Tag Archives | sedation

Are There Differences in Complications After Wisdom Teeth Surgery Depending on the Sedation Received?

An interesting article titled “Complications of Moderate Sedation Versus Deep Sedation/General Anesthesia for Adolescent Patients Undergoing Third Molar Extraction” appears in the 2016 Journal of Oral and Maxilofacial Surgery written by Gino Inverso and et al. (vol. 74, pp. 474-479).  The authors set out to determine if there is any difference in complications occurring after wisdom teeth surgery when patients are given either moderate sedation or deep sedation. For patients undergoing wisdom teeth surgery they may have some say in what level of sedation they receive and it may also be based on the desires of the surgeon. Specifically the authors examined the complications resulting from moderate sedation versus deep sedation/general anesthesia for adolescent patients undergoing wisdom teeth extraction. They sought to determine if any differences in complication risk exist between the two levels of sedation. The authors explored a database commissioned by the the American Association of Oral and Maxillofacial Surgeons (AAOMS) which is known as the Oral and Maxillofacial Surgery Outcomes System (OMSOS). A total of 79 surgeons in 58 sites across the 6 AAOMS districts participated in the data collection. The patients had data entered into the OMSOS from January 2001 to December 2010. The patients included in the present study had to be less than or equal to 21 and had wisdom teeth extracted in an ambulatory […]

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Using Dexmedetomidine For Wisdom Teeth Surgery

An interesting article titled “Sedation Protocol Using Dexmedetomidine for Third Molar Extraction” appears in the 2016 Journal of Oral and Maxilofacial Surgery written by Dae-Seung Ryu and et. al. (vol. 74, pp. 926.e1-926.e7). The article seems to determine a sedation protocol for dexmedetomidine. The authors state that IV sedation is often given in cases of wisdom teeth surgery with midazolam being a medication commonly used. When midazolam is combined with opioids it can cause respiratory depression. Dexmedetomidine is an alpa2-agonist acting on adrenoceptors in many tissues, including those in the nervous, cardiovascular, and respiratory systems. Compared with midazolam, the major advantage of dexmedetomidine is its minimal effect on the respiratory system. It also produces an analgesic effect which can help alleviate the sensation of pain after tooth extraction. The authors set out to study the pain, patient satisfaction, sedation depth, and adverse effects after wisdom teeth extraction using dexmedetomidine and to compare IV and intranasal (IN) routes of administration. The patients included in the study were in Seoul Korea. They  were required to have ipsilateral upper and lower third molars. The upper molar had to be a routine extraction and the lower molar had to be a surgical extraction. A total of 240 patients were randomly assigned to one of three groups. In group 1 wisdom teeth extractions were performed under local anesthesia only. In group 2 […]

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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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