What is Nitrous Oxide?

Nitrous Oxide or "Laughing Gas" is one of the safest forms of sedation available and can take the anxiety out of most routine dental procedures including cleanings. Non-allergenic and non-irritating, most feel the onset effects within minutes and these effects are completely reversed within about 5 minutes of gas termination. This complete reversal allows you to safely drive home or go to work right after your appointment!

Almost anyone can have nitrous oxide treatment. We can vary the depth of sedation depending on your level of anxiety. The gas also tends to reduce gag reflexes and saliva flow. Most importantly, you will bask in a feeling of relaxation as we care for you.

The gas is administered through a simple rubber hood that rests on your nose providing a feeling of numbness, security, and warmth. If you are known to be claustrophobic, this might not be the choice for you. At or near the end of your treatment, we will provide you with 100% oxygen so you will feel completely normal within 5-10 minutes. At that point, you are 100% ready to independently carry on your life.

What does sedation feel like?

A sedation appointment feels calm and peaceful, and is probably completely unlike any other experience you've had at the dentist. Patients tell us that the whole experience feels like a dream. After the appointment most people have little or no memory of the visit - as if it was a dream, and they can't quite remember the details.

What is oral conscious sedation?

Oral sedation is a great option for many healthy adults. Dr. Fuller uses very safe, gentle medication in the form of a small pill. Often, patients can be comfortably sedated with just one or two pills!

What is an oral conscious sedation appointment like?

Oral sedation utilizes the oldest of all routes of drug administration, the mouth. Safe, economical, and convenient, oral sedation when properly used can deliver a deeper relaxation state than nitrous and provide some amnesic effects. If you suffer more from the thought of coming in than actually being here, this may be the choice for you. After an initial consultation to determine if you need anxiety relief or just need to complete extensive treatment in one visit, we will take baseline vital signs and write a prescription. Halcion (Triazolam) will be taken about an hour before your dental appointment, so you will be relaxed before we start. Although awake, you will feel relaxed and drowsy. Your companion will bring you to the office. During your treatment, we will monitor your pulse, oxygen saturation rate, and your blood pressure with state of the art patient monitors. We never leave your side. Once you are relaxing comfortably in the dental chair, we'll cover you with a warm blanket. We'll begin the dentistry once you are totally relaxed. Before you know it, the appointment will be over. The same medication we use for sedation dentistry can also be given to you the night before to help you sleep. So, don't let anxiety prevent you from having the confident smile or healthy mouth you have always wanted. Take the time to come in and meet us so we can decide together what is best for you. If you would like a first appointment to simply talk about your anxieties and fears, we will do that and no dental exam would be done.

What is IV conscious sedation?

IV sedation uses an IV line in your arm or hand to administer the sedative medications, but is otherwise very similar to oral sedation. Dr. Fuller has received advanced training that enables him to deliver IV sedation very safely and effectively. Some patients find that this method makes sense for them. We'll discuss all the options with you, and help you to make the choice that is right for you.

What happens after the appointment?

It's likely that you'll still feel a little sleepy. We'll keep monitoring you until we know you are ready to leave the office, and your companion will drive you home. You'll need to take it easy for the rest of the day, and for safety reasons, your companion will be instructed to keep you company that day. You may want to rest, and you certainly won't be driving or doing anything that requires your full concentration. Feel free to eat and drink all you want because this will probably make you feel better.

The next day

You are free to resume your normal activities. Most patients feel no discomfort or residual effects from the dental treatment. Fortunately, sedation medications have an amnesic effect. That means you will have very little memory of your visit.

Is it Safe?

Yes. The medications that we use are extremely safe. To ensure safety and comfort, our whole team has been trained to care for sedation patients, and we will be monitoring you the entire time you are in the office.

What if I am embarrassed?

There is no need to be embarrassed anymore. No one here will criticize you or give you a lecture about the condition of your teeth. We see people like you every day, good people who for one reason or another, have been unable to get the care they need. We're just glad you found us.

Sedation Facts:

  • It Really Works! You really can relax through your dental appointment.
  • You will have little or no memory of the experience.
  • You won't remember any sounds or smells.
  • You can relax for up to five to six hours after the IV sedation (or the anti-anxiety pill if you choose). The time you are relaxing will vary depending on your needed treatment and type of anesthesia delivered.
  • Complex dental treatments that often require multiple appointments can often be done in as little as one or two! All while you relax.
  • People who have difficulty getting numb will have no problem when relaxed.
  • Sedation dentistry is a safe way to reduce the fatigue of extended dental treatment requiring long visits.

How long will I be relaxing?

Depending on your needs, from two to six hours. You will rest for 3-4 hours when you get home also, most likely.

Will someone need to accompany me?

Yes, due to the sedative effects of the medication, you will need someone to drive you to our office and home again.

Will I be monitored?

Yes, one of our team is always with you and your vital signs are constantly monitored during the entire visit. You are never alone.

Is IV Sedation safe?

Dr. Fuller is ACLS (Advanced Cardiac Life Support) certified and all of the assisting staff are basic life support certified. Dr. Fuller worked as a paramedic in Billings and Bozeman and is very up to date on emergency scenarios, so you won't have to worry about who is around you while you are relaxing.

What is the medication normally used?

Our most commonly used sedative agent is Triazolam. It is a sedative hypnotic pill in the same family as Valium. It is the same medication that is prescribed hundreds of thousands of times a year by physicians as a very safe sleeping aid. The drug enforcement agency has categorized it as a schedule IV substance, which means it is only one category higher than common aspirin. In over one million dental sedations monitored by the DOCS organization, there has never been a severe emergency or death using this medication.

What are contraindications to sedation dentistry?

  • Pregnancy
  • Nursing mothers
  • Acute narrow angle glaucoma
  • Allergy or sensitivity to benzodiazepine medications
  • Severe medical conditions
  • Significant respiratory problems like severe asthma or emphysema
  • Psychosis
  • Taking a medication called a MAO inhibitor
  • Alcoholics

We estimate that 90-95% of the adult population are good candidates for oral sedation dentistry.

Are there any special restrictions prior to sedation dentistry?

We will go over preoperative instructions in detail when you are scheduling your visit. The highlights are:

  • Nothing to eat or drink 8 hrs prior
  • Reduce caffeine for 12 hrs prior
  • No alcohol or narcotic drugs
  • Take prescription drugs as you normally would unless otherwise directed
  • No contact lenses
  • Wear light-weight comfortable clothing, preferably with short sleeves
  • It is absolutely essential that you have your escort drive you to your appointment and back home

I'm afraid to go to the dentist, but I know I should. What can I do?

Don't put it off any longer. Make a call to our friendly staff or e-mail Dr. Fuller and tell him about your fears. By developing a relationship with us, you are also involving yourself with your treatment plan. We can discuss options to help you control and decide your own treatment and techniques to help you relax and feel more comfortable during your visit.

I've heard that gum disease could affect my overall health. Is that true?

Yes. The bacteria that cause gum disease, or periodontal disease, have been linked to medical problems such as heart disease, adult diabetes, and preterm low-birth-weight infants.

We check for symptoms of periodontal disease each time you come for an appointment. We can treat gum disease in the earliest stages without surgery and show you how to care for your teeth and gums to prevent recurrences.

I really don't like visiting the dentist, is there anything you can do to help me relax? We understand many people have fears about having their teeth worked on. So, we strive to create a relaxing atmosphere. For entertainment and distraction, we have special headphones and DVD movies available in all rooms so you can keep your mind on more pleasant things. And for the more complex procedures, We can provide anti-anxiety measures such as local anesthesia with laughing gas, oral sedation, and also IV sedation to keep you comfortable and relaxed. Please be open and unashamed in requesting assistance to control your anxiety so you can relax at your next visit.

Are you accepting new patients?

Absolutely! We will always accept new patients and look forward to exceeding your expectations with our dental care.

Do you accept referrals?

Your referral is the highest compliment that you can give our practice. We welcome your referrals and will always strive to accommodate the needs of your friends and family. However, you might send your enemies elsewhere!

Do you schedule early or late appointments?

The practice is open on Monday through Friday from 8 am to 4 pm. If you desire an early or late appointment, we highly recommend that you pre appoint your next visit before you leave our office. This will ensure that you are able to schedule at the time most convenient for you.

What if I need to cancel an appointment, will I be charged?

Last minute cancellations deny other patients the benefit of treatment they need. We appreciate every effort you can make to give us as much notice as possible if you need to change an appointment. We do understand that occasionally an emergency will present itself and that there is no other option. Patients are not charged for these cancellations but if you have repeated occurrences we may suggest that you find another dental provider.

I'm a new patient and know there are probably forms to be filled out. Can I do it in advance?

Sure. We soon will have online forms set up so you can simply click on the one you need, print it and complete it at home. Don't forget to bring it with you for your first visit!

Can I choose which dentist works on me, or which hygienist cleans my teeth?

You can always request your "favorite" doctor or hygienist. We note this in your file and make every effort to ensure that you get treatment from the person you want. Occasionally, due to illness or some unavoidable delay, we are unable to honor these requests. If this happens you will be offered the option to reschedule or see another dental provider.

What are the different payment options you provide?

Dental care is vital to your overall health and image, but we understand that you have a budget. We gladly accept MasterCard, Visa, Discover and American Express along with checks, debit cards, and cash. We offer an array of payment options including flexible interest-free payment options. If you desire a payment plan, we offer the services of an outside company, Care Credit®. They have excellent terms and offer the advantages of interest free financing and paying for your treatment over an extended period of time. Though insurance won't directly reimburse us, we'll file your insurance claim and assist you in attaining the maximum level of coverage your insurance will provide.

What makes you different than any other dental practice I can visit?

Fuller Periodontics & Implant Dentistry offers the latest technology for optimal comfort; a benefit we believe our patients deserve.

We are not a general dentistry practice. Our practice is limited to Periodontics, Implants, and Reconstructive Therapy. See our detailed definition of Periodontics.

How do I know when it's time to come in for a checkup?

Although everyone has different requirements, most of our patients return every 3 to 6 months for a professional cleaning and routine checkup. This timeframe varies depending on your particular oral health and needs. While twice daily brushing and daily flossing go a long way towards maintaining a healthy mouth, it is wise to check for plaque that has hardened into tartar, requiring professional cleaning to avoid gingivitis or periodontitis.

It is best to schedule your next appointment prior to leaving your recent visit. If that is not done, our computer system will generate a postcard reminder which will be mailed to you approximately one month prior to your due date. Due to the nature of computers, postal delivery systems and of course, human beings, it's a good idea to flag your calendar to contact us when you will be due.

My breath needs help and I brush everyday. Is it just me or is there something you can do to help?

It could, indeed, be your own imagination. This makes up about 10% of those who feel their breath needs help. However, if you are in the other 90%, there are various things we would suggest. First, there could be a health condition that contributes. If you have not had a recent physical with your physician of choice, we highly recommend it.

Next, we need to consider your tongue. It harbors 85% of the bacteria in your mouth, and if not cleaned regularly, volatile sulfur compounds (VSCs) can proliferate and create an odor you are uncomfortable with.

Regular tongue scraping with an instrument made for that task is helpful. Another method for ridding your mouth of those VSCs is by rinsing regularly with a stabilized chlorine dioxide mouthwash. These can be bought through our office. Unfortunately, the 3 companies who make them are all multilevel organizations, so the stores do not carry these.

One recent discovery is the use of an herbal combination called "Tooth and Gum Tonic" put together by a small company in Ohio. An independent research organization tested a variety of mouthwashes, and although the chlorine dioxides outlasted other "alcohol" mouthwashes, "Tooth and Gum Tonic" fared even better. We have this in our office as well, but we can get you the address if you wish to order it yourself.

Do I really have to floss every day?

Yep. Flossing helps prevent cavities in areas that your toothbrush just can't reach. Dislodging stuck food particles will deter decay. It will also reduce the development of plaque around your gums which helps prevent periodontal disease. If these health reasons aren't enough, consider this: flossing regularly means that your breath will smell better because you will eliminate the bacteria and food particles that cause bad breath. You will keep your teeth longer, and it has been shown to increase your life expectancy by over 6 years!

What is a "fee for service" dentist?

A fee-for-service dentist is a dentist paid directly by the patient for services provided, based on the dentist's cost to provide them. Treatment options and materials as well as the time the doctor spends with you is not controlled by an insurance group, company or third party.

Is there a way I can ask the Doctor questions directly?

During your appointment, feel free to ask the doctor any questions that you may have. If you need extended time for questions, we may suggest you reschedule for an individual consultation so you can have some uninterrupted time. If you wish to speak to one of the doctors via telephone, they are usually unavailable during working hours. Feel free to leave a message, and they will make every effort to contact you that evening. They also gladly receive e-mail messages and respond within 24 hours, sometimes within minutes!

What kind of toothbrush should I use?

Again, this can vary with each individual, but in our opinion, the standard of care has become the electric, or sonic, toothbrushes. They prevent you from causing damage to susceptible tooth structure, yet do a more thorough job on the plaque than a regular toothbrush. Our favorite has recently become the Sonicare, which has a sonic action that creates a polished feel to your teeth.

Is it bad if my gums bleed after I brush my teeth?

Bleeding gums can be a sign of periodontal disease. Healthy gums do not bleed. If your hair bled, you would be concerned. Likewise, if your gums bleed, it is a sign that there is an underlying problem that needs professional attention. We can treat periodontal disease and teach you homecare to prevent further problems. Healthy gums lead to a healthy smile. Call our office so we can schedule your appointment today.

How do the doctors keep up to date on all the current techniques and materials?

Aside from the many clinical journals he reads and the courses he attends, Dr. Brian converses daily with over 1000 dentists worldwide via the magic of the Internet. This network is an invaluable resource for keeping our office on the leading edge of technology and dental research.

Dr. Brian attends numerous hours of continuing education every year - well beyond what is required by the state.

I've always been nervous about getting x-rays. Are there any dangers? Do you have any way to cut down on the amount of radiation you use on me?

Realistically, x-rays are relatively harmless at the doses that are used in dentistry. However, we understand any concern you may have, and have therefore embraced the newest player in this arena. Digital radiography has come of age, and we are pleased to offer it in our office. It decreases the amount of radiation absorbed by 80-90%, but to be honest, we are more thrilled with the diagnostics it provides. We can blow the image up on our monitor, enhance the resolution, and search for abnormalities with many tools available.

How can I have whiter teeth?

Your mouth is different from everyone else's, but generally, whitening your teeth at home with our lab-fabricated custom-made whitening trays or prescription strength whitening strips is effective. You probably have several friends who have done this, so ask around! I want my teeth to look straighter but I don't want to wear braces. What can I do?

As stated before, porcelain veneers are ideal for this. These can be used for "instant braces". In about 3 weeks, not only can front teeth appear to be straight, but also designed any color you want!

Insurance: Do you accept my insurance plan?

If you belong to a traditional insurance plan (sometimes called an indemnity plan) or PPO, we can assist you by filing your insurance claim. Our practice is not a member of any networks or DMO insurance plans. If you are not sure what type of plan you have, we will be happy to call for you and explain your benefits to the best of our ability.

Why doesn't insurance cover my recommended treatment?

Your insurance coverage is a contract between your employer and the insurance company. Specific negotiated limitations keep the premiums down. Insurance may partially cover the cost of treatment, but it should not dictate your dental care. You and your dentist need to decide what treatment is appropriate for you regardless of details of insurance parameters.

Emergency: What do I do if I have an emergency when the office is closed?

Dr. Brian Fuller will be on call when the office is closed. If you are a patient of record you should call the main office phone number. There will be directions on how to contact us. A doctor or staff member will return your call as soon as possible.

I've heard that gum disease could affect my overall health. Is that true?

Yes. The bacteria that cause gum disease, or periodontal disease, have been linked to medical problems such as heart disease, adult diabetes, and preterm low-birth-weight infants.

We check for symptoms of periodontal disease each time you come for an appointment. We can treat gum disease in the earliest stages without surgery and show you how to care for your teeth and gums to prevent recurrences.

My dentist recommended treatment, but my tooth isn't hurting. Why should I fix the problem now?

Teeth do not repair themselves, and early detection of a problem means you'll spend less money and less time at your dentist's office. Be happy that your dentist found and diagnosed the problem before it became painful. If you wait until you feel pain, the problem will have worsened, and the necessary treatment may be more time consuming and expensive.

I'm already missing some of my teeth. What options do I have for tooth replacement?

Several options exist today including complete or partial dentures, bridges, and implants. What would work best for you depends on many factors such as the condition of your other teeth and gums. We'll be happy to discuss options for replacing your lost teeth and help you decide which would be the most appropriate treatment.

What precautions do you take to ensure patient safety?

Our entire practice team is well trained in state-of-the-art sanitation techniques designed to ensure patient safety. This goes beyond wearing gloves and face masks to prevent passing germs, and includes a specialized sanitation center and a water filtration system guaranteeing a fresh water source for each patient.