Sedation is a common part of wisdom tooth extractions and
implant placements. But more and more
dentists are offering patients who otherwise might be anxious the option to
have their dentistry performed under sedation.
While death from conscious sedation during a dental procedure is rare,
you want to make sure your dentist is properly trained and takes every
precaution possible. You might want to
have second thoughts if the dentist doesn’t require a comprehensive physical
before administering conscious sedation.
Every patient needs continuous monitoring for changes in
blood pressure, heart rate and oxygen levels, with a trained assistant present
who keeps close records of these vital signs and medications provided. And certain guidelines should be followed,
such as other ongoing health issues, allergies, weight characteristics, when
the patient last ate and any other conditions that might alter the risk of
complications. Steps have to be taken
before, during and after the procedure to ensure the safety of the patient.
Given the risks associated with sedation, some
anesthesiologists express concern that dentist might not be receiving enough training
to perform well in an emergency situation.
Apparently however, the lure of thousands of new found dollars has
stimulated an increasing attendance in weekend courses on oral sedation. These
courses promise to train dentists in how to safely administer sedation to both
adults and children, in a few short lessons over one or several weekends.
The ADA supports the right of ‘appropriately trained’
dentists to use sedation or even general anesthesia to treat patients, while the
American Academy of Pediatric Dentistry, has expressed concern over the use of weekend
courses to adequately prepare a dentist with the emergencies that can arise
through the use of oral sedatives. Weekend
seminars are valuable sources of continuing education, but a single or even
multiple seminars do not the appropriate expertise necessary to perform sedation
dentistry. Even under the best of circumstances, maloccurrences occur.
I personally have found that the concentration required to
perform excellent dentistry does not allow for proper monitoring of a sedated
patient. If it’s not nitrous
oxide/conscious sedation, I do not sedate patients. This is not to suggest there aren’t bona
fide specialists in the field of dental anesthesiology but having the training
and experience to properly handle critical, even life threatening emergencies,
while a patient is sedated is paramount.
It’s the patient’s responsibility to ensure the dentist has
acquired sufficient training and it is the responsibility of a parent to ask
about the doctor’s credentials before allowing their child to be sedated. I cannot overemphasize the importance to seek
out a board eligible or certified dental anesthesiologist if you or your child
needs sedation in order to receive dental care.
You should not be afraid to ask the dentist for their credentials,
and you want to be fully informed about the process before you agree to
conscious sedation for you or your child.
If we can be of assistance do not hesitate to contact us.
Novy Scheinfeld, DDS, PC
290 Carpenter Drive, 200A
Atlanta (Sandy Springs), GA 30328
404-256-3620
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If the sedation process will not be performed appropriately, this can be dangerous especially to children. I agree to this. According to my resources, only a small percentage of dentists who have completed the Commission on Dental Accreditation (CODA) program in deep sedation and general anesthesia can use these more complex techniques. These dentists are typically oral and maxillofacial surgeons and dentist anesthesiologists. Some dentists use a dentist anesthesiologist, who is specially trained to give all levels of sedation and anesthesia to both children and adults.We need to make sure that we are getting the exact trained dentist to perform such important procedure. Thank you for this ideas and with this, we'll be more careful. Should we ask what dose of the sedative is appropriate for our age and health and whether it is within the dose recommended by the FDA?
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