Sedation Dentistry at the Office of Kevin M. Christ, DMD
Dental Pre-care Treatment
Before IV sedation, Dr. Kevin M. Christ, DMD conducts a comprehensive dental exam which includes a review of your medical history. If necessary, he will consult with your physician to make sure you are a good candidate before performing IV sedation.
During sedation, Dr. Kevin M. Christ, DMD will closely monitor you, along with the use of electronic equipment that shows blood pressure, heart rate, the amount of oxygen in your blood, and often your heart function on an EKG monitor. You and the person taking you home will receive post-treatment and home care instructions, including what you should eat and drink before being released. It is usually okay to resume eating and drinking after getting home, provided the numbness from the local anesthesia has worn off. Drinking water is important after sedation since you will have been without food or water for several hours. If there is any soreness after surgery keep off the affected areas until they feel comfortable.
If pain medication is necessary it is usually best to use over-the-counter non-narcotic medications such as Tylenol, aspirin or Ibuprofen, or prescription-strength medication. Medications like codeine or hydrocodone that keep sedative effects are not advised.
Three Methods of Sedation Used in Our Office
The office of Kevin M. Christ, DMD uses three types of Sedation for the comfort of our patients.
First, we offer Inhalation Conscious Sedation, Nitrous Oxide/Oxygen Sedation also known as “laughing gas”. This is the most frequently used sedation method used in dentistry. All bodily functions remain normal and the person is able to breathe on their own. The patient is more relaxed and may fall asleep and experience some degree of amnesia about what happened during their dental appointment.
Secondly, we offer External Conscious Sedation. ‘Orally Administered Sedation’ is administered by taking a pill. All body functions remain normal and the person is able to breathe on their own. The patient will often fall asleep. Some degree of amnesia is common. The disadvantage with this method of sedation is that the level of sedation for each person is not predictable or controllable. For some patients, this type of sedation may be ineffective.
The third type of sedation we offer is IV Sedation, also known as Deep Conscious Sedation, and is commonly used by Oral Surgeons and Anesthesiologists. Our office utilizes an outside Anesthesiologist. With this type of sedation, medications are administered directly into the bloodstream. This is not a General Anesthesia. The patient can communicate and is breathing on their own. The greatest advantage of IV Sedation is that if someone is not sedated enough, the doctor can administer more medication and the effects are immediate. The drugs used for IV Sedation are more effective than the same drugs taken orally. There is a more profound amnesia associated with this technique and better control
Medication Used for Intravenous (IV) Sedation:
Medications range but the most popular class of medication used for IV sedation in Dr. Kevin M. Christ’s office is known as benzodiazepines, which are defined as any of a class of heterocyclic organic compounds used as tranquilizers.
Acts quickly and wears off fast. It can act faster than some of the older benzodiazepines. Midazolam also has a very good amnesic effect.
Valium can make IV Sedation safer and is still used for oral sedation. Valium is longer-acting but takes longer to wear off. Sometimes it can irritate the veins more than midazolam.
For some people who do not tolerate midazolam or Valium, lorazepam can have it’s benefits. Because midazolam and Valium are metabolized by liver enzymes, some patients that have compromised liver function or who are taking other medications should not use them.
Propofol is not generally used in dental offices. This type of medication is very fast acting but wears off very quickly (half-life). It requires the physician to carefully monitor the patient and requires special equipment that delivers doses in time increments. This also requires the machine to be programmed for a particular individual.
Or opioid analgesic, is added to the IV sedative medication. Sometimes this medication can contribute a sedative effect. This medication can help with paid during dental procedures and relief after the procedure is complete.
Is another opioid analgesic that some dentists prefer to Fentanyl. However, this does cause some respiratory depression.
Is a non-steroidal anti-inflammatory and analgesic (non-opioid) that is used in place of the narcotic analgesics since it does not cause respiratory depression.
Some surgical procedures may be performed under local or regional anesthesia. Local anesthesia involves injecting an anesthetic directly surrounding the operative site, whereas regional anesthesia involves injecting an anesthetic in proximity to the sensory nerves supplying the operative site. Regional anesthesia includes spinal and epidural anesthesia, as well as various peripheral nerve blocks, which can be used to anesthetize virtually any area of the body. While these techniques are generally extremely effective in controlling pain, they are often supplemented with sedation or a general anesthetic to enhance patient comfort during surgery. Additional benefits of local or regional anesthesia include enhancement of postoperative pain control.