Q&A Topic: Is sedation dentistry right for me?
Dr. Ron Briglia
Q: How do I know if I am a good candidate for sedation dentistry?
Those who can benefit from sedation dentistry are any patients who avoid going to the dentist for any number of reasons. Patients with a very bad gag reflex can benefit by becoming very relaxed, which will eliminate their gag reflex. Patients who have had traumatic dental experiences as children and have developed a phobia will also benefit. If you have trouble getting numb or staying numb, no matter how much local anesthesia is administered, you’d also be a candidate. Other potential patients include those who have busy work schedules or family lives and can’t take a lot of time off work for multiple dental appointments. Even patients who hate the sounds and smells involved with dentistry would benefit.
Q: How long does a typical sedation dental appointment last?
Typical sedation appointments last between three and six hours, but can be less, depending on the exact procedures that you are having performed. It’s not common to be sedated for a dental cleaning, but we can perform a cleaning as part of your sedation appointment. For example, a sedation visit can be utilized for periodontal deep cleanings, root canals, basic fillings, crowns or even cosmetic smile makeovers. Some sedation appointments can be done in a few hours if you require less work.
Q: Are there different types of sedation dentistry?
Yes! There is oral sedation and intravenous (IV) sedation. Oral sedation involves placing one sedative pill underneath the tongue. The pill dissolves and the medication enters your bloodstream, by-passing the stomach and liver. Oral sedation has some limitations: You can only receive one pill, regardless of weight or height, making it difficult to gauge how effective the sedation will be or how long it will last. Many practices that claim to provide sedation dentistry only provide oral sedation. IV sedation is by far the superior form, used in hospitals or in short-procedure units. Once an IV is started, small doses of the sedation medications can be given throughout the procedure to keep you comfortable. The normal saline IV drip also hydrates the patient during an appointment.
Q: What medications are used in sedation dentistry?
Sedation pills are typically Halcion or Triazolam. It’s a Benzodiazepine that is absorbed through the blood vessels underneath the tongue, giving a varying degree of relaxation sedation. For IV sedation, a liquid Benzodiazepine called Versed is used. A Benzodiazepine helps you relax, takes inhibitions away, and helps produce amnesia.
Another medicine that’s used to control pain during IV sedation is called Fentanyl. Fentanyl is 10 times stronger than morphine, and blocks pain in the central nervous system. One other medication in our IV sedation regimen is used to dry up the salivary glands. It’s called Glycopyrrolate, and it helps reduce the salivary gland flow to keep the oral cavity dry. Toward the end of the appointment, an antiemetic called Zofran can be used. This helps reduce post operation nausea and vomiting. It’s administered in either the IV or pill form. Oxygen is also used throughout the entire appointment.
Q: Are there any risks involved in sedation dentistry?
We thoroughly screen our patients, including a medical consult with the patient’s primary doctor, to review their medical history and any contraindications prior to a procedure. Throughout the procedure, we also use a monitor that tracks EKG, heart rate, respiration, blood oxygen content (SPo2 ) and exhaled CO2. Generally, we deal with patients who are healthy or have well-controlled medical issues. Not everybody is a candidate for in office sedation dentistry, though. If a patient has too many medical issues, then a hospital-based sedation dental program may be more suitable.
Briglia Dental Group
600 Marshall St #201
West Chester, PA 19380