It ’ s Your Smile
By
Dr . Jernell Escobar
Dr . Escobar has been practicing dentistry in the Bay Area since 2006 . She took over Dr . Palmerlee ’ s practice when he retired in 2012 . She is passionate about providing exceptional oral health care in a patient centered environment . Dr . Escobar participates in continuing education seminars with other leading clinicians in exploring new and innovative methods and materials for restoring smiles .
Sedation Dentistry
A
trip to the dentist can strike terror into the hearts of many . Most people can compose themselves and complete the necessary treatment and go on with their lives . However , for a select few , being awake and alert during dental treatment is not an option . Enter the practice of sedation dentistry . It is now possible to sleep through your dental visit . The only thing you have to decide is what level of sedation is right for you .
The first and lightest level of sedation is the use of nitrous oxide , commonly known as “ laughing gas ,” in conjunction with local anesthesia . For most , the use of nitrous oxide can significantly raise the pain threshold and relax the patient . Most people do not fall asleep with nitrous oxide , but find that they are able to complete treatment due to their relaxed state .
For those who find that nitrous oxide does not provide the means necessary to complete treatment , the next level of sedation is to combine nitrous oxide and the use of a pill . The pill is usually from a class of drugs called benzodiazepines . Valium and Halcion are two examples of these drugs . Combining benzodiazepines and nitrous oxide , for many , produces sleep or a deeply relaxed state during the dental procedure . Depending on the amount of medication that is to be used , your dentist may need a special certification , known as a conscious sedation permit , in order to prescribe this treatment . This has become a very popular modality for the treatment of dental anxiety and is what is commonly advertised as sedation dentistry .
The two aforementioned sedation methods still may not be enough to allow someone to comfortably complete treatment . Intravenous or IV sedation is the next option . Many oral surgeons and dental specialists employ this method of sedation routinely . It consists of administering drugs directly into the bloodstream of the patient which causes the patient to fall asleep . The work is completed and the patient wakes up a little groggy and is driven home with little or no memory of the treatment . This is a much deeper level of sedation than the other two methods and requires additional monitoring of the patient ’ s vital signs as well as management of the patient ’ s airway . Therefore , those utilizing this method require special training as well as specialized equipment .
The final method is traditional general anesthesia . This is now being routinely done in dental offices utilizing mobile anesthesia units . The patient has a pre-operative meeting with the anesthesiologist and then the dental appointment is set . The patient arrives and the anesthesiologist sedates the patient in the dental office . The dentist completes the treatment and the patient is awoken . There are several advantages to general anesthesia over intravenous sedation . First , the patient ’ s airway is completely managed during general anesthesia . Second , the patient requires no additional local anesthesia except for post-surgical pain management . It is worth mentioning that if one elects general anesthesia as their means of sedation , it is best to complete as much treatment as possible to take full advantage of the appointment .
In conclusion , for those who find themselves unable to complete dental treatment due to extreme anxiety or dental phobia , the sedation methods we discussed can provide a means to complete the treatment that they have been avoiding .
This is the fifth in a series of articles , which will attempt to address some of the most common questions that are regularly posed to dental practitioners . We hope that the reader will find this to be useful and perhaps find answers to questions they might have regarding dental procedures . We will preface all of these articles by reminding the reader that no armchair diagnosis or advice is a substitute for a trip to a dental professional . Every person ’ s case is unique and proper diagnosis and treatment planning with a dental professional is essential for optimal case outcome .
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