About Sedation Dentistry
In sedation dentistry, a patient is put into a relaxed state, similar to being asleep. It is used most often with patients who experience moderate to high anxiety with dentistry, and complex procedures requiring longer periods of time to complete. It is important to point out that in most cases, the patient maintains consciousness, as sedation simply lessen the person’s apprehension and put him or her into a sleep-like state.
According to recent studies, it has been discovered that as much as a third of the general population associates dentistry with fear. This reservation causes patients to allow simple conditions to go undiagnosed longer, consequently creating bigger more complex and often costly problems.
This highly common anxiety associated with the dentist’s chair can be modified by both psychological and pharmacological techniques, such as sedation. In some instances, psychological approaches such as hypnosis are sufficient. In many instances,however, the administration of sedatives is more beneficial.
Types of Dental Sedation
Local anesthetics are used to control regional pain. They can be topical (applied on top of the tissue) or delivered via injection, numbing a particular area.
Sedative drugs have a calming psychological effect and control fear and anxiety, but do not control the pain itself. Thus, sedatives are always used in conjunction with local anesthetic injections. Recent studies have shown that patients recover from surgical and complex procedures better when the area of the operation is completely numbed, even when the patient is put under. Relative to the procedure, the patient always takes the sedative well before the numbing injection, minimizing any potential anxiety and fear associated with needles.
General anesthesia, or full sedation dentistry, provides complete relief from both anxiety and pain, offering tranquil and anxiety free dental visits. It involves putting the patient completely to sleep, allowing people who are too scared of visiting a dental practitioner to avoid what is commonly referred to as extreme cases of “dental phobia.” In addition to its application in instances of extreme apprehension, general anesthesia is used in cases of extreme severity, such as reconstructive dentistry.
 The effective control of anxiety and pain (implemented through an array of methods including nitrous oxide, tranquilizers, anti-anxiety medications, etc.) has been an integral part of dental practice since the early development of the profession. IV sedation, or fluid that is delivered through an injection into a vein of the arm has traditionally been the most common means of sedation dentistry. Intravenous (IV) sedation is both safe and effective; it is always performed by a trained professional (a board certified dentist or anesthesiologist) and always puts the patient into a complete sleep.
How Sedation Dentistry Works
Today, oral sedation is among the most frequently utilized from of sedation dentistry that is employed to ease patients’ experiences. This form of sedation does not require needles to administer and while it creates a superior level of comfort, the patient remains conscious (albeit very drowsy and relaxed) for safety and cooperation. A local anesthetic, however, is still required for the procedure, as sedatives are capable of relaxing the patient, but not of quelling the actual pain associated with a procedure.
In-office monitoring of the patient is a critical part of sedation dentistry procedure. This includes the use of a pulse oximeter, oxygen monitoring equipment, and agents for medication reversal (in the event of a rare but serious adverse reaction). To ensure safety, a very careful review of patients’ medical history as well as any prescribed medications is done prior to the procedure.
Independent of the sedation technique that is used, it is vital to pre-arrange for responsible care. Driving after sedation is prohibited and a few hours of monitoring the patient are needed after the completion of the procedure.
Benefits of Sedation Dentistry
The perfection of sedation dentistry has allowed millions of individuals to receive treatment – individuals whose conditions would otherwise worsen. Without the means of controlling pain and discomfort, much of the dental procedures would become impossible to perform and the condition of general oral health would severely decline. Moreover, the use of sedation is often a critical part of treating children or mentally challanged.
Am I a Candidate for Sedation Dentistry?
Are you uncomfortable with the idea of going to the dentist?
Do you have especially sensitive teeth?
Do you have a gag reflex that is difficult to control?
Are you uncomfortable around Needles?
Do you lack the time that is needed for adequate and comprehensive treatments?
Do you require reconstructive dentistry?
If you’ve answered “Yes” to any of these questions, then you may be a candidate for sedation dentistry. If so, you could rely on sedation to insure that you feel no discomfort and have no unpleasant memories of a dental procedure.
Choosing a Sedation Dentist
Numerous dentists offer sedation dentistry, but finding the right doctor for your needs can often be difficult. First and foremost, sedation requires special training which can involve an additional 30 to 40 hours of education. The ADA (and other overseeing agencies in US and Canada) mandates that practicing dentists undergo coursework in techniques, medications, equipment, and evaluation of patient’s medical histories. It is also refreshing to see your doctor participate in ongoing education and training related to sedation procedures. Groups such as the American Dental Society of Anesthesiology and the American Society of Dental Anesthesiologists both offer various programs, so be sure to ask your dentist if he attends on a regular basis.
The following are some additional points you may want to speak with your dentist about:
Does the dentist have extensive experience at sedation?
What type of conditions does the sedation dentist treat on a regular basis? Be sure to find a practitioner that commonly treats the condition you are coming in for.
What type of sedation do you need, and does the sedation dentist offer this specific technique?
Is your sedation dentist a specialist that can combine treatments and reduce the needed number of appointments?
Does this sedation dentist accept your dental insurance?
General Anesthesia vs Sedation
People often erroneously refer to “sedation dentistry” as sleep dentistry. This is in fact a general misconception. In reality, when taking sedatives during the course of a dental visit, a patient feels sleepy while the procedure is taking place – this is the intended effect of the sedative. However, the patient remains awake for the entire visit, but is made to feel calm and relaxed. Memory of the visit is also affected, and very little of the experience is retained in the memory.
Alternatively, general anesthesia involves putting the patient completely to sleep. Medication is administered intravenously and the patient is completely unconscious for the treatment. Sleep dentistry is always performed in the most severe cases, such as oral surgery (i.e. dental implants).
Is Sedation Covered by Dental Insurance?
Dental insurance generally does NOT cover sedation. However, in certain select instances, insurance can cover the additional cost (if, for example, treatment that could alternatively be spread over multiple visits are conducted during one visit). Intravenous sedation is generally not covered under any of the common circumstances.
To schedule an appointment with Dr. Madison or discuss the sedation dentistry options available at Beverly Hills Periodontics & Dental Implants please call (310) 553-2940 or fill out the form here.
Read about gum grafts, crown lengthening, and other forms of cosmetic dentistry in our blog. |