Tag Archives | sedation

Overcoming fear of the dentist’s chair

It’s something that most of us experience through our childhood, yet for some of us this also expands as we grow older. Whatever group you fall into, it’s time to overcome your fear of the dentist once and for all. Some of you will have already tried all sorts of tricks to beat it. It may have been scheduling appointments at slightly different times, with evening dentists in Northampton sometimes reporting an increase in the number of nervous patients during this period for that very reason. In truth, the options available to you are endless and we’ll now mull over some of the best ways in which you can overcome your fear of the dentist’s chair for good. Make the most of your first visit It might “feel” like the hardest visit, but in actual fact your first visit to the dentist is probably going to be the easiest for you. The reason is simple; on most occasions this visit will be for a minor procedure – which includes a simple check-up or a clean and polish. By opting for a simple appointment for your first time, you can at least slowly build yourself up and prepare your body for […]

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Does Midazolam Impact the Recovery Room Stay for Wisdom Teeth Surgery?

An interesting article titled “Does Intravenous Midazolam Dose Influence the Duration of Recovery Room Stay Following Outpatient Third Molar Surgery?” appears in the 2015 Journal of Oral and Maxilofacial Surgery written by Kyle S. Ettinger and et al. (vol. 73, pp. 2287-2293). Midazolam is very commonly used for patients undergoing wisdom teeth surgery and the authors set out to determine if it impacts the length a patient stays in the recovery room. Intravenous (IV) midazolam has a rapid onset of effect, short duration of action, minimal impact on cardiac function, minimal effect on respiratory depression, and it produces anterograde amnesia. Some more recent literate has shown that IV midazolam might be associated with prolonged recovery time for oral surgery. Midazolam can cause postoperative cognitive impairment. The study used patients who had all four wisdom teeth removed at the Mayo Clinic in Rochester Minnesota between the ages of 14 and 29. The primary predictor variable for the study was the total dose of IV midazolam administered. The primary outcome variable was the duration of recovery room length of stay (LOS) documented in the electronic anesthesia record. A total of 2,610 patients were eventually included in this retrospective study. The mean dosage of midazolam administered was 4.1 mg (SD, 1.1 mg; range, 0.5 to 10.0 mg). The […]

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Can You Use Nitrous Oxide Inhalation combined with Propofol Sedation for Dental Treatment?

An interesting article titled “A Prospective, Randomized Controlled Trial of Conscious Sedation Using Propofol Combined With Inhaled Nitrous Oxide for Dental Treatment” written by Chizuko Yokoe and et al. appears in the 2015 Journal of Oral and Maxilofacial Surgery (issue 73, pp. 402-409). The article discusses how propofol is one of the most common sedative agents used during dental procedures. However, when used by itself it can lead to adverse complications in patients. The authors set to explore if you can safely combine nitrous oxide with propofol for dental procedures and also improve the quality of the sedation. A total of 90 patients in Osaka, Japan were used in this study. All patients were between 20 and 70 years of age and were not able to undergo their procedure without the use of sedation. After the patients were seated in a dental chair, the electrocardiogram, blood pressure, heart rate, and SpO2 were monitored. A nasal cannulas were used to deliver nitrous oxide. A peripheral 22-gauge catheter was inserted into a dorsal hand vein to allow for propofol to be infused. Patients were blinded and grouped into a group receiving sedation with nitrous oxide inhalation and propofol or a group receiving […]

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How safe is deep sedation or anesthesia in dentistry?

An interesting article titled “How safe is deep sedation or general anesthesia while providing dental care?” appears in the Sept. 2015 issue of JADA (volume 146, issue 9, Pages 705–708) and written by Jeffrey D. Bennett and et al. The article discusses how deep sedation and general anesthesia are given daily in dental offices or practices and this is usually done by oral and maxillofacial surgeons and dentist anesthesiologists. Sedation and anesthesia is given to patients to be able to more easily perform procedures and keep the patient safe and comfortable. Unfortunately in rare cases problems can happen and hence the authors were interested in exploring this. The authors state “Using the available data and informational reports, the authors estimate that the incidence of death and brain injury associated with deep sedation or general anesthesia administered by all dentists most likely exceeds 1 per month.” The authors feel that a patient safety database for anesthetic management in dentistry would provide a more complete assessment of the mortality and morbidity involved. This would be beneficial to developer safer anesthetic care. The authors further state “Optimization of patient care requires appropriate patient selection, selection of appropriate anesthetic agents, utilization of appropriate monitoring, and a highly trained […]

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The History of Dental Pain Management: The Progress That Has Been Made

This is a guest article by Dr. Justin Clemens. Within the past 30 – 40 years, it has become increasingly popular to sedate patients to have dental work completed. Although this seems like a long time, in the sense of medicine and dentistry, it really isn’t. This is where the true melding point of medicine and dentistry occurred. Let’s take a little trip in time to see where we began in dentistry to help us better understand where we are now in terms of pain management. The most recent of what we would call “modern dentists” were more like “tooth mechanics”. They were simply drill and fill or just yank it out with no numbing at all. This was until the advent of cocaine in the late 1800s. It is from cocaine that we derive all of our synthetic local anesthetics with which you may be familiar. The big ones that might ring a bell would be Novacaine, Lidocaine and Septocaine, just to name a few. These essentially made dentistry painless. Patients can still feel anxious about dentistry even with all those drugs available. This is because of the hundreds of years of barbaric dentistry before these drugs were invented. It is not […]

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