Conscious sedation dentistry
Conscious sedation dentistry
How can a person be conscious and at the same time sedated?

When one hears this term all of us would be wondering.how a person could be conscious at the same time sedated. This can happen or would have happened for every person at some time or the other. For example when you are in a midst of a boring lecture in a hall or a classroom you are physically present in that place but mentally absent from that place,but when you are disturbed or asked a question you will respond but will not know what the teacher or the spokesperson has spoken about. May be you will remember some information but not the entire sequence. This is what will exactly happen in conscious sedation dentistry.

How is conscious sedation administered?

It can be administered in various routes such as oral route,intravenous route,inhalational,and intranasal(etc)but the most common and reliable routes of administration pertaining to dentistry and pediatric dentistry are inhalational(nitrous oxide)and intravenous(use of midazolam).

What is NOIS?

Nitrous Oxide Inhalational Sedation as the term implies is used in both adults and children to make their dental treatment very pleasant and comfortable. This is administered with a particular equipment with necessary safety protocols by mixing N2O-O2 .A particular dose for that particular patient when given, takes about 3-5 minutes to act on the body. Nitrous oxide commonly called laughing gas triggers your happiness and smile stimulating hormones in the body .When these are stimulated automatically anxiety,fear and pain stimulation is inhibited,thereby your tolerance level is increased to a large extent. At this point when you communicate with the person he/she obeys your verbal commands more effectively and efficiently in a happy state of mind.At this relaxed state,a prick of the needle does not bother them,bitter substances really do not taste very yucky and vomiting sensations are subdued. So, the co-operation ability of the person is enhanced to a great extent.

What is the age range at which NOIS can be administered?

People right from the age of five till the age of eighty or more can also be given this form of sedation.

Is it not recommended for younger kids less than five years?

Basically it requires some amount of co-operation from the child to inhale and exhale through a small mask kept on the nose and they have to do it continuously till the end of the procedure. Children below five years come under the category lacking co-operative ability(i.e)their mental and physical development is immature to handle such procedures with ease.

Then what is the alternative for such young children?

Either the problem can be addressed with Day Care General Anaesthesia or with the use of intravenous sedation. Basically it is left to the pediatric dentist to decide on what type of sedation will be ideally suitable for the kid and not the otherway round.

Why is it that the focus is on children when you talk about sedation?

Every child who walks into the dental operatory will show signs of anxiety and fear towards dental treatment.when this anxiety and fear is not addressed comfortably for the children they tend to carry it in their head till they become adults. Because of this they happen to be poor dental patients with multiple problems at a later age.

“Adults do not show anxiety and fear unless elicited but children show it very openly”

That is the only difference,so sedation is more commonly used in children than in adults.

How do you decide whether an individual requires sedation or not?

Lot of factors come into play in this decision,a few factors among them are:-

  • Intensity and invasiveness of the dental problem
  • Age of the child or individual
  • Less number of dental visits
  • Addressing multiple problems in a single appointment
  • Overseas patient(staying for a stipulated period)
  • History of unpleasant dental experience previously
  • To develop a positive attitude towards dental treatment
How frequently do you use it in your dental office?

Nearly 7-8 out of my 10 pediatric clients.I treat is the ratio in which practice conscious sedation for children.

In adults approximately 30-40%of the patients in my dental practice will require some form of sedation to handle them comfortably.

What are the advantages the seeker(patient) experiences?
  • Less no of dental visits as multiple dental work is addressed
  • Less intake of medications
  • Time compression(you stay in the dental chair for 4to5 hours continuously,but will experience like you have stayed for about 20 to 30minutes)
  • Positive attitude towards dental treatment.
  • Allay of anxiety and fear towards dentistry.
What are the advantages that the operator (dentist) experiences?
  • More productivity for the operator
  • Less strain in his posture
  • Work can be done continuously without stopping
  • Less salivary secretions-quality of work is enhanced
  • Consistency in delivering good quality treatment.
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