Sedation dentistry techniques -
Anxious About Dentists? Stress-Free Treatment If you have a dental phobia or anxiety about a procedure, our sedation and anaesthetic options will keep you pain-free and relaxed throughout your dental procedure.
We offer multiple methods to best meet your individual needs and the type of procedure you are having. We create a personalized treatment plan for your safe, comfortable, and effective treatment. What Will Being Sedated Feel Like? Is Dental Sedation Safe For Me?
Excepteur sint. We have a full consultation with you, to determine a safe and effective treatment plan and sedation dentistry method that is right for you; using conscious sedation or sleep dentistry.
Next, we use local anaesthetic so you don't feel pain, and administer the chosen sedation dentistry method. We do not proceed until you are fully sedated. While you are relaxed and comfortable, we complete your dental treatment, able to focus on your oral health needs.
Rest assured, you are monitored at all times. After, we ensure you are recovered from the sedation and are doing well after your procedure. We guide you on all post-procedure care for both your procedure and sedation.
Sedation Dentistry Options At Waterloo West Dentistry, we will provide you full information about your sedation options. Ensuring Everyone Benefits from Dentistry. Sedation dentistry helps ensure that everyone can benefit from necessary dental procedures, since no one should be discouraged from seeking dental treatment.
Sedation is excellent for helping with:. Oral sedation makes you feel drowsy, relaxed, and comfortable. Your worries and anxieties fade away. During the procedure, you will experience light sedation.
However, you are still awake and responsive. Oral sedation has many great advantages over other sedation methods. The benefits include the following:. You take the oral sedative one hour before your dental procedure.
Once the sedation begins to take effect, your dentist monitors your breathing and blood pressure to ensure they remain in the normal range. The sedation creates positive feelings of drowsiness and relaxation.
You are freed from worry, stress, and anxiety throughout the procedure. Your limbs may feel heavy and relaxed, and they may tingle slightly.
If your dental procedure is invasive, your dentist might administer additional local anesthesia to numb the treatment area. Once the procedure is complete, your dentist checks your heart rate, breathing, and blood pressure to see if everything is normal.
Since oral sedation can have some lingering effects, a friend or family member should be ready to drive you home after your appointment. You should avoid working or participating in intense physical activity until all side effects have worn off. In the meantime, you may experience nausea, drowsiness, headaches, or a general feeling of sluggishness.
There are many sedation dentistry methods available for patients at Bloor West Smiles, including the following mentioned below. All are used to make you feel more at ease during your procedure.
Before you receive any sedation, let your dentist know about any medication that you are taking. Nitrous oxide is administered alongside oxygen to produce a calming effect in patients.
You will not lose consciousness, and you will still be able to communicate with your dental team. There are rarely any side effects of nitrous oxide. Plus, the effects wear off almost immediately once the gas is flushed out with oxygen. This form of sedation is injected directly into the bloodstream.
It has immediate effects, and patients often feel as if they slept through their procedure. Many feel groggy or sleepy afterward. Since it is administered through a needle, it is not recommended for those with a severe phobia of needles.
Both general anesthesia and deep sedation are administered through medication. You will be nearly or fully unconscious throughout the procedure. Oral sedation and other forms of sedation are very safe and effective.
This prevents the patient from perceiving visual, auditory and painful stimuli, and presents a clinical picture in which the patient stands awake, his eyes are open and can move involuntarily, but appear to be unaware of the environment.
Since ketamine is water and oil soluble, it can be administered by intravenous, intramuscular, oral, rectal, intranasal routes. The highest plasma concentration is reached approximately 1 minute after intravenous administration, 5 minutes intramuscular administration and 30 minutes after oral administration.
Ketamine has a sympathomimetic effect on the cardiovascular system, causing an increase in blood pressure, heart rate and heart rate. After the application of ketamine, spontaneous respiration continues, and muscle tone of the upper respiratory tract increases. Pharyngeal and laryngeal airway reflexes are usually preserved.
Ketamine acts as a bronchodilator. Ketamine stimulates saliva and tracheobronchial secretions that may cause laryngospasm. The use of oropharyngeal tampon is recommended when ketamine is used during dental treatments [37].
Wathen et al. Vomiting was higher in the ketamine-treated group than in the ketamine and midazolam-treated group. At the same time, vomiting was observed more frequently in children who received ketamine under 10 years of age compared to children who received ketamine over 10 years of age.
Ketamine can cause skeletal muscle hypertonicity and rigidity. This effect can be reduced by administration of benzodiazepine. Random movements that are not associated with painful stimuli may be seen in the patient.
These movements should not be confused with insufficiency of sedation level [37]. Ketamine should be administered only by an experienced anesthesiologist in a hospital setting [35].
Propofol is the most commonly used intravenous anaesthetic agent for induction of anaesthesia, which is not chemically related to other intravenous anaesthetics.
It has no analgesic effect and can be used for sedation in doses lower than the dose required for general anaesthesia. It has a narrow security range when used for sedation [39]. It is preferred in sedation applications due to its short duration of action and rapid recovery, as well as its low side reaction [33].
It is a strong respiratory depressant. Since it does not cause histamine release, it can be used safely in patients with asthma. Propofol is also known for its amnestic and antiemetic properties. During injection, it may cause pain.
To prevent injection pain, it is recommended that the drug be injected slowly into a large vein and administered prior to intravenous lidocaine [40]. Propofol should not be used in children with egg allergy due to its formulation containing egg lecithin [34]. Since the safety and efficacy of propofol use in children has not been established, its use is not recommended [33].
In case of application, it is recommended to be applied in a hospital environment by an experienced anaesthesiologist [39]. Nitrous oxide is used to provide general anaesthesia in the s, analgesia in the s and conscious sedation today [41].
Hulland et al. In the study of Işık et al. Nitrous oxide is a non-irritating, pleasantly smelling, colourless gas obtained by heating the ammonium nitrate crystals to °C.
It is the only inorganic gas used to create anaesthesia in humans. When the nitrous oxide gas is inhaled, it is rapidly absorbed from the alveoli and transported by physical dissolution without binding to any element in the blood when it enters the circulation [43].
Because of its low solubility in blood, the onset of action and recovery time are very fast. Although nitrous oxide is classified among inhalation anaesthetics, it is the weakest and provides limited analgesia and is unlikely to provide surgical anaesthesia unless concentrations leading to anoxia are reached [4].
Some patients may experience amnesia, but with little change in learning or memory. When used at the recommended concentrations, there is a superior safety margin in which no significant morbidity and mortality is recorded [45].
As it does not irritate the respiratory tract mucosa, it does not increase the risk of bronchospasm and can be used in patients with asthma. Changes in respiratory rate and depth are not due to the direct effect of nitrous oxide, but because of the patient's anxiety [46].
This is particularly advantageous in the treatment of patients with cardiovascular system disorder [4]. As a result, the dentist should know which method to use and choose the appropriate sedative agent.
While making this choice, the degree of difficulty of the application, cooperation of paediatric patients, anatomical and physiological characteristics of the children, age, and average processing time should be taken into consideration. In addition, the dosage, safety, duration of action, ease of administration and titration of the sedative agent to be used should be considered.
Considering all these, a sedation route that provides optimum results should be preferred. It should be remembered that success in sedation can be achieved when maximum treatment is provided with the lowest dose-correct sedative agent-appropriate method.
Received: January 03, Accepted: January 13, Published: January 20, This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Oznurhan F, Derdiyok C Sedation methods and drugs used in dental sedation. J Dent Res Pract 4. DOI: Home Contact Us.
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The drugs and application methods in dental sedation Fatih Oznurhan. Sivas Cumhuriyet University, Faculty of Dentistry, Department of Pediatric Dentistry, Turkey E-mail : bhuvaneswari.
Sedation application ways Agents selected for sedation; inhalation, oral, intramuscular IM , intravenous IV , intranasal IN , sublingual SL and rectal. Inhalation Inhalation is the route of sedation where the gas or volatile sedative agent reaches the alveoli in the lungs and shows its primary effect by absorption via blood-gas [7].
Oral The oral route is an easy and economical way to administer and is the oldest used drug administration route. Intramuscular Intramuscular administration is a parenteral technique in which the drug enters the cardiovascular system directly without passing through the gastrointestinal tract.
Intravenous Intravenous administration is the fastest mode of action of the drug, and hand-heart-brain circulation is completed in approximately seconds. Intranasal Intranasal administration, which has recently begun to be used with increasing interest in non-invasive applications, is used as an alternative to sedation by oral or injection, especially in paediatric patients [21].
Sublingual The advantages of this method are that the permeability of the mucosa in the sublingual region is very high and that the drug passes directly into the systemic circulation with virtually no enterohepatic circulation. Rectal The availability of more reliable drug administration routes reduces the frequency of rectal administration.
Drugs used in sedation Hydroxyzine The Hydroxyzine is an antihistamine that has features of reducing sedative, antiemetic and salivary secretion [4]. Promethazine Promethazine is a phenothiazine with sedative and antihistaminic properties.
Diazepam Diazepam is an oil-soluble and water-insoluble long-acting benzodiazepine. Midazolam Imidazobenzodiazepine is a benzodiazepine group with strong sedative, amnesic and anxiolytic properties. Effect of midazolam on systems: Cardiovascular System: Cardiovascular depression is minimal in induction doses.
Arterial pressure, cardiac output and peripheral vascular resistance show little decrease. Sometimes it can increase the number of heart beats.
Midazolam is considered to lower blood pressure and peripheral resistance more than diazepam. Respiratory system: It inhibits the respiratory reaction to carbon dioxide. This depression is important in intravenous administration or when combined with other drugs that cause respiratory depression.
Although apnoea is less than induction of barbiturate, it can also be observed in intravenous administration. Cerebral: Cerebral reduces oxygen consumption and blood flow. It is very effective in epileptic seizures. Oral sedative doses constitute anterograde amnesia. Their muscle relaxation is at the spinal level.
Induction doses may cause loss of consciousness. No direct analgesic effects. Drug interactions: Erythromycin inhibits midazolam metabolism, prolongs its effect and intensifies. This antibiotic inhibits the destruction of oral midazolam in the liver, leading to an increase in plasma levels, thus increasing the severity and duration of the sedative effect.
Ethanol, barbiturate and other agents that causes central depression strengthen the effect of midazolam [32]. Meperidine Meperidine, an opioid agonist, has been used mainly for intravenous sedation for many years.
Fentanyl Fentanyl is a short-acting opioid agonist with a fast onset time. Chloral hydrate Chloral hydrate is one of the hypnotic group drugs synthesized in Ketamine Ketamine is an aesthetic agent which has been preferred for many years in anaesthesia practice and has analgesic, hypnotic and amnesic effects.
Propofol Propofol is the most commonly used intravenous anaesthetic agent for induction of anaesthesia, which is not chemically related to other intravenous anaesthetics. Result and Conclusion As a result, the dentist should know which method to use and choose the appropriate sedative agent.
Financial disclosure None. Conflicts of interest The authors declare that they have no conflicts of interest. References Leelataweedwud P, Vann WF Jr Adverse events and outcomes of conscious sedation for pediatric patients: Study of an oral sedation regimen.
J Am Dent Assoc J Clin Pediatr Dent Pediatr Dent
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