Many people can’t quite explain their fear of dental work, but that doesn’t mean it doesn’t exist; not being able to pinpoint the exact source of a fear doesn’t make it any easier to deal with, either.
If you have a longstanding tendency to avoid seeing your dentist — for even preventive exams and cleaning — you know how troublesome it is to have to make an appointment for serious dental work and the degree of angst you experience. West Chester Dentist Dr. Ron Briglia understands.
Not all dental practices have the ability to offer dental IV sedation, but Briglia Dental Group does, and does not hesitate to point out the benefits for patients who require pain free dentistry.
What IV Sedation Involves
Sedation can be accomplished in a variety of ways to allow a dentist to perform required work on patients with a overriding fear, a strong gag reflex or the memory of unnecessary pain, making them fearful and anxious. In addition to numbing gels and shots, nitrous oxide — laughing gas — is employed with great results for short-term relaxation and a more comfortable time in the examination chair. They are appropriate and, in many cases, provide all the sedation that is required. However, for more serious work or for dental appointments that can extend over a period of hours, a more serious anesthetic is often necessary. There are options here, as well. Oral sedation, the “little blue pill,” is placed under the tongue and offers fast-acting sedation benefit. Disadvantages are that only one dose may be administered by dissolving a pill under the tongue, and its efficacy depends to a certain extent on an individual’s weight, physical tolerance to medication and degree of built-up anxiety.
Administration of medicine intravenously has a number of advantages: an underlying saline drip keeps patients hydrated during the procedure, anesthetic dosage is readily controlled, patient condition is easily monitored, and the IV itself allows for other medications to be easily administered; for instance, preparations to dry the salivary glands, to reduce nausea and post-op vomiting or, in rare cases, to deal with an emergency.
Several different drugs may be employed for IV sedation. This is the same technique used in a variety of medical procedures, including colonoscopy, and the goal is to encourage relaxation, reduce feeling to eliminate pain and produce amnesia. The benzodiazepine that we favor is known as Versed, and it usually provides effective results. Another synthetic narcotic, Fentanyl, blocks pain in the central nervous system and it is effective for dental work requiring a longer duration.
Risks and Required Preparation
There are some risks associated with IV sedation, but prior to scheduling any dental procedure that would require this type of sedation, we consult with a patient’s primary care physician. In most cases, the IV sedation is considered safe enough to pursue. If not, however, we will discuss options and, in extreme cases, may even suggest a hospital-based sedation dental procedure. A recent general medical exam is a good way to begin preparation for this type of dental work.
Secondly, we will discuss with you any medications you regularly take and any medical conditions you currently have. But, we routinely also do that prior to any extended or ongoing dental work.
Sedation dentistry is not designed to add another layer of anxiety to your dental experience, but there are some considerations:
You may be groggy or sleepy after sedation dentistry. We always suggest that you make arrangements for someone to drive you to your appointment and be available to pick you up afterward.
On the day prior to sedation dentistry, we advise a lot of liquid, a light diet and nothing after about 11 p.m. Appointments are usually scheduled for 8 a.m.
Because a good night’s sleep is beneficial, we often prescribe a sleep aid to alleviate apprehension and promote relaxation.
We suggest comfortable, loose-fitting clothing with short sleeves. We monitor a patient’s physical condition and blood pressure constantly during every procedure and we need unhampered access to the arms. We do, however, assure your comfort with blankets and even pillows. Our monitoring protocols include checking your blood pressure, blood oxygen levels, heart rate and heart rhythms, exhaled CO2 and a 3-lead EKG. Our trained staff is enabled to deal with any out-of-the-ordinary readings.
Post-operative procedures are simple, but well-defined, and we always go over them with your designated caregiver. As previously mentioned, usual effects may include drowsiness or even slight disorientation, but they are generally short-lived and are no cause for concern.
Following a procedure that involves IV sedation, we monitor patient condition for an ample amount of time before we release you to go home. During that period, you will rest comfortably, be offered something to drink, and we may even begin oral pain medication as well. Once at home, you will most likely be hungry, but we discourage large, heavy meals. Something nutritious like a milk shake or soup is certainly all right, but that cheeseburger ought to be delayed for at least several hours and probably until the next day.
Just as with any other surgical procedure, your body and your mind both require a bit of readjustment, from the sedation as well as from the procedure. Do not try to resume normal activity, even unassisted walking, immediately. Give yourself a rest, knowing that it’s acceptable. Dr. Briglia, who has been practicing IV sedation dentistry for 12 years, will personally check in with you by phone within the first few days to assure that all is well.
Briglia Dental Group is proud of its reputation as a “painless dentist.” Do you have questions about IV sedation? Have you delayed scheduling an appointment for advanced dental repairs or periodontal services? Why not contact us so we can discuss the available options? We’ll address your fear and work together to find the best way to deal with it before we get to work on your teeth. Call us at (610) 692-4440 or feel free to schedule your appointment here!