Quad Cities, IL/IA

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Sit Here Without Fear


By Andrew Mulka, DDS,  MyoTech Integrative Health Center

Fear is one of the most common reasons people have for avoiding the dentist. This article aims to present all patients with an option that can make their trip to the dentist more enjoyable. Conscious IV sedation offers patients the option of having treatment performed without remembering it later on. As a licensed provider of conscious sedation, I know firsthand how great of an opportunity it is to provide this comfort to my patients.

Types of sedation
Nitrous sedation (also called laughing gas) is a very simple form of sedation. The patient breathes oxygen mixed with nitrous oxide. With nitrous, patients still know what is happening.

Oral sedation uses pills to create a deeper state of sedation than nitrous. With this form of sedation, the patient usually is aware of what happens.

Conscious (moderate) sedation uses an IV to administer drugs that cause the patient to become sedated. With this form of sedation, the doctor is able to adjust the level of sedation until the patient is comfortable. The patient can still breathe on their own and may be able to follow orders. With this sedation, most patients do not remember anything after the drugs have been given.

Deep sedation (general anesthesia) is the deepest type of sedation. Patients can no longer breathe on their own and need a tube to control breathing. This form of sedation is very rare in dentistry and is usually only performed in hospitals or medical clinics.

Advantages of conscious sedation
Dentists who have a license to perform conscious sedation appreciate the control it affords them. With the lowest level of sedation via nitrous, the patient’s anxiety of being in a dental office is usually so strong that it negates the effect of nitrous. Oral sedation uses similar drugs as conscious sedation, however, the dentist does not know whether the dose prescribed the patient will be appropriate. If the dose is too weak, the patient could take another dose, but it would take 30 to 60 minutes to take full effect. If the dose was too strong, this could result in an emergency situation. Deep sedation is not preferred as it requires a tube to be placed in the mouth, which limits the dentist’s accessibility.

With the use of IV conscious sedation, the dentist starts with a low dose of sedative. If more sedative is needed, the dentist will keep titrating the drug until it has the desired effect. Depending on how long the treatment is, if the patient needs more sedation, the dentist can easily give more and have an immediate effect. If the patient had an adverse reaction to the drugs, an IV line is already present to administer reversal drugs. In addition to sedation and emergency drugs, the dentist can give pain medicine through the IV to help keep the patient out of pain immediately following treatment until the patient is home and can start taking the necessary pain medicine. Monitors are used during treatment to be sure the patient’s health status is not changing. At a minimum, heart rate, blood pressure, and blood oxygen levels are monitored. Most sedation dentists choose to monitor more than is required.

Treatments that can be provided
A general dentist can perform any treatment a patient may need that the dentist would normally perform. These treatments include removal of teeth, placement of implants, fillings, cleanings, gum surgery, bone surgery, root canals, and crowns. During a conscious sedation appointment, the dentist prefers to perform all needed treatment to help the patient save time and the cost of additional sedation appointment fees. This benefit can drastically reduce the number of appointments any patient would need to have treatment completed. This is a great convenience to the fearful patient.

For more information or to schedule an appointment, contact MyoTech Integrative Health Center at 309-764-0008. Located at 1828 Avenue of the Cities, Moline. Visit us at www.myotechdental.com.