Some are very afraid of seeing a dentist, believing that it is better not to go - maybe it will pass? The very idea that after visiting the dentist there will be unpleasant sensations is unlikely to seem attractive to anyone. Many parents believe that it will be much easier for children, as well as for themselves, to be physically and emotionally under anesthesia during the procedure.
There is a dental practice called sedation dentistry that uses nitrous oxide pain relievers. They immerse the patient in a state of sleep or drowsiness, thereby reducing emotional stress. For anyone who is afraid of dental intervention and puts off going to the clinic due to fear, sedation dentistry is the ideal solution to the problem. Appointments are quick and the doctor is able to do more work at a time, thus reducing the number of visits.
Preparations used in sedative dentistry
Sedation dentistry uses anesthesia in varying degrees of sedation, including:
- Inhalation . Gives minimal effect. The patient breathes nitrous oxide, known as "laughing gas", in combination with oxygen through a mask placed over the nose. The gas helps to relax. The doctor can control the gas supply, that is, the degree of anesthesia, since the gas tends to quickly evaporate. This is the only form of sedation after which the patient is able to go home on their own after the procedure.
- Oral anesthesia . Depending on the total dosage, such anesthesia may be mild or moderate. Minimal sedation - taking pills. Basically, tablets are Halcyon. Their action is comparable to the effect of Valium. Usually the tablets are taken one hour before the procedure. They make the patient drowsy, but do not let him sleep at all. So during the treatment the person is awake. A larger dose is appropriate when moderate sedation of the teeth is required. This type of anesthesia is commonly used in sedation dentistry. Some people even fall asleep as a result of taking the pills. Awakening is accompanied by a slight trembling in the body.
- Intravenous anesthesia . The sedative drug is administered through a vein, so the effect of anesthesia comes quickly. This method allows the dentist to constantly adjust the level of sedation.
- Deep anesthesia . The degree of sedation is very high. Such anesthesia plunges the person into an unconscious state or a state of very deep sleep for the duration of the procedure. After full anesthesia, it takes time for the drugs to stop their effect, and the person can recover.
Possible risks
When thinking about sedation dentistry, there are some significant drawbacks to keep in mind. First, anesthesia is usually not among the services provided by health insurance, and the cost of this procedure is quite high. Secondly, this method is not suitable for everyone. With caution and only after consulting a doctor, anesthesia can be used for people with obesity and sleep apnea attacks. Such patients are more likely to develop complications after anesthesia.
Another problem is that all people react differently to anesthesia, and sedation itself varies depending on the drugs used. Some, for example, even from a small dose of pills, can fall asleep soundly and feel nothing during the procedure, and then wake up and remember nothing. Others, even from more intense sedation, may remain conscious, but not feel how the doctor works. For others, it may be necessary to increase the dose of pain medication so that they can relax. In this case, the doctor and assistants will have to monitor the patient very carefully, but even in this situation, things can go very, very wrong.
Fatal outcomes in sedation dentistry
Children under the age of 12 are very susceptible to drugs used for anesthesia in sedation dentistry. The reaction to drugs can be spontaneous and unpredictable. So, in 2007, several high-profile cases involving the death of children were recorded in the state of Virginia. The panel found that attending dentists failed to properly monitor and record important signs and pulse oximetry readings. At least one of the cases was associated with an excessive dose of anesthesia, which was administered to the child by unqualified employees of the dental clinic, and then the parents were left alone with the child before the operation without the supervision of medical personnel.
State regulations for sedation dentistry
Due to several deaths, as well as another 7 unsuccessful incidents of sedation dentistry, the state has decided to introduce new standards for dentists practicing sedation dentistry. They are now required to complete a refresher course that includes at least 18 hours of training and practice with a minimum of 20 patients, and to learn how to safely guide and monitor sedation and anesthesia in the dental office.
The state obliged doctors to install emergency equipment in the office and have an emergency protocol, keep a strict record of patients and drugs. Dentists must now be licensed (permitted) for anesthesia and sedation, and the relevant authorities periodically check dental clinics to ensure they comply with all new rules.
The dental office should be attended exclusively by highly qualified personnel, modern equipment necessary to ensure the safety and health of patients. Before committing to sedation dentistry, make sure the dentist is trained and qualified to handle sedatives.
Pills or anesthesia?
Taking pills as a sedative is a risky procedure for several reasons. Firstly, this method is slow, since the complete resorption of the tablet and the onset of its action may take several hours. If you take a large dose, the patient will be "passed out", and the dentist will not be able to wake him up or cancel the effect of the drug. With such sedation, neither the knowledge and experience of the dentist, nor modern equipment will help if an emergency occurs, for example, when the patient's blood pressure starts to jump or breathing stops.
Unlike pills, anesthesia is less dangerous. The fact is that the dose is prescribed strictly individually, and by specially trained personnel. It is also always possible to equalize the level of anesthesia in case the patient has received an overdose.
Overcome your fear of the dentist
At first glance, sedation dentistry seems to help with fears of dental procedures, but it works in the opposite direction. A number of reasons contribute to this. In the case of deep anesthesia, you simply will not remember the treatment process, so you will not know that dental treatment is not worth fearing.
Sedative drugs (pills) can give exactly the same effect, and in addition, they can impair memory, prevent the comprehension of new incoming information, and prevent the brain from recovering memories. You may believe that the success of the treatment at the dentist depends in some way on the method of sedation, but in fact the key to success is the skill of the doctor and the professionalism of his assistants. There are many healthy and safe ways to relieve the pain and anxiety of a patient at the dentist's office, without the use of sedation dentistry (read " Anesthesia in Dentistry ").
