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Anxiety-Free Dentistry Can Help Control Dental Fears

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Local anesthetics, commonly called Novocain by patients (Novocain is no longer used, having been replaced by newer, safer, and more effective drugs), are drugs which, when injected near a nerve, prevent stimulation from reaching the brain where it would be interpreted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:

• Place the patient in a reclined position during the injection.
• Place a topical anesthetic (a gel or spray) on the patient's gums where the injection is to be given. This should remain in contact with tissues for at least one minute.
• Use of a distraction technique, such as pulling or shaking the lip as the needle is slowly inserted.
• Injecting the local anesthetic drug slowly. This is critical to a comfortable injection.
• Permitting the local anesthetic drug time to work. Most local anesthetics will become completely effective within approximately five minutes after their injection.

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

+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.

The Role of the Sedation Dentist In Dental Care for Children

Conscious Sedation Dentistry

While many younger patients in the dental care office are cooperative and manageable without the need for sedative drugs, there are a significant number of children who cannot tolerate dental care without the use of these techniques.

For older, mildly apprehensive children, the use of oral conscious sedation may prove effective during dental care. Drugs such as chloral hydrate, Vistaril, Phenergan and Versed are frequently used either alone or in combinations selected by the sedation dentist for dental care.

Inhalation conscious sedation, using nitrous oxide, or laughing gas, is also highly effective in a mildly apprehensive older child who is older than six years.

In some instances, the use of a physical restraint (known as a Papoose Board or PediWrap) may be necessary to minimize excessive movement (which could be dangerous) during dental care treatment.

Naturally, many younger children are not mature enough to understand the need for their cooperation during dental care treatment. In this situation, the techniques described above have little chance for success. Deep sedation or general anesthesia may be required for dental care treatment to be successfully provided.

When this is necessary, the sedation dentist will employ a highly trained and certified dentist anesthesiologist, medical anesthesiologist, or, in some cases, nurse anesthetist, whose sole responsibility is to ensure the safety of the child while the dental care is being done.

Dentists trained to administer general anesthesia have received a minimum of two years of specialized advanced training and have been certified by their state Board of Dental Examiners.

Monitoring devices, some of which evaluate breathing, blood pressure and heart rate, will be employed by the sedation dentist to help ensure the safety of the procedure.

All aspects of the child's medical history, including any drugs he/she may be taking, should be disclosed to the dentist before any dental care.

It is suggested that the parent ask the following questions of their dentist prior to signing an informed consent granting permission for the administration of conscious sedation, deep sedation or general anesthesia to a child:

• Will the child require sedation or general anesthesia for his/her dental care treatment?
• Who will monitor the child while the sedation dentist works on his/her teeth?
• What kind of monitoring equipment do you use?
• Are you and your assistants trained in resuscitation?
• Will you continue to monitor the child after the procedure, until the drug has completely worn off?

Children's Dental Care Treatment

The administration of local anesthetics (commonly known as Novocain) is needed whenever potentially painful dental care procedures are performed (even during conscious sedation dentistry and general anesthesia).

The administration of local anesthetics to children by a trained sedation dentist is extremely safe and represents the ideal means of providing comfortable dental care treatment.

The following are some of the procedures the doctor might use to make this procedure more comfortable for the child:

• Place the child in a reclined position during the injection.
• Place a topical anesthetic (a gel or spray) on the child's gums where the injection is to be given. This should remain in contact with the tissues for at least one minute.
• Use of a distraction technique, such as pulling or shaking the child's lip as the needle is slowly inserted.
• Injecting the local anesthetic drug slowly. This is critical to a comfortable injection.
• Permitting the local anesthetic drug time to work. Most local anesthetics will become fully effective within approximately five minutes after their injection.

The duration of the numbness varies from drug to drug - some providing a short duration (two to three hours), with others remaining effective for up to twelve hours. The sedation dentist will select a drug for the child that is appropriate for the planned dental care procedure.

Since a child's tongue and/or lip may remain numb for several hours after the completion of their dental care treatment, the parent should carefully watch the child to prevent them from accidentally biting and injuring their lip or tongue during this period of time.

Properly administered, local anesthetics are safe and effective in almost 100% of younger patients. If a child is unable to tolerate the injection of the local anesthetic in their mouth, it may be necessary to use one of the techniques of conscious sedation, deep sedation or general anesthesia.

Local anesthetics can safely be administered by a trained sedation dentist to patients receiving sedation or general anesthesia during their dentistry visit.

By Stanley F. Malamed, DDS

+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.