surface gel, a slow injection and testing the numbness. For patients who are afraid of needles, these three steps make a marked difference.

A sedative taken by mouth

A mild medicine taken before the procedure helps you relax. Its effect varies from person to person, and you must not drive afterwards. It can be a choice for mild to moderate anxiety.

Intravenous sedation

Its effect is more predictable, and its depth can be adjusted during the procedure. You stay conscious, you are monitored and you usually do not remember the procedure. The route most often chosen for long sessions and severe anxiety.

General anaesthesia

A procedure in which you are unconscious, needing an anaesthetist and suitable equipment. In dental treatment it is used rarely and only in certain circumstances. A separate option that should not be confused with sedation.

What you should know

The points below cover both the facts about sedation and the price of putting treatment off.

The price of putting it off is paid in bone

Every year that passes because of fear does not make treatment any easier. The bone where a tooth has been lost shrinks away, and the longer you wait, the fewer options there are and the bigger the treatment becomes. The hardest appointment is the first; everything after it is easier.

Sedation is not being put to sleep

You stay conscious and answer questions. A patient who arrives expecting 'I won't feel anything, I'll be asleep' has misunderstood what it is. Setting the right expectations is half of what makes the experience go well.

The rules on being accompanied and fasting are not bent

These are not comfort rules but safety rules. If they are not followed, the procedure cannot go ahead that day, and this is not the clinic being difficult; both exist to prevent serious consequences.

Sedation does not cure the fear

It manages that session. In the long term, a relationship with dentistry is built as positive experiences add up. A good plan also aims for you to be able to have later, simple procedures without sedation.

After sedation

How long the effect takes to wear off varies from person to person and with the method used; the rules are the same.

The first few hours
You rest in the clinic for a while and are monitored. You may feel dizzy when you stand up. You go home with the person accompanying you; public transport or travelling alone is not appropriate.
The day of the procedure
Do not drive, do not operate machinery, do not make important decisions and do not drink alcohol. If possible, have someone with you that day. Instructions for after the surgery are given separately, and you receive them in writing.
The next day
For most patients the effect has worn off completely and they return to normal life. Healing from the procedure itself follows its own course; swelling and tenderness are to be expected in the first few days.
Later appointments
When the first experience goes well, most patients are able to choose a lighter method for later procedures. This is the outcome the plan aims for: the fear growing smaller over time.

Message us right away if

Dizziness or nausea goes on for a long time after sedation. Feeling a little weak for a short while is normal; a marked problem lasting hours should be reported. Call your clinic and explain what is happening.
You have shortness of breath, chest pain or confusion. This is not a matter for a clinic appointment but an emergency. Do not wait; call 112.
You are panicking before your appointment. Rather than cancelling the appointment, call and explain the situation. The plan can be changed: a shorter conversation, adding sedation or splitting the procedure. A cancelled appointment means a fear that has not been resolved.
There is a problem with fasting or having someone to accompany you. Let the clinic know in advance. Because these two rules are not bent, a problem that comes up on the day of the appointment means the procedure is postponed; when it is discussed beforehand, the plan is made accordingly.

What affects the cost

Methods to help you relax can be separate items in the treatment and should be discussed from the start. These are the deciding factors:

The method chosen: Communication and properly given local anaesthetic are not an extra item. A sedative taken by mouth, intravenous sedation and general anaesthesia, however, are each priced separately.
How long the procedure takes: Sedation may be charged according to how long it lasts. In a long full-mouth operation, this item is larger than for a short procedure.
Additional monitoring and staff: You are monitored while sedation is given, and extra staff are present if needed. This is part of safety and not an item to cut back on.
Combining sessions: Being able to carry out several procedures in one sitting thanks to sedation can reduce the total number of sessions, and with it the cost of travel and time off work.

Frequently asked questions

Can I have implants while I'm asleep?

What most patients mean is sedation, and with sedation you stay conscious; you are relaxed and answer questions, but you usually do not remember the procedure. General anaesthesia, where you are completely unconscious, is a separate procedure and needs an anaesthetist and suitable equipment.

Will I feel pain under sedation?

No. Sedation relaxes you but does not numb you; what removes the pain is still local anaesthetic, which is given alongside sedation too. One does not replace the other; they work together.

I haven't been to a dentist for ten years and my mouth is in a very bad state. I'm embarrassed.

We hear this a lot, and we want you to know that resolving exactly these situations is our job. Nobody is lectured about their past. Let us also say this: the price of putting it off is paid in bone, so every year makes things a little harder. The hardest appointment is the first.

I'm afraid of needles. Is there another way?

Fear of needles is very common and can be managed. The area is first numbed with a surface gel, the anaesthetic is given slowly, and most patients do not feel the needle go in. If that is not enough, the local anaesthetic can be given under sedation, and you will not remember that stage.

Can I go to work after sedation?

No. That day you must not drive or make important decisions. You need someone to take you home. For most patients the effect has worn off completely by the next day; healing from the procedure itself follows its own course.

I have panic attacks. Is sedation suitable for me?

In most cases it is, and it makes things markedly easier. You need to tell us which medicines you take and which doctor is treating you; some medicines affect the sedation plan. The assessment is made together.

Can we just talk at the first appointment, without anything being done?

Yes, and we recommend it for patients who are afraid. Starting by talking through what will be done, without sitting in the chair, is an ordinary request. It is also possible to have an initial assessment remotely by sending your X-rays; making the first step as small as possible helps.

Sources

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Next step

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