A SOLUTION FOR FEARFUL DENTAL PATIENTS: CONSCIOUS SEDATION DENTISTRY – WHAT IS IT?

Imagine being so frightened of visiting the dentist that you endure a toothache. For some people this is a reality. Others may quell their fear enough to get themselves to the dentist’s office, but the visit is an emotionally excruciating ordeal. For people like these, Conscious Sedation Dentistry (CSD) is a blessing. What is CSD?

Conscious Sedation Dentistry is the oral administration of a drug that alleviates the anxiety and fear of the dental visit. The patient is awake and able to respond to commands, such as “open wider,” and can even get up out of the dental chair to use the bathroom. However, the patient won’t feel anxious and, most of the time, will not even remember the dental visit.

Local anesthetic is routinely used to numb the teeth being treated. For those who fear these injections, CSD remedies that problem as well. There are some patients who do not fear dentistry, but, for some reason, their teeth just do not become numb from the injections. No one is sure why this happens, but, with use of CSD, these patients’ teeth do get numb.

Some people will ask me, “How can you use conscious sedation? Using drugs does not fit in with a holistic dental practice.” In my practice of Whole-Body Dentistry, I try to understand the impact the mouth has on the rest of the body. If someone is so fearful of having dentistry that they end up needing a root canal or an extraction, that outcome is far worse than the short-term use of a drug. The conscious sedation drug will be out of the system within a day, while the negative impact of having a root canal or an extraction is long lasting. In general, I do not agree with the drug- based paradigm of western medicine, but I acknowledge that there is a time and place for everything. If I were to undergo major surgery, I would want a prescription drug in addition to a homeopathic to help alleviate the pain. If someone is a Type I Diabetic, insulin will save his or her life. I do, however, have a problem with the chronic use of multiple drugs. Did you know that the average American is on eleven prescription drugs!

More on CSD

There are two types of conscious sedation, intravenous and oral. The effects are the same, but the route of administration is different. My remarks, below, pertain solely to the one type of Oral Conscious Sedation (OCS) that I use in my practice.

Of major importance is the fact that OCS is extremely safe.

The type of OCS drugs mainly used is benzodiazepines. The dosage used for dental work is far below the level approaching a toxic dose. Also, before this sedation is administered, there is software that is used to search for any possible unsafe interactions between the OCS drug and any other medications the patient may be taking. If this analysis reveals a possible interaction, another sedative medication will be employed.

In some instances a patient may be given some Valium to take the night before the dental treatment visit. The patient is also instructed not to eat anything for about eight hours prior to this dental appointment. Also, someone must drive the patient to and from the dental office and stay with the patient for the rest of the day.

After arrival at the office the patient will be made comfortable in the dental chair and be given a predetermined dose (base on their weight, age, and etc.) of the appropriate OCS drug. Throughout the dental procedure the patient’s blood pressure, heart rate, and tissue oxygen saturation will be monitored to further enhance the safety of OCS medication.

Given that it takes about an hour to reach a point of relaxation, no procedures are begun until the patient is completely comfortable. Anxious patients really appreciate CSD. They enjoy feeling comfortable, losing a sense of how long they are in the dental chair, and, for the most part, not even recalling the procedure. They especially appreciate having a healthy mouth!

© 2012, Mark A. Breiner, DDS

 The information presented is for educational purposes only. You should consult a qualified health practitioner for diagnosis and treatment.