Going to the dentist is a big fear for many people. Feelings can range from anxiety and discomfort to outright phobia. For some people, the experience is so acute it keeps them from seeking dental care for extended periods of time.


A dentist in Story City has the solution to this problem — a problem that can have a big impact on the dental health of those who put off getting care sometimes for more than a decade.


Dr. Daniel Binkowski at Story City Dental is the only general dentist in the greater Story City and Ames area and one of the few in central Iowa to offer IV sedation for any procedure.


“Some people are so scared of being at the dentist’s office that they actually vomit while they’re in the chair,” Binkowski said.


But with the use of IV sedation, the patient is put to a point of relaxation that they can get the dental services they need.


“If you opt for this level of anesthesia, you’ll enjoy an unparalleled level of relaxation during dental procedures that surpasses oral sedation, helping you overcome any fears or anxieties that have kept you from receiving the dental work you need,” Binkowski said.


Deep Sleep Sedation through IV sedation guarantees relief to patients who harbor anxieties about going to the dentist, Binkowski states on his website. At Story City Dental, you can choose between moderate sedation, in which you’ll drift in and out of a sleep state, or deep sedation, in which a certified registered nurse anesthetist (CRNA) helps you achieve a deeper sleep state close to unconsciousness. Regardless whether moderate or deep sedation, patients experience a blissful, anxiety-free visit with IV sedation — and find more confidence to keep returning to the dentist for optimal dental health.


“Many people harbor fear for the dentist. We have seen countless patients neglect their dental health simply due to previous bad experiences. Usually these anxious patients come into our office when neglect of a simple dental problem has been allowed to grow and now the pain is preventing them from normally functioning on a daily basis,” Binkowski said.


There’s no reason to let pain grow to these levels of severity, though. There are many different options for anxiety control during an appointment to ensure a good patient experience, Binkowski said.


Most dental offices offer two common types of anxiety control: Nitrous oxide and oral sedation.


Nitrous oxide is sometimes known as laughing gas. It’s a vaso-dilator, which widens blood vessels and thereby increases blood flow. When the gas is inhaled, the body begins to relax and patients tend to experience euphoria and analgesia. The dentist administers nitrous oxide gas through a nasal hood. After the mask is placed on the patient, they will eventually start to feel tingling in their fingers and toes and sense relaxation. These sensations will continue throughout the procedure until the gas is removed. Once the procedure is over, the operator usually places the patient on 100 percent oxygen for five minutes to “flush” the remainder of the gas out of the blood stream. Afterwards, these effects disappear quickly and patients can resume normal activity. Under prolonged used at high concentrations, above 40 percent, the patient can experience nausea and vomiting.


“This is the least invasive of all the anxiety control options, is easy to titrate the mild effects, does not require much training and generally does not require any patient monitoring equipment,” Binkowski said.


Oral sedation is also known as sleep dentistry, oral anti-anxiety medication or mild sedation.


Oral sedation involves anti-anxiety medication that a dentist will prescribe and a patient must fill at a pharmacy and bring with them to their appointment. Common drugs prescribed are benzodiazepines such as Halcion (most common), Valium, Zaleplon, Ativan, Xanax and Hydroxyzine. Generally the patient takes the recommended dosage the night before the appointment and a second dose one hour before the appointment (this varies). Unlike nitrous, the patient must be driven to and taken home from the appointment by an escort. Onset time and the effects of the drug vary from patient to patient.


“This is what most all office in the local area are using when they advertise ‘sleep dentistry’, but the effectiveness of these drugs at producing a sleep effect couldn’t be farther from the truth,” Binkowski said.


“With IV Deep Sedation, we offer the same thing oral surgery offices offer using our Certified Registered Nurse Anesthetist (CRNA),” Binkowski said.


This is the most effective method for achieving rapid sedation, controlling dental anxiety and producing a sleep effect stronger than IV moderate sedation.


“You will achieve an even deeper level of sedation bordering on unconsciousness — which is why most oral surgeons turn to it for wisdom teeth extractions,” Binkowski said. “Sleep is guaranteed and patients tend to fall into a ‘depressed level of consciousness’ where they may or may not be able to respond to stimuli.”


No memory of the procedure will exist after completion of the surgery. The IV medications used for Deep sedation are Propofol and Ketamine with several other drugs that can be used in combination with them to produce certain desired systemic effects. The main difference between what we offer and what you will find in an oral surgery office is that our Certified Registered Nurse Anesthetist is responsible to patient monitoring and anesthesia thus Binkowski can concentrate on the procedure.


“Secondly we do not hand-dose the sedative, we use a drug infusion pump which allows us to keep a steady, safe level of deep sedation during the duration of the procedure. Action of the drugs is seen immediately in real time. Like IV moderate sedation the same pre-op appointment is required. In some cases consultation with the patients managing physician pre-op is required. A separate appointment is made for the dental procedure (with the IV sedation),” Binkowski said.


The patient must be driven home by their escort. The amnesic effects of the drug last for the duration of the procedure and some time afterward.


“Patients we talk to at post-op all say they only remember falling asleep and waking at the end, nothing else and they wish they could have always done all their dental work under IV sedation,” Binkowski said.


Another option is IV moderate sedation, which is a substantially more effective and safer method for controlling dental anxiety and achieving a moderate level of sedation when compared to oral sedation, Binkowski said, which is why some oral surgeons turn to it for wisdom teeth extractions and most periodontists use it for soft tissue surgeries.


“While sleep is not guaranteed, patients tend to fall into a ‘twilight sleep state’ where they are still able to respond to commands by the provider. Depending on the combinations of the drugs being used for the sedation, many patients describe a sensation of extreme relaxation to an intensely euphoric feeling with almost all reporting that they don’t remember anything or only bits and pieces of the time period encompassing the procedure,” Binkowski said.


Binkowski opened Story City Dental in June and it is located at 525 Timberland Drive, in the new building he designed with his wife Kelly.


Known as “Dr. B” by most of his patients, Binkowski’s career path has been an interesting one. He received his BS and PhD in biochemistry at Iowa State University, where he also was on the Cyclone swimming team. He met his wife Kelly at ISU and they married in 2004; they have four daughters, Autumn, Addyson, Piper and Zoe.


Binkowski graduated from Creighton University School of Dentistry, after receiving an Air Force Health Professions scholarship. He continued his education during his active duty in the Air Force from 2011 to 2015. He spent an extra year learning clinical procedures from several board-certified specialists in the Air Force’s Advanced Education in General Dentistry program at Offutt AFB in Omaha. He was ranked one of the top residents in his class for his clinical ability and treatment planning capabilities, as well as treating multidisciplinary complex dental cases. After, he volunteered for an assignment at a clinic in Eielson AFB in Alaska, where he provided a variety of dental services to the active duty population, such as the removal of fully impacted wisdom teeth, periodontal surgery, endodontics, prosthodontics and IV sedation.


As a result of his varied experience and training, Binkowski brings a wide array of clinical skills into private practice. Patients at Story City Dental can expect to receive comprehensive dental care all under the Story City Dental roof and rarely need to be referred.


And as the only general dentist in central Iowa to offer IV sedation, Binkowski can help patients overcome any fears or anxieties that keep them from the dental health they need.