Use of sedation eases fears of dental procedures

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James G. Jenkins

One of the main reasons some patients avoid needed dental treatment is fear. Usually this is due to either some past traumatic experience or a current overwhelming imagination of the needed procedures.

I've seen patient's reactions to instructional videos on dental implants. Because it involves bone, patients automatically assume this is going to be painful.

Most of the time, these fears can be minimized by educating the patient about the procedure. They visually are relieved to know that bone itself has no "feeling." All of the surrounding tissue does, though.

In addition, there is some vibration and sound to the hand piece that prepares the proposed site(s) for the implants. This is very tolerable to most patients. Some, however, need some form of sedation to make them comfortable throughout the treatment.

Nitrous oxide (laughing gas) can often be used to provide enough relaxation to proceed through the treatment. It is extremely safe and reversible. This means that as long as the patient breathes through the nose piece, they will have the desired effect.

If the patient gets too relaxed and starts to breathe through the mouth, the effect will be reduced. Usually, coaching the patient on breathing will keep the patient at a stable level of relaxation.

Even in this long-term, time-proven procedure, there have been advancements to make it work better. The most significant one is the mask and tubing. In the past, a large mask was placed over the nose, which could make the patient feel claustrophobic and it limited the vision of the operator.

Now, there is a much smaller device with an inner tube that delivers a positive flow of the gas. The patient does not have to work at their breathing so much, and the much smaller size is comfortable and less threatening.

A deeper form of relaxation is in the form of what is termed "conscious sedation." After a pre-treatment sedation work-up, the patient is given some medications to take the night prior to the scheduled appointment. Upon arrival at the appointment, additional medications can be administered to provide the proper sedation level for the treatment.

Nitrous oxide is also used to administer the local anesthetic. This incremental administration of medications is one of the safest forms of sedation, as complete unconsciousness is not necessary. The added bonus is that following the procedure, the patient has no memory of the treatment.

If you feel that dental implants would benefit you and are afraid to even think about the procedure, conscious sedation and-or nitrous oxide are great aides to help you get what you need.

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

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