CONSCIOUS SEDATION IN DENTISTRY
Dr. Rajat Sachdeva
20 + years of experience , Entrepreneur, International Speaker, TMJ Specialist, Micro Endodontist, Restorative Dentist
Even though modern dentistry has advanced so much so as to deliver the patients an essentially pain free treatment, this isn’t enough for some population who are excessively apprehensive about dental treatments. At Dr. Sachdeva’s dental clinic, we practice great chair-side manner but we also know that it cannot solely relieve a patient’s stress and anxiety and we need to use alternative methods like conscious sedation.
This blog is aimed at giving our patients a fair idea about the concept of conscious sedation to help them make an informed choice.
WHAT IS CONSCIOUS SEDATION
Conscious sedation is a technique which uses drugs to achieve a mild to deep level of sedation in patients by depressing their central nervous system (CNS). However, verbal contact with the patients is maintained wherein the patient can still communicate his/her queries with the dentist.
Conscious sedation (or even called procedural sedation) in the dental office can be achieved through either oral drugs or IV (intravenous) route. However, one of the most popular and safest method of sedation in a dental setting has been laughing gas.
Laughing gas, chemically known as nitrous oxide is a colorless, sweet smelling gas and has been a tried and tested formula for conscious sedation.
WHY CHOOSE LAUGHING GAS?
Nitrous oxide gas is an excellent alternative for any patient who is scared of a needle as this form of sedation will require inhalation of gas through a small mask fitted on to your nose. It requires a few seconds for the gas to act and almost immediately the patient will start feeling euphoric and a slight tingling sensation in hands and feet ensues. This shows that the gas is working well.
An important point to note here is that nitrous oxide is not an analgesic, so the patient will stillrequire the administration of local anesthesia before the procedure. It is essential that the dentist communicate constantly with the patient and understand his/her needs and the amount of nitrous oxide is monitored continuously and adjusted accordingly.
On the completion of the treatment, we stop the nitrous oxide supply and it is eliminated from the patient’s system soon. With just a few minutes of rest in the dental chair, the patient is back to normal and can even drive themselves home.
WHEN IS CONSCIOUS SEDATION NEEDED?
1.?????Patients suffering from extreme anxiety and phobia of dental treatments
2.?????When a traumatic and extensive dental procedure is planned
3.?????When the patients are suffering from medical conditions like asthma or epilepsy which may be aggravated by stress
4.?????Children more than 1 year of age
5.?????Mentally challenged patients who are difficult to control
6.?????Ineffective local anesthesia due to any reason
PREPARATION FOR CONSCIOUS SEDATION
In order to operate under conscious sedation, the dentists need to make a few preparations in the operating area and patients so that the procedure is executed successfully.
Patient preparation:
1.?????Consent: We at Dr. Sachdeva’s dental clinic believe in complete transparency of the treatments and hence communicate each and every detail regarding the treatment to the patient. All the patients receiving dental treatment under conscious sedation are required to give their written consent to us before we begin the procedure. In case of children, the consent is signed by their legal guardian.
2.?????Presedation checkup: American Society of Anesthesiologists has classified the physical status of the patients receiving conscious sedation and according to it, patients who satisfy ASA grade I and grade II criteria are selected. However, in case of children, it is recommended that only ASA grade I are treated under conscious sedation.
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ASA –I- Healthy patients
ASA-II Mild systemic disease
ASA-III Chronic conditions
ASA-IV Severe systemic disease
ASA-V Moribund patients
ASA-VI Brain-dead patients
Ss: For elective procedures using conscious sedation, the 2-4-6 fasting rule applies (that is 2 h for clear fluids, 4 h for breast milk, and 6 h for solids)
Operating preparation:
1.????Monitoring equipment such as ECG, pulse oximeter, ETCO2, NIBP, and defibrillator should be handy in working condition.
2.???Crash cart should be available with all the resuscitation equipment and drugs required to resuscitate a patient
3.???Every procedure should be carried out after ensuring the availability of appropriate size suction catheter, adequate oxygen supply, functioning flowmeters and tubings for oxygen delivery to patient, and appropriate-sized airway equipment.
?CHALLENGES ASSOCIATED WITH CONSCIOUS SEDATION:
Just like any dental procedure, operating under conscious sedation has its own challenges.
However, with appropriate care before, during and after the procedure, we can very well control and ensure that there are no untoward complications.
WHY CHOOSE US?
Dr. Rajat Sachdeva has years of experience in the field of conscious sedation and his philosophy and mission of delivering high quality, advanced and ethical treatments to his patients is unmatched.
When carrying out a case of conscious sedation, the importance of efficient and trained supporting staff in an operating setup adequately equipped with monitoring tools along with importance of detailed presedation assessment and detailed case history cannot be overemphasized.
We are proud to announce that our clinic has been adequately designed to perform such treatments. We have invested heavily in upgrading our infrastructure and training our staff so as to deliver what we promise to our patients.
We have an excellent follow-up team wherein we maintain detailed records of our patients and reach out to them regularly even after the treatment is over.
We are a 24*7 team who works round the clock to provide services to our patients.
If you want to know more about the technique, do come for a consultation today.