Sometimes dental treatment requires some form of sedation in order to be safely and comfortably tolerated. There are a number of reasons why our patients may need sedation while undergoing treatment. A patient may have moderate to severe fear, or phobia, suffer from cognitive or general anxiety disorders, or a patient may have a sensitive gag reflex, or any number of medical or age-related conditions that compromise his/her ability to remain still enough to ensure utmost safety during treatment.
Understanding your sleep and sedation dentistry options can help you and Dr. McBirney work together to determine your best sedation solution. With more than a decade of experience working with special care and special needs patients, as well as holding several area hospital affiliations allowing for intravenous or general anesthesia, Legacy Dental Care Los Altos is unique in offering a full spectrum of sedation dentistry (or sleep) options.
Conscious sedation is what terms such as “relaxation,” or “comfortable” dentistry are referring to. Conscious sedation can be achieved with nitrous oxide (best for patients with minimal anxiety or fear), or—for a deeper sedative result—with oral sedation such as valium (best for patients exhibiting mild fear, a mild gag reflex or for simpler/quicker procedures). Both of these conscious sedation options have been developed to relax patients who might otherwise experience heightened sensitivity as their pain or anxiety thresholds are aggravated by chemicals our bodies release in response to fear. Each conscious sedation option can be used alone, or may be combined to customize your depth and duration of sedation.
- Nitrous Oxide (inhalation sedation): Used for over 100 years, it is an excellent analgesic administered via a nasal hood, and easily fine-tuned by the dentist. All bodily functions remain essentially normal, and effects wear off quickly.
- Oral Conscious Sedation: The patient administers this him/herself, usually about an hour before treatment. After consulting with us, we will determine the most appropriate oral sedation medication and dosage based upon your health history and necessary duration of action. An added bonus of this option is that it has an amnesic that often leaves a patient with little or no memory after treatment.
Unconscious (or semi-conscious) sedation options exist for patients who need to take sedation to the next level due to extreme phobia, physical, developmental, or mental/emotional limitations that prevent them from being able to remain still and/or cooperative for procedures. Deeper sedation might also be indicated for patients who require multiple treatments that they would like addressed in as few sittings as possible.
- I.V. (intravenous) Sedation: Known as “conscious, or deep conscious, sedation,” patients feel they are sleeping, but can still respond to direction or inquiry. Sedation is administered directly into the bloodstream intravenously with more potent drugs than used for oral conscious sedation. This option will impact bodily functions and requires specialized monitoring equipment.
- General Anesthesia: For patients who have the most severe phobia or physical/developmental conditions, including severe gag reflexes. General anesthesia must be performed by an anesthesiologist and requires a hospital affiliation. Once anesthetized, a patient is in a complete state of unconsciousness during treatment. The patient will have no sensation or memory of the treatment. Patients with treatment needs that span a number of hours may find general anesthesia the most comfortable option for sedation, and in most cases they can return home safely within 2-4 hours after their procedures
Although Legacy Dental Care Los Altos strives to make every patient feel comfortable and safe in our care, we realize that fears of the dentist are a very real concern affecting a good portion of the population to some degree, and an estimated 10-15% of the population to a greater degree. This latter group of patients has what is known as dental phobia, and it often prevents them from seeking regular treatment to the detriment of their oral, and therefore overall, health. Patients with dental phobia might consistently make and break dental appointments (a fearful “fleeing instinct”), or they become no-shows because their fear of the dentist causes avoidance. At Legacy Dental Care Los Altos, we do not want any patient to suffer with infections, broken teeth, or generally poor smile appeal because they cannot overcome dental phobia. We want to treat you before a tooth gets infected or broken, or your gums require intense periodontal work.
Dental phobias and stress can be so severe and operate on such a subconscious level that they can lead to “dental fear dreams,” or panic attacks that are marked by classic symptoms of increased breathing and heart rates and sweating. This is why we offer a full range of sedation dentistry options, ranging from oral sedation that induces relaxation or comfortable dentistry, to intravenous or general anesthesia, we can work with you to best manage your fear.
Because of the unique nature of our practice – providing Sedation and Sleep Dentistry for patients with phobias or special needs—Dr. McBirney is a noted expert in this field. Your regular dentist may not be able to provide a full range of sedation options, or s/he may not hold a hospital affiliation. Inhalation or oral sedation may not be enough for patients with severe phobias who either face extensive work because of avoidance of the dentist, or whose phobia is so marked that the only way to safely treat them is with deeper sedation.