Dr. Smith realizes that there are many different procedures that require many different levels of sedation. Many patients will use one type of sedation for one procedure and a different type of sedation for another. This is why it is so important to explain everything in the initial visit. That way we make sure that the patient is properly relaxed and prepared for everything we are doing. Here are the different ways that each type of sedation in administered.
This is a mild form of sedation that makes the patient feel as though they had a couple glasses of wine during the procedure. Every operatory is equipped with a simple hookup for nitrous oxide, even the hygiene rooms. The patient merely breathes the gas to get the desired effect. The level of the gas is easily adjusted to make the patient as comfortable as possible. After the procedure, there is no lingering after effect. The patient is able to legally drive home making this a very convenient and popular form of sedation.
Single Pill With Laughing Gas
This is a simple way to relax the patient while keeping in a moderately sedated state. The patient takes one pill about an hour before the appointment. This will usually mildly relax the patient. The patient is then given nitrous oxide to get them into an even more relaxed state. This is a very popular option for cleaning visits for those patients that do not like to get their teeth cleaned. The patient does need a driver to take them home after the procedure.
Multiple Pills With Laughing Gas
The patient takes a pill about and hour prior to their appointment. Dr. Smith then evaluates them when they arrive at the office and usually will give one or two more pills to get them into a more sedated state. Once they are moderately relaxed, Dr. Smith will usually put them on oxygen and nitrous oxide to make sure that they are absolutely comfortable. These patients usually have a hazy yet positive memory of their visit to the dentist. This is a popular choice for simpler visits like fillings and deep cleanings.
The patient often takes a pill one hour before the visit to get them into a relaxed state. Dr. Smith is excellent at starting the IV and the patient often barely knows it goes in. Dr. Smith then uses a combination of medications to safely get the patient into moderate conscious sedation. A team of three is with the patient during treatment–Dr. Smith, his assistant, and the monitoring assistant. The monitoring assistant’s only job is to monitor the patient’s vital signs such as breathing, oxygen levels, blood pressure, carbon dioxide levels, EKG and patient awareness. Every member who functions as the monitoring assistant has taken advanced training for sedation monitoring. When the procedure is over, the patient gradually wakes up having little to no memory of what has been done. They usually sleep the rest of the day extremely happy knowing that after all the years of worry, they have a solution to their dental fears.
Intravenous Sedation with Nurse Anesthetist
As discussed on the Special Needs page, there are some patients that Dr. Smith does not feel comfortable sedating on his own. For these patients he brings in Heather Reimund from Sacramento. Heather has been a nurse anesthetist for over 30 years treating all sorts of special needs and medically compromised patients. For special needs patients like autism, Down’s syndrome, and cerebral palsy, Heather will start them with a sedative drink. This will allow her to place the IV. Once she has that in place she uses her vast experience to chose just the right medication to sedate the patient and allow Dr. Smith to do his work.
Northpoint Outpatient Surgery Center
Although Dr. Smith does not use this option often, there are been some patients who require a hospital environment to have their dental work done. Dr. Smith has privileges at the Northpoint Surgery Center for those patients that require general anesthesia for their dental work. Here they are intubated and put under general anesthesia by an anesthesiologist. Dr. Smith performs the needed dental work right there in the operating room.
In Fresno, there are only a few dentists who are licensed to perform Intravenous Sedation. The training and licensing required to do IV sedation are extensive, so most dentists who advertise “Sedation Dentistry” are only using a pill to mildly sedate or relax people.