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Bracebridge, ON P1L 2B8
The most commonly employed technique used in conscious sedation dentistry is inhalation sedation with nitrous oxide and oxygen (N20-02) or "laughing gas". It is estimated that approximately 35% of U.S. dentists use this technique to relieve dental anxiety.
The goal sought when laughing gas is used is to eliminate dental anxiety, making the patient more comfortable while the sedation dentist is able to more effectively complete the planned dental care procedure while the patient is sedated. Consult with your dentist to find out if this procedure right for you.
A small rubber inhaler will be placed over the patient's nose and adjusted so that the patient is comfortable. At this time, the patient will be breathing 100% oxygen.
Some patients at their first laughing gas visit will feel that they are not getting enough "air." The patient should tell the sedation dentist and he or she will provide them with even more oxygen to breathe.
Once the patient is comfortable breathing oxygen, the dentist gradually will introduce nitrous oxide. Over the next three to five minutes, the patient will be asked, "What are you feeling?" as the amount of nitrous oxide is slowly increased.
The signs and symptoms that most patients experience when receiving laughing gas include an initial feeling of lightheadedness, which gradually leads to an all-over feeling of warmth. Many persons mention a comfortable "vibrating" or "humming" sensation. It is common to feel one's fingertips and hands become "numb."
This same sensation may develop in the mouth - a benefit to the sedation dentist (and patient) during the dental care treatment. Some patients will mention that their arms and legs feel "very light." Interestingly, other patients will say that their arms and legs feel "so heavy I can't even move them."
If either of these occurs to the patient, it is perfectly normal. The individual might notice that they are perspiring a little, too. This is a normal effect of nitrous oxide and oxygen dentistry.
The sedation dentist will talk with the patient throughout the dental care procedure and the individual will be able to respond without any problem. This is a major advantage, and a safety feature, of conscious sedation using laughing gas.
If, at any time during the procedure, the patient feels that they are getting too much nitrous oxide or if they begin to feel uncomfortable, they should tell the dentist immediately and within seconds the dentist can adjust the flow of gases, and the patient will feel more comfortable again.
At the conclusion of the sedation dentistry treatment, the patient will once again receive 100% oxygen (for a minimum of three to five minutes). At the end of this time, the person should feel absolutely back to normal. If they still feel even a little bit sedated, the dentist should give the patient oxygen for a few more minutes.
Most dentists permit the fully-recovered laughing gas patient to leave the dental office unescorted and to resume their normal activities. In some situations where a patient recovers more slowly, they might be required to have an escort (friend or relative) drive them home.
Laughing gas inhalation sedation is highly effective in the management of mild to moderate levels of dental anxiety. It also is an excellent technique in persons who are extreme gaggers; laughing gas usually eliminates or minimizes gagging in most patients.
Finally, laughing gas is highly recommended for apprehensive patients who have medical problems such as angina pectoris, persons who have had a heart attack, or persons with high blood pressure, asthma or epilepsy.
Inhalation sedation dentistry should not be used with persons who are claustrophobic or with persons who are unable to breathe through their nose. Please discuss these with your dentist before treatment using laughing gas begins.
By Stanley F. Malamed, DDS
Many patients face their dental appointment with a degree of anxiety. Research has shown that the largest cause of this fear is the fear of pain ... the fear that at some time during their dental care treatment they are going to be hurt.
Sedation dentists have information available about a variety of drugs known as local anesthetics, which are the safest and most effective drugs in all of medicine. Local anesthetics are a resource used in anxiety-free dentistry for the prevention and management of dental anxiety resulting from dental and surgical procedures, not to put the patient to sleep.
Local anesthetics, commonly called Novocain by patients (Novocain is no longer used, having been replaced by newer, safer, and more effective drugs), are drugs which, when injected near a nerve, prevent stimulation from reaching the brain where it would be interpreted by a person as pain. Sedation dentists interested in practicing anxiety-free dentistry know these also work very well as temporary relief of a tooth ache.
The injectable local anesthetics, used today by sedation dentists provide complete relief about 100% of the time. The duration of the numbness varies from drug to drug -- some providing short durations, while others remain effective for up to 12 hours. A doctor will select a drug for a patient that is appropriate for the type of dental care procedure they are having done.
In order to be effective during dental treatment, local anesthetics usually need to be injected. For many people, this is the most uncomfortable part of the entire dental appointment.
Local anesthetics can be administered quite comfortably. Sedation dentists and dental hygienists take pride in their ability to administer local anesthesia easily and comfortably.
The following are some of the procedures sedation dentists practicing anxiety-free dentistry might use to make this procedure more comfortable:
If an individual is fearful of receiving a local anesthetic injection, they should tell the assistant or the sedation dentist BEFORE the procedure starts. The use of conscious sedation such as laughing gas, as part of anxiety-free dentistry, can work wonders to make this procedure more comfortable for the patient.
By Stanley F. Malamed, DDS