Sedation Dentistry: Comparing Oral and IV Sedation

May 14th, 2012 Posted in Sedation Dentistry
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Sedation dentistry has ushered in a new era of safe, anxiety free, comfortable dentistry.  Patients who have dreaded going to the dentist in the past are able to have pain free dental procedures thanks to advances in sedation dentistry.

Many dentists practice conscious sedation dentistry.  Unlike sleep sedation or hospital sedation dentistry under general anesthesia, with conscious sedation dentistry the patient is never unconscious.  In many cases, the patient is so relaxed that they doze off during the treatment, but they are always able to be aroused and can answer questions and communicate during the treatment.

Many patients mistakenly believe that they were unconscious during the treatment because they usually have very little memory of the procedure.  To the patient, it seems like only a few minutes have passed during a procedure that may last an hour or longer.

Conscious sedation can be achieved either through oral medication taken prior to arriving at the dentist’s office or through administration of intravenous sedatives.  Some patients prefer taking an oral medication to having an IV, but oral medications have some drawbacks.  The sedative effect is much longer lasting so the patient needs someone to drive them to the dentist and home again.

With IV sedation, the sedative effect begins almost immediately after the sedative is administered and the effect wears off quickly following the procedure.  In addition, the level of sedation is much easier to control with intravenous sedation.  The amount of sedative delivered can be adjusted up or down to achieve the optimal level of sedation.  Oral sedatives are much more difficult to control and the effect can be unpredictable.

IV sedation is more expensive than oral sedation, but the advantages generally outweigh the additional added expense.

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Misconceptions About Sedation Dentistry

May 14th, 2012 Posted in Sedation Dentistry
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Sedation dentistry is a relatively recent development in dentistry that offers painless, anxiety free dental care for patients who cannot tolerate traditional dental techniques.  However, many misconceptions exist about sedation dentistry that may be unnecessarily keeping some patients from getting the dental care they need.

For example, not all sedation dentistry is the same.  There are many different levels of sedation from very mild oral sedatives and nitrous oxide to full, unconscious sedation under general anesthesia and everything in between.  Most dentists only offer conscious sedation which may or may not include intravenous sedation.

Dentistry under general anesthesia is a highly specialized area of dentistry practiced by relatively few dentists.  Fortunately, most patients can have comfortable dental care with conscious sedation.

One effect of most sedatives is that the patient has little or no memory of the procedure after the sedative wears off.  This leads patients to believe that they were unconscious during sedation but except for dentistry under general anesthesia, the patient is always conscious and able to respond to commands and answer questions. Sometimes the patient is so relaxed that they will nod off, but they can be awoken at any time while under sedation.

Some patients avoid sedation dentistry due to the initial increased cost.  In the long run, sedation dentistry may actually save money.  With sedation dentistry, patients are less inclined to put off necessary dental care.  This saves money since the sooner the procedure is completed, the less damage there will have been to the tooth and the less expensive the treatment will be.  Putting off dental care will result in more extensive and more expensive dental care in the future.

In addition, sedation dentistry can save money by allowing several procedures to be completed in a single visit.  By completing treatments in a single visit that would have taken two or three visits, the cost of sedation dentistry may even be less than traditional dentistry.

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Comfortable Dental Care With Sedation Dentistry

May 14th, 2012 Posted in Sedation Dentistry
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The days of every dental visit being an exercise in anxiety and discomfort are long gone.  No longer do you need to spend the entire visit with your heart racing while you grip the arms of the dental chair until you knuckles turn white.  Sedation dentistry has developed in recent years that ensures that every patient can have a comfortable, relaxed dental experience no matter what their anxiety level or other dental issues.

Sedation dentistry encompasses a wide range of sedation levels to fit the needs of every patient. The mildest form of sedation is the use of nitrous oxide, also called laughing gas.  For many patients, this is all that they need to relax and have a comfortable experience.  For patients who need further sedation, many dentists offer oral or intravenous conscious sedation.

With conscious sedation, the patient is very sedated, but still conscious. They can respond to questions although after the sedation wears off, most patients have no memory of the treatment.  Dental procedures under conscious sedation are usually performed in the dentist’s office.

The deepest level of sedation is fully unconscious sedation and these procedures are handled in a specially equipped surgical suite or in a hospital operating room.  Not all dentists practice the full range of sedation dentistry.  The deeper the level of sedation, the more additional training that the dentist is required to have and many dentists choose not to handle fully unconscious sedation.

However, relatively few dental patients need full, unconscious sedation. Most patients can have very comfortable, anxiety free dental care with the appropriate level of conscious sedation.  If you avoid getting regular dental care because of uncomfortable experiences in the past or if you have other issues that make getting regular dental care difficult, unpleasant or uncomfortable, talk to your dentist about the benefits of sedation dentistry.

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Hospital Sleep Dentistry

May 14th, 2012 Posted in Sedation Dentistry
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When you are looking for a dentist who is qualified to perform full sedation dentistry, keep in mind that the term “sedation dentistry” covers a very broad range of sedation levels. There are many dentists who offer sedation dentistry, but only a few specially trained dentists offer true full sedation dentistry.  Full sedation dentistry is often referred to as hospital sleep dentistry because most dentists perform full sedation dentistry in a specially equipped hospital surgical suite.

Dentists use varying levels of sedation to provide a comfortable, safe dental experience to their patients.  Sedation dentistry includes very mild sedation such as nitrous oxide or laughing gas.  A deeper level of conscious sedation can be achieved with oral or intravenous sedatives.  At this level of sedation, the patient is conscious but in in a relaxed, dream-like state.  Many dentists have the training and experience to safely perform conscious sedation.

Full unconscious sedation dentistry is a highly specialized field of dentistry.  Only dentists who have received extensive training are qualified to perform dentistry on patients who are fully sedated.  These procedures take place in a hospital operating room or surgical suite with the assistance of surgical nurses and an anesthesiologist.

There are many dental patients who can benefit from hospital sleep dentistry.  In fact, there are some patients who cannot safely receive the dental care they need any other way. These include patients who are unable to get numb with regular anesthesia, those with severe gag reflex, and patients suffering from dental phobia.  In addition, hospital sleep dentistry is an excellent alternative for patients with physical, emotional, or developmental disabilities who cannot tolerate dental care in a traditional setting.

 

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General Anesthesia for Dental Care

May 14th, 2012 Posted in Dentistry for Developmentally Disabled
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Most people associate general anesthesia with a surgical procedure, but for some dental patients, dental care under general anesthesia is the only safe, comfortable way to get the dental care they need.  While many dentists offer milder forms of sedation such as nitrous oxide (laughing gas) and mild oral sedatives, only a few highly trained dental specialists offer dental care under general anesthesia (also called hospital sleep sedation dentistry).

These specially trained dentists provide a complete range of dental care  - everything from dental cleanings and check-ups to fillings, root canals, caps, veneers, bridges, and other dental procedures.  While dental care under general anesthesia may seem a little “over the top”, the reality is that hospital sleep dentistry provides much needed dental care for patients cannot get the care they need in any other way.

For example, many patients with a developmental disability cannot tolerate dental care in a traditional setting, even with the strongest conscious sedatives.  These patients often forgo dental care which seriously compromises their oral health as well as their overall health.  Hospital sleep dentistry provides a means for these patients to receive safe, comfortable dental care that helps maintain their oral health and improves their quality of life.

Other patients suffer from uncontrollable dental phobia that is so severe that hospital sleep dentistry is the only way they can receive dental care.  Other candidates for hospital sleep dentistry include patients who are allergic to novocaine or who cannot get numb with novocaine or other analgesics.  Some patients have medical conditions that make it uncomfortable or even impossible to tolerate dental care in a traditional dental setting.

For all of these patients and more, hospital sleep dentistry offers a solution – safe, anxiety free, comfortable dental care in a hospital operating room under full anesthesia.

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Preventing Gum Disease

May 9th, 2012 Posted in General Dental Care
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Millions of Americans have some form of gum disease which can range from a mild inflammation of the gums to a serious infection that can infect the jawbone and cause tooth loss.  Taking good care of your teeth and gums can prevent gum disease and keep your teeth and gums healthy.

Gum disease is caused by bacteria that are naturally present in our mouths.  This bacteria forms a sticky film called “plaque” on our teeth.  Brushing your teeth and flossing help remove plaque, but when plaque is not removed it hardens and forms “tartar” that can only be removed by a professional dental cleaning.

Plaque and tartar irritates the gums and causes inflammation.  This mild form of gum disease is called gingivitis and is easily treated by a professional teeth cleaning.  Good brushing and flossing will help prevent gingivitis.

Untreated gingivitis can progress to a more serious form of gum disease called periodontitis.  As the infection spreads below the gum line, the body’s natural immune system attempts to fight the infection.  Both the bacteria and the body’s response causes bone and connective tissue to start breaking down.  In extreme cases, the bone is severely damaged that the patient’s teeth fall out.

Periodontitis is treated in various ways depending on the extent of the disease.  Treatment may include deep cleaning to remove the plaque and tartar below the gums, medications to fight the infection, and oral surgery to replace damaged bone or gum tissue.

Prevention of gum disease starts with good oral health habits.  Brushing your teeth twice a day and regular flossing will help reduce the amount of plaque and tartar build up. Get dental checkups and cleanings twice a year to remove tartar and to identify signs of tooth decay and gum disease early when they can be easily treated.

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Dealing With Dental Sensitivity

May 9th, 2012 Posted in Cosmetic Dentistry
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Almost everyone has experienced some form of dental sensitivity from time to time.  From a twinge when consuming a cold drink to a sharp pain when biting, dental sensitivity is a common occurrence.  For most people, dental sensitivity is rare and passes after a short period of time.  Other people experience dental sensitivity constantly for months or even years.

Fortunately, dental sensitivity is easily treatable.  No one should endure chronic dental sensitivity.  In fact, in many cases dental sensitivity is the body’s way of telling us something is wrong.  Other than mild, transient dental sensitivity, you should see your dentist if you feel pain or discomfort when drinking or eating cold or hot things, when biting, or when eating sweets.

A healthy tooth is covered with a layer of enamel that protects the dentin, or middle tooth.  The dentin contains nerve branches inside tiny tubules that lead to the tooth’s nerve.  When the enamel wears away, the dentin is exposed and these nerves can react to pressure and hot or cold temperatures.

Dentin exposure can be caused by many different things including wearing away the enamel through vigorous brushing, tooth wear, cavities and tooth decay, a cracked or leaking filling, receding gums, and teeth whitening.  Recent dental procedures can also cause temporary dental sensitivity.

There are desensitizing toothpastes that help reduce dental sensitivity.  Using one of these toothpastes should reduce the problem.  In addition, fluoridated mouth wash will also reduce dental sensitivity.  If you are still experiencing dental sensitivity after trying these products, see you dentist.  There are several options including sealers, fluoride treatments, and laser treatments that can reduce or eliminated dental sensitivity.

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Oral Cancer

May 9th, 2012 Posted in General Dental Care
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According to the National Institute of Health, about 35,000 Americans are diagnosed with oral cancer every year. About 7,600 people die from oral cancer annually.  Cancers of both the mouth and throat are included in oral cancer.  There has been a steady increase in the rate of occurrence of oral cancers for the past five years.

Until recently, the primary risk factors for oral cancer were tobacco use and heavy alcohol consumption.  Tobacco use combined with alcohol poses the greatest risk for developing oral cancer.

More recently, exposure to the human papillomavirus (HPV) especially HPV16 has been identified as the most common cause of oral cancers.  Other causes include sun exposure that cause cancers of the lip and some studies have linked diets low in fruits and vegetables to an increased risk of oral cancer.  The risk of developing oral cancer increases with age although oral cancers linked to HPV typically occur in patients between 20 and 50 years old.

Symptoms of oral cancer include white or red patches inside your mouth or on your lips, a sore in your mouth or on your lip that fails to heal, bleeding in your mouth, loose teeth, pain or difficulty in swallowing, a lump in your neck, and numbness in the lower lip or chin. All of these can be symptoms of other illnesses and not related to cancer, but if you experience any of these symptoms, see your doctor or dentist.

Early detection of mouth cancer is very important.  Oral cancer has a high survival rate if detected and treated early, but most oral cancers are not detected until they are well advanced.  Survival rates are much lower for oral cancers detected at an advanced stage.

Regular dental cleanings and check-ups will help detect oral cancers.  As part of your dental check-up your dentist will conduct a short, painless oral cancer examination.

 

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Oral Health For Seniors

May 9th, 2012 Posted in General Dental Care
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More than 40 million Americans are over age 65 and the number is expected to double by 2050.  As the American population ages, health care issues become increasingly important, including oral and dental health.  Maintaining good oral health habits can help older Americans lead healthy, active lives.

It is estimated that about 25 percent of Americans over the age of 60 have no natural teeth left.  Most of this tooth loss can be attributed to gum disease and tooth decay.  Missing teeth can negatively affect the diet and nutrition of older Americans because people with no teeth or who use dentures tend to prefer soft, easily chewable foods and may avoid fresh fruits and vegetables.

In addition, oral cancers are more prevalent in older Americans.  Over 40,000 new cases of oral cancer are diagnosed every year and about 8,000 people die annually from the disease.  Survival rates are good with early detection, but most oral cancers are not discovered until they are in the later stages and the prognosis is poor.

By following good oral health habits, older Americans can live happier, healthier, more comfortable lives.  Good oral health habits start with twice daily tooth brushing and regular flossing to control plaque, the primary cause of gum disease.

In addition, twice yearly dental cleanings and check-ups will help prevent gum disease and allow for the early detection and treatment of gum disease and oral cancers. Even seniors who no longer have any natural teeth should see their dentist regularly to help maintain overall oral health and be screened for oral cancers.

Finally, avoid tobacco use and drink alcohol in moderation.  In addition to the other known hazards from tobacco use, it poses an increased risk for oral cancer and gum disease.  Alcohol consumption and tobacco use together are one of the primary risk factors for oral cancers.

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What Causes Tooth Loss

May 9th, 2012 Posted in General Dental Care
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Millions of Americans are missing one or more teeth.  The Center For Disease Control reports that one out of four adults over the age of 60 have no natural teeth remaining.  While there are various alternatives to replace missing teeth including dental implants, dentures, and bridges, the better alternative is to take good care of your teeth so that you can have your natural teeth as long as possible.

It is common to have congenitally absent teeth.  In most cases there will be a baby tooth, but not adult tooth to replace it when the baby tooth falls out.  In some cases, the baby tooth will not fall out and will function like an adult tooth long into adulthood. In these cases, it is usually not harmful to leave the baby tooth in place until fails due to dental disease or some other cause.

Teeth are commonly knocked out due to trauma such as an accident.  In some instances a knocked out tooth can be successfully reimplanted by a dentist, but only if the patient seeks immediate attention from their dentist.  Tooth trauma can also result in a cracked or broken tooth that cannot be repaired.

Gum disease is the most common cause of tooth loss.  Gum disease is essentially a bacterial infection of the gums that leads to bone loss.  As the bone supporting the teeth decays, the teeth become loose and fall out.

Tooth loss due to gum disease can be prevented by following good oral health habits. Brushing the teeth twice daily with a fluoride toothpaste, flossing regularly, and visiting your dentist twice a year for dental cleaning and a dental check-up will help keep your teeth and gums healthy.

 

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