Sedation Dentistry

Sedation dentistry can be provided in our office either orally or through an IV and provides relaxation for patients undergoing specific dental treatments. Many patients prefer sedation dentistry to help them get through long or painful procedures.

When I was fifteen years old, I had eleven cavities. I went to a dentist who extracted three of my teeth and would have taken out more if I was cooperative. He told me, “You will only feel a little pinch.” It was a pinch; to me, it was a terrifying ordeal, and I vowed if I could ever improve the process, I would.

Since the late 1800s, dentists have always used various pain control methods to allow their patients to relax and have their work done. Some patients could have an extraction with local anesthesia but needed additional sedation levels for a root canal. Other patients could have a root canal with local but needed sedation for wisdom tooth extractions. It is all about perception. Some patients are scared when they hear the sound of a drill; others are bothered by a needle’s sight or the smell of medicine they associate with a dental office. Some people have a gag reflex — some so bad that they start to gag when a hand with a dental instrument approaches their face. Dental fear is an individual thing.

Based on a patient’s health and the dental procedures needed, we can propose different sedation levels. A patient treated at one level for one procedure may be treated with less for a similar procedure at a different time. For purposes of discussion for general dentistry, we can call it “the five levels of sedation.”

Types of Sedation for Dentistry

Level One

Intro-sedation or techniques the doctor can use to make the patient feel more comfortable. This may include hypnosis, use of hard- and soft -tissue lasers, warming of the local anesthetics, or using small pediatric needles to start all injections, speaking to the patient in a low, calm voice.

Level Two

Adding nitrous oxide decreases the patient’s apprehension and local anesthesia as needed, and other techniques used in Level One.

Level Three

Anti-anxiety or relaxation medications are given to patients intra-orally (by mouth) before treatment. Patients go through treatment in a more relaxed state. Some amnesic properties are present in these medications. Patients’ pulse, heart rate, and blood pressure are monitored.

Level Four

Treatment is done with the addition of intravenous (by vein) sedation medication to produce a mild conscious sedation state. The patient can maintain his or her airway and respond to stimuli, thus minimizing the possibility of low oxygen levels and cardiac events. In addition to the patient’s pulse, heart rate, and blood pressure is monitored, a capnography machine is also used to monitor their oxygen and carbon dioxide levels.

Level Five

Treatment is performed under general anesthesia in a hospital setting, monitored by an anesthesiologist. If you are hesitant to do dental treatment or even visit a dentist, try discussing these sedation levels with your dentist. There is always an option that can help you.

Keeping Sedation Safe with Good Monitoring Equipment

Capnography allows us to see a graph of the patients’ carbon dioxide levels as they breathe. Capnography is one of the best additions to in-office sedation dentistry that I have ever used. This device allows the doctor to monitor the sedated patients’ carbon dioxide levels to ensure that the correct levels are maintained.

Another great device used in sedation dentistry is an EKG, which can give us a good idea of your primary heart rhythms during a moderate sedation session. EKG, blood oxygen level, blood pressure, pulse rate, carbon dioxide levels, and capnography (breathing chart) are parameters that quickly alert us to the level of sedation and alertness and provide us with a way of continually monitoring the patient through a dental visit.

One of the best safety measures in sedation dentistry is the accuracy of the patient’s medical history. Accurate history includes past use of drugs, including illicit drugs, operations, medications, history of illnesses, and recent medical checkups. Sedation dentistry involves a whole team, and the group consists of the people giving care and the patient and their full involvement with their treatment.

Undiagnosed or untold medical conditions are among the greatest hindrances to properly treating a patient undergoing sedation dentistry. Do not keep parts of your medical history a secret from your sedation dentist!

Sedation Dentistry At Relax Dental

Sedation dentistry can be provided in our office either orally or through an IV and is designed to provide relaxation for patients undergoing specific dental treatments. Many patients prefer sedation dentistry to help them get through long or painful procedures.

Dr. Bertrand Bonnick, regarded as a leader in the field,  is a highly qualified sedation dentist in North Carolina. He recently received the highest award for demonstrating an exceptional interest in the advancement of conscious sedation dentistry. He is also a Diplomate of the Dental Organization for Conscious Sedation. [D.D.O.C.S.], a national organization that promotes conscious sedation dentistry

Sedation dentistry is on the rise due to the Dental Organization for Conscious Sedation, the American Society of Dental Anesthesiologists, and many institutions offering training in their facilities. Many specialty and general practice residencies offer sedation education as a part of their curriculum. In North Carolina, new legislation allows practitioners to obtain permits to do anxiolysis, minimal sedation, moderate sedation, or general anesthesia. Many available anesthesia patients are seen in a hospital or ambulatory surgery center. We list our NC sedation dentistry practice information under Our Dental Practice.

Preliminary Sedation Dentistry Appointment

When you come to our High Point, NC office for a consultation, our sedation dentists are trained to evaluate the following:

  1. Need for sedation
  2. Medical history obtained and reviewed
  3. Dental treatment plan, if possible
  4. Selection of Oral or IV sedation dentistry procedure
  5. Check for the presence of superficial veins (if IV procedure selected)
  6. Obtain baseline vital signs
  7. Preoperative instructions to the patient
  8. Patient education
  9. Informed consent signed
  10. General medical consultation if needed