sedation

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

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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 … Read more

How safe is deep sedation or anesthesia in dentistry?

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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 … Read more

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

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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 … Read more

Updates on Anesthesia Provided by Oral and Maxillofacial Surgeons

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Recently, it has come to my attention that the American Association of Oral and Maxillofacial Surgeons (AAOMS) has released a new white paper titled “Office-Based Anesthesia Provided by the Oral and Maxillofacial Surgeon,” in 2013, located over at http://www.aaoms.org/docs/papers/advocacy_office_based_anesthesia.pdf. This data contains some important data from the OMS National Insurance Company (OMSNIC) which to my knowledge had been previously closed. This data is Anesthesia Morbidity and Mortality Data from 2000 to 2010  for a total of 29,975,459 in-office anesthetics (conscious sedation, deep sedation and general anesthesia) provided by oral and maxillofacial surgeons in their offices. It was found from this data that the ratio of office fatalities/brain damage per anesthetics administered is 1 to 365,534.  I had long wondered what this data showed as I have previously looked at numerous studies attempting to determine how many deaths occur when anesthesia … Read more

Politics of Dental Anesthesiology

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A recent article titled “Dental anesthesiology falls short of becoming ADA specialty,” by Rob Goskowski, Nov. 1, 2012, located at http://www.drbicuspid.com/index.aspx?sec=sup&sub=rst&pag=dis&ItemID=311903, discusses a recent vote that took place at the House of Delegates during the 2012 American Dental Association (ADA) Annual Session. The House of Delegates voted against recognizing Dental anesthesiology as the 10th ADA recognized specialty. Steven Ganzberg, a clinical professor and the chair of dental anesthesiology at UCLA says: “This action by the ADA confirms that the ADA process of specialty approval is fatally flawed….This was clearly an effort by the ADA, through AAOMS [the American Association of Oral and Maxillofacial Surgeons], to restrict professional activities that specialty recognition would have provided.” Dr. Ganzberg and some other supporters were hoping that the specialty would be approved as they felt it would lead to increased training and emergency preparedness … Read more