Sedation dentistry is often hailed as a solution to all of a patient’s problems regarding dental therapies. It can address anxiety, fear, stress and pain. It can provide a comfortable experience for the dental patient, allowing the dental professional to work safely and quickly. As with any pharmacological agent, there are risks, and before you agree to any sedation dentistry option, it is smart to educate yourself about some of those risks.
While single doses of oral sedatives such as Valium or Halcion are unlikely to harm a patient, there are concerns regarding multiple doses of these drugs that could potentially cause a patient to be overly sedated, or even completely unconscious. Because each patient has a different metabolism, drugs can take between twenty minutes and an hour to become fully effective.
These time-delay issues are not problematic for inhaled sedation or for IV sedation, as these types of sedation dentistry are effective almost instantaneously. For oral sedation, however, a dentist who administers more than one pill could cause an overdose if the medicine kicks in at the same time. Most dentists lack both the equipment and the training to effectively and quickly address an overdose in a patient who is unconscious.
In 2000, a group known as the Dental Organization for Conscious Sedation was launched. Its purpose is to train dentists on sedation dentistry methods such as how to properly monitor a patient during a dental procedure to ensure that their heart rates and oxygen levels are healthy. Despite this, there are still concerns about adverse effects of adults with oral conscious sedation. There have been no reported adult deaths from overdosing; however, some children have died from oral sedation, leading to the practice being recommended only for adults.
If you are about to undergo a prolonged dental procedure, or if you are considering sedation dentistry to address personal anxiety or a dental phobia, look for a dentist who has received training in sedation dentistry and has high levels of experience to ensure that your procedure is as safe and comfortable as possible.
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Sedation dentistry, also known as “sleep dentistry,” refers to the practice of calming and relaxing a patient prior to a dental procedure with the use of pharmacological agents. Sedation dentistry began in the late 1700s when a chemist named Humphry Davy began experimenting with inhaled gasses and first observed the analgesic effects of nitrous oxide, commonly known as “laughing gas,” on himself and on dental patients.
In 1844, an American dentist named Horace Wells used nitrous oxide as a dental anesthetic during the extraction of his own molar tooth. Wells made the observation that while he experienced very little pain while undergoing the extraction, he was still fully conscious during the procedure. A few years later, dentist William Morton and surgeon John Warren performed a public oral surgery at Harvard University, demonstrating the analgesic properties of a sulfur-ether compound, further proving that sedation dentistry should be explored further.
For years, trial and error procedures informed doctors of the safety of various levels of pain-relieving gasses. It was discovered that 100% nitrous oxide, when used in prolonged dental cases, could lead to hypoxia, a condition in which the body is deprived of the oxygen it needs to thrive, something that can eventually lead to death. Finally, a Chicago surgeon named Dr. Edmund Andrews began mixing nitrous oxide with oxygen, administering them simultaneously. This allowed for safer analgesic options for both surgical and dental procedures. Ether and chloroform, combined with some nitrous oxide, was later shown to provide deeper sedation for prolonged treatments.
Intravenous (IV) sedation began in the 1960s at the Loma Linda University School of Dentistry in California. Dentists there experimented with IV sedation for the highest level of management for pain, anxiety and fear for dental patients undergoing surgery.
Today, dentists routinely turn to sedation dentistry for their patients to relieve pain, stress and to provide the most comfortable dental therapies as possible. Talk to your dentist to discover the latest sedation dentistry options and to see how they can help you positively experience your next dental procedure.
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