Dentistry for Anxious Patients
in Honolulu, HI
 If the thought of oral surgery makes you anxious, you are not alone, and our Honolulu office sees patients like you every week.
Dental anxiety is one of the most common reasons adults delay or avoid the surgical care they need. At Pacific Maxillofacial Center, we hear it often enough that we structure our visits around it, with the full range of sedation options and a team trained to keep you comfortable from the consultation through recovery.
Our two board-certified oral and maxillofacial surgeons hold both DDS and MD degrees, which gives our office something most general dental practices cannot offer in-house: deep anesthesia training and the ability to provide all five levels of dental sedation on site. Whether you need a single wisdom tooth removed or you are facing a longer oral surgery procedure, the conversation starts with how we will help you get through it.
This page walks through the sedation options we offer, what your first visit feels like, and how we adapt our approach based on where your anxiety sits on the spectrum.
On This Page
Why Dental Anxiety Is So Common Before Oral Surgery
The triggers behind dental anxiety are predictable once you name them: the sound of dental instruments, the loss of physical control that comes with being reclined and unable to speak easily, a sensitive gag reflex, past experiences that did not go well, fear of needles, or simply not knowing what is going to happen next.
None of those reactions are unreasonable. Surgical procedures involve sensations that the brain interprets as threats even when the actual risk is low, and pretending otherwise does not help anyone. What changes the experience is having options that meet your nervous system where it actually is, instead of where it should theoretically be.
That is the core of what we do for anxious patients at our Honolulu office. We talk through the procedure honestly, identify which sedation level fits the case and your anxiety profile, and structure the visit so the unknowns get answered before the procedure begins.
Your Oral Surgery Team in Honolulu
Pacific Maxillofacial Center was founded in 1999 by Dr. Todd K. Haruki, who returned home to Hawaii after 12 years of graduate and post-graduate surgical training on the mainland. Dr. Haruki is a Diplomate of the American Board of Oral and Maxillofacial Surgery and a Fellow of the American Dental Society of Anesthesiology. Those credentials, combined with his MD training, are the foundation of how our sedation program is run.
Dr. Neil Oishi also holds dual DDS and MD degrees and is a Diplomate of the American Board of Oral and Maxillofacial Surgery. He serves as an on-call facial trauma surgeon at Queen’s Medical Center, which means he routinely treats patients arriving in pain and under high stress. That experience translates well to anxious patients in an elective oral surgery setting.
Both surgeons completed hospital-based residencies that included extensive anesthesia training. That dual training matters here because the same person planning your surgery is the person responsible for your sedation. There is no handoff to a separate anesthesia provider, and the entire team monitors you continuously throughout the procedure.
Sedation Options by Anxiety Level
 We offer all five levels of sedation at our Honolulu and Waipi’o offices, which means we can match the depth to the case and to where your anxiety actually sits. The deeper sedation options are not always necessary, and the lightest options are sometimes not enough. The right answer depends on the procedure, your health history, and an honest conversation about how you handle dental visits.
- Local Anesthesia – We numb the surgical site with medication. Used in virtually every procedure to ensure the area itself does not hurt, regardless of whether deeper sedation is also used.
- Nitrous Oxide – You inhale it through a small mask. Takes effect within minutes, wears off within minutes after the mask comes off, and lets most patients drive themselves home. Best fit for mild to moderate nervousness.
- Oral Conscious Sedation – You take a pill about an hour before the appointment. Leaves you drowsy and relaxed but still able to respond. You will need a ride home. Fits patients with moderate anxiety or those who want more relaxation than nitrous provides.
- IV Sedation – We deliver medication through an IV line. Most patients remember little to nothing of the procedure. Strong fit for high anxiety, longer procedures like impacted wisdom teeth, or patients who would prefer not to be aware of what is happening.
- Deep Sedation and General Anesthesia – The deepest level we offer. You are fully asleep, with no recollection of the procedure. Used for the most complex cases or for patients whose anxiety would make any lighter option counterproductive.
The right level is not a personal failure if it is deeper, and it is not a badge of toughness if it is lighter. We will recommend an option during your consultation based on what we are doing and what you tell us about past dental experiences. If you have already read up on IV dental sedation or nitrous oxide sedation, come in with questions; the more specific the conversation, the better the fit.
What Your First Visit Looks Like
 The first appointment is a consultation, not a procedure. We use that time to review your medical history, take any imaging we need, walk through what the surgery will involve, and have the sedation conversation. You are not committing to anything in that appointment. The goal is to give you enough information to feel informed about whether and how to proceed.
Telling us on the phone when you schedule that anxiety is a factor for you changes how we prep for the visit and how much time we allot to the consultation. Bringing a family member or close friend with you is welcome, and we encourage it for anyone who feels steadier with a support person nearby.
If you are coming from anywhere in Honolulu or West Oahu, plan a small buffer of time around the appointment. Rushing in from a tight schedule does not help anyone’s nervous system. If you would like to handle new patient forms before you arrive, we can send them in advance so the first thing you do in the office is meet the team, not fill out paperwork.
Benefits of Sedation-Supported Care
The first benefit is the obvious one: you actually get the surgical care you have been putting off. Many patients who walk into our Honolulu office have not seen a dentist in years, and sedation makes it possible to handle work that has accumulated over that time without the anxiety running the entire appointment.
The second benefit is what happens to memory. Most patients with IV sedation or general anesthesia have little to no memory of the procedure itself. For someone who has been afraid of dental care since childhood, that gap in memory can change the way the next appointment feels. There is no fresh trauma to brace against, which is part of why we encourage patients with deep anxiety to start with deeper sedation rather than working up to it.
The third benefit is practical. Because we manage anesthesia in our own facility with our board-certified surgeons, we can often combine multiple procedures into a single sedation appointment, such as extraction plus immediate bone graft, or multiple extractions plus implant placement. Fewer visits means fewer anxiety hurdles to clear.
Why Choose Our Practice for Anxious Patients
We do not double-book patients, which means the team is not splitting attention while you are in the chair. Every staff member is CPR certified, and our surgical and recovery staff are trained to assist with IV sedation and outpatient general anesthesia in our office setting.
Dr. Haruki holds an ADSA Fellowship, the senior level of membership in that society. We use that anesthesia training to administer and monitor sedation in our own facility. Many offices that perform deep sedation bring in a visiting anesthesiologist or refer patients out for general anesthesia entirely. We keep the team consistent from the first phone call through recovery.
We also see a meaningful share of patients who have had difficult dental experiences elsewhere. That informs how we run the appointment: explaining what we are about to do before we do it, checking in throughout, and never proceeding with anything you did not agree to. If you decide partway through the consultation that you need a different sedation approach than we initially discussed, we adjust. The plan is yours.
Sedation Cost and Insurance Considerations
Cost matters, and we want to be straight with you about how sedation factors in. The fee for the surgical procedure itself and the fee for sedation are typically billed separately, and the sedation cost varies depending on which level you choose and how long the procedure runs. Lighter options like nitrous oxide carry a smaller fee than IV sedation or general anesthesia.
Dental insurance coverage for sedation varies widely between plans. Some plans cover sedation in connection with specific oral surgery procedures, some cover it only when documented as medically necessary, and some do not cover it at all. Our front office staff is well-versed in checking benefits, and our insurance and financing section explains how we work with most plans and what payment options are available. The honest answer on cost requires checking your specific plan, which we are happy to do before your appointment.
We have monthly payment plan arrangements available for patients who would like to spread the cost out, and we will discuss that openly during the consultation if it would help. Call our Honolulu office at 808-585-8455 if you want benefits checked before scheduling.
Schedule Your Consultation
If you have been putting this off because of anxiety, calling is the hard part. Call our Honolulu office at 808-585-8455 or request an appointment online. Our Honolulu office is at 1060 Young St #312, Honolulu, HI 96814. We also see patients at our Waipi’o office. The Contact page is the easiest way to reach us in writing if you have questions first.
Frequently Asked Questions
Will I be judged for being anxious about dental work?
No. Dental anxiety is one of the most common reasons adults delay care, and our team has seen the full range of it. Tell us when you schedule that anxiety is a factor. That information helps us plan the visit, not flag you for any kind of judgment.
What happens if I start to panic during the procedure?
With nitrous oxide and IV sedation, the medications themselves take the edge off long before that happens. If you start to feel overwhelmed at any point, raise your hand. We will pause, talk it through, and adjust. We do not push through a panic response.
Will I say or do something embarrassing under sedation?
No. The deeper sedation options keep you relaxed but they are not truth serum. This is one of the questions we hear most often, and many patients describe the experience as similar to a long, foggy nap.
Will I remember the procedure afterward?
Memory varies by sedation level. With local anesthesia and nitrous oxide, you are fully aware and will remember the visit. With oral conscious sedation, memory tends to be hazy. With IV sedation and general anesthesia, most patients remember little to nothing of the procedure itself.
Is sedation safe for patients with health conditions?
For most patients, yes, but the specific answer depends on your medical history, medications, and the sedation level. We review all of that in detail during your consultation. Dr. Haruki’s ADSA Fellowship and both surgeons’ MD training give the office solid anesthesia oversight for complex medical situations.
Can I bring someone with me to the appointment?
Yes, and we require a ride home for anyone receiving IV sedation or general anesthesia. Even for lighter sedation, a support person is welcome in the consultation. Our before and after IV anesthesia guide covers the day-of logistics in detail. Let the front desk know in advance so we can plan space accordingly.
How do I know which sedation level is right for me?
The recommendation comes out of the consultation conversation. We factor in what we are doing surgically, how long it will take, your medical history, and how you describe your anxiety. Some patients come in already knowing what they want; for others, we walk through the options together and decide.
Will my insurance cover sedation?
Coverage varies by plan. Some plans cover sedation in connection with specific oral surgery procedures, others cover it only when documented as medically necessary, and others do not cover it at all. Details on plans we work with appear in our insurance and financing section. Call our Honolulu office to verify your specific benefits before scheduling. |
