Are you delaying treatment you need or want?

Terrified to pick up the phone to schedule because of painful procedures in the past?

Have trouble gagging or getting numb? Overwhelmed by thoughts of repeated visit to the dentist?

Experiencing dental pain?

Looking to smile again with confidence?

If you answered yes to one or more of the questions above, you are not alone.

Here is the answer, pain free dentistry or sedation dentistry. For many, going to the dentist is a needlessly frightening event, even though dentistry has changed dramatically in past years. New sedation dentistry techniques can make treatment pain-free, reducing what would take multiple sessions to a single visit. With the use of medications, patients can now have their dental care accomplished while they are totally relaxed and absolutely comfortable. In Conscious Sedation, sedative hypnotic medication is administered, allowing the patient to relax while the dentist works on him or her. It is a technique in which the use of a drug or drugs produces state of depression of the central nervous system enabling treatment to be carried out, but during which verbal contact with the patient is maintained throughout the period of sedation. The drugs and techniques used to provide conscious sedation for dental treatment should carry a margin of safety wide enough to render loss of consciousness unlikely.

INDICATIONS FOR CONSCIOUS SEDATION

Indications for the use of conscious sedation as an adjunct to patient management include patients with:

Dental anxiety and phobia
Prolonged or traumatic dental procedures
Medical conditions potentially aggravated by stress
Medical conditions affecting the patient’s ability to cooperate
Children with special needs
Anxious or phobic patients, those with movement disorder or with physical and / or mental disability who are unlikely to otherwise allow safe
completion of treatment and who would thus be denied access to dental care
Enables an unpleasant procedure to be carried out without distress to the patient
Multiple extractions / Total extractions
Wisdom teeth removal
Multiple Root canal treatment
Implant surgery
Gum surgeries

The three standard techniques of inhalation, oral and intravenous sedation employed in dentistry are effective and adequate for the vast majority of patients. The technique used must be selected to provide the most of anxiety relief for the individual patient. No single technique will be successful for all patients. In certain situations, two or more techniques may be employed; for example in a patient with needle-phobia, inhalation sedation may be used to facilitate intravenous cannulation. Fasting for Conscious Sedation is not normally required – light food and clear non-alcoholic fluids prior to an appointment as for Conscious Sedation are enough. However some recommend the same fasting requirements as for general anaesthesia in view of the potential for depression of upper airways reflex sensitivity. A responsible adult escort must accompany the patient and assume responsibility for the post-sedation care for the rest of the day.

MONITORING

Stringent clinical monitoring and appropriate recording of the level of responsiveness, airway, respiration, pulse and color is of particular importance throughout Conscious Sedation procedures of all types and for each patient. All members of the clinical team must be capable of monitoring the condition of the patient. For intravenous sedation, this must include the appropriate use of pulse oximetry and blood pressure monitoring of the patient without addition electronic devices is generally adequate. A member of the dental team must supervise and monitor the patient during the recovery period and both equipment and drugs for dealing with medical emergencies must be immediately to hand. The practitioner must be available to see the patient urgently in the event of any problems arising.

DISCHARGE

The decision to discharge a patient into the care of the escort following any type of sedation must be the responsibility of the seditionist. After assessment, the patient must be discharged to the care of a competent adult. The patient should be able to walk unaided without stumbling or feeling unstable before being allowed to leave professional supervision. Where a cannula has been inserted for the administration of intravenous sedation, it is preferable that it be removed at this stage. Adult patients who have received nitrous oxide and oxygen inhalation sedation may leave unaccompanied at the discretion of the sedationist.