Conscious sedation in dentistry benefits many patients

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Is anxiety or fear keeping you from visiting the dentist? If so, you might benefit from sedation during dental procedures.

Sedation dentistry uses medications to help patients relax and has been a real breakthrough for those who fear dental procedures so much that they avoid going to the dentist at all. Sedation can be used for everything from a simple cleaning to more comprehensive procedures.

The level of sedation your dentist will recommend varies depending on the level of your fear. With minimal sedation the patient is awake but relaxed. For many years dentists have used nitrous oxide (also called laughing gas) for this purpose. The nitrous gas is combined with oxygen and inhaled through a mask.

The combination works very quickly as long as the patient breathes it in. It wears off just as quickly when removed from the patient.

Now, oral sedation options in pill form including Halcion (in the same drug family as Valium) give dentists and patients the option of moderate sedation. At the assessment appointment, the patient is instructed not to eat after midnight the evening prior to the appointment. The patient is given a mild sedative to take before bedtime prior to the appointment and another stronger sedative to take the morning of the appointment.

Additional medications are given, depending on the patient's level of sedation, prior to the actual dental procedures beginning. Patients will feel drowsy and might slur words while speaking. Some people might even fall asleep while in the dentist's chair but can be stirred with a gentle shake or oral command.

The sedation effect can last up to six hours. Due to the nature of the procedure, a trusted friend or family member is needed to drive the patient to and from the appointment. These medications have a very desirable amnesic quality. This prevents the patient from remembering much or any of the dental procedures.

Regardless of which type of sedation is used, patients also typically need a local anesthetic. This numbing action relieves the sensation of pain at sites where the dentist is providing treatment.

In addition to helping people overcome anxiety and fear, sedation can be helpful for patients who have a low pain threshold or very sensitive teeth, who can't sit still in the dentist's chair, or have an easily triggered gag reflex. It can also be a good solution for those who need a large amount of dental treatment done and don't want to come to multiple appointments.

While sedation is generally safe, it's important to discuss risk with your dentist. He or she should ask about your medical history, any medications you are taking, and chronic conditions such as sleep apnea.

Dentists are regulated by the Commission on Dental Accreditation (CODA) as well as state boards. For this reason, dentists must complete specialty training to administer sedation safely.

Isn't it time to stop putting up with difficulty in eating, pain and aggravation due to dental fear?

James G. Jenkins, D.M.D. is the owner of Bluffton Dental Care in Bluffton.

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