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adult Oral Sedation dental office
adult Oral Sedation as part of dentistry can be a wonderful addition to the services provided to your patients. This article is not intended to provide any training in oral sedation, you are encouraged to take such approved courses.
The ability to treat patients that otherwise go without proper care can be very rewarding for you, your team and your patients. Currently, California, licenses acquired through the Dental Board is required. Part 1004 defines an adult as conscious in all patients over the age of 13, although I personally just treat patients over 18 This permission is only needed if the dentist is going to give medication doses that exceed FDA daily recommended dose. A dentist can apply either by submitting 10 board approved sedations completed before Dec. 31, 2005, have 25 hours of classroom instruction and examination of the patient first live experience of a Board approved CE provider. The license must be renewed every 2 years to a minimum of 7 hours of CE in sedation. Just training the whole dental team, monitoring equipment, emergency training and equipment is required.
Usually in our work, our sedation patients fall into two categories- fear based and time based. Patients fear base are just as you would think, they usually have some previous dental experience that has kept them form a dental office. It is not uncommon for us to see a patient who has not had a dental visit for 10, 20, 30 years in some cases. Typical concerns are bad childhood experience, pain treatment, fear of needles, sound, smell, difficulty getting numb, gag reflex or bad rapport with the dentist. Time based patients usually have at least some fear, but also want to have as few commands as possible to get back to maintenance visit. Patients with hectic work schedules and frequent business travel are examples of patients based on time. The entire dental team must be highly skilled, compassionate, well trained and have excellent communication skills to properly handle patient sedation. Increased patient fears or needs require the team go the extra mile to put the patient at ease.
As before, we treat only patients 18 years or older. Generally, ASA I or ASA II are good candidates and advanced training ASA III can be treated. We consult with each patient a doctor for treatment. Also, a complete medical history and pre-op vitals taken. Oral sedation is very safe, but there are some contraindications – pregnancy, allergy medicine is used, the interaction of some drugs the patient is already taking – I will not go into all that now. Triazolam is the main drugs we use for sedation mouth. Triazolam is a benzodiazepine sedative-hypnotic in the family. Amnesia is natural and welcomed side effect for my patients. Usually the patient takes a small dose of diazepam sleep and we can also complement triazolam with hydroxyzine. We also, quite often, additional sedative with a low dose of nitric oxide during the administration of local anesthetic and oral. Typical sedation appointment is 5-6 hours. We can carry out the treatment of simple restorative, crown and bridge and periodontal treatment (with one trained Hygienists our) full mouth reconstruction, endodontic treatment, oral and laser gum treatment. Our patients are constantly monitored by a pulse oximeter / pulse / blood pressure monitor. We do not put our patients to sleep. They are in a relaxed state that allows them to complete the requested treatment. We can communicate with patients about their appointments as needed. At the conclusion of the appointment, escort the patient is given after surgery and teaching the patient will return home to nap the rest of the afternoon. Patients appreciate amnesiac effect of triazolam. I’ve had patients call the office later in the day, upset that they have slept through and missed their appointments only to be told they were in the office from 7:30 to 1:00 pm.
I hope this give you a brief insight into adult sedation intake and how this can be a wonderful service to provide your patients.
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Source by Craig Johnson DDS