Sedation Dentistry: From Nitrous Oxide to OCS to Full Anesthesia
Post your comments about sedation dentistry options to our blog
When we asked dentists about the highest level of sedation dentistry they offer
to their patients, responses were across the board. Some offer full anesthesia;
others offer OCS; others offer no sedation services.
A number of dentists voiced their preference for IV sedation. "It's the platinum of sedation without side effects," wrote a prosthodontist. "I would lose over half my practice without dental sedation," said another dentist. But one dentist worried, "With some of the practitioners I've seen, conscious sedation is a catastrophe waiting to happen."
Read the dentists' comments for further insight.
General dentists and specialists have markedly different patterns of sedation. Given the more intensive procedures often performed by specialists, it's not surprising that they offer a higher level of sedation on their patients.
Female dentists responding to this survey were more conservative in their use of dental sedation than were their male counterparts.
For more insight, check out these comments!!
Sedation is the future of dentistry
- "Sedation is going to be big player in future of dentistry in USA. General anesthesia and IV sedation are here to stay." (Washington dentist)
- "Sedation is not used often enough in dentistry." (New York dentist)
Dentists like sedation
- "Sedation dentistry is an excellent benefit and marketing tool." (Michigan cosmetic dentist)
- "I would lose over half my practice without dental sedation." (Arkansas dentist)
- "It makes the patient feel more comfortable and easier to work on and that makes my day a whole lot more better." (Indiana dentist)
Patients like sedation
- "Sedation dentistry is a must to meet our patients' expectations. They demand it." (South Dakota dentist)
- "It works wonderfully for anxious patients as well as for big cases/long appointments. It makes for really easy visits and incredibly appreciative patients." (California dentist)
- "It's surprising how many apprehensive patients avoid the dentist until they're in pain. It is a great service to the public. It's unfortunate that the full spectrum of anesthesia is not available everywhere and that many dentists are afraid to utilize these anesthesia services even when available." (Texas dentist)
Sedation is a pain
- "Although sedation seems like a nice thing to have available for your patients, the reality is that it is a real pain to provide! My favorite method of sedation is someone who is able to take just local anesthesia!" (Nevada dentist)
Nitrous oxide
- "Nitrous sedation is my favorite because of total reversibility." (California dentist)
- "Nitrous works for the vast majority." (California dentist)
Oral conscious sedation
- "I love being able to provide oral conscious sedation for my patients. It creates a happy and compliant patient who is easy to treat. The amnesia is also a big plus." (Maryland dentist)
- "This is absolutely one of the most rewarding services I have every added to my practice in my 30 years. It's rewarding on both a financial and an emotional level. With OCS I am able to convert dental cripples into dental missionaries. They often begin as the most emotionally challenging patients. At the end of the first appointment, you love the smile you see and the peace you feel. No doubt, it's very rewarding for me." (Georgia dentist)
IV sedation
- "IV sedation is the platinum of sedation without side effects." (Massachusetts prosthodontist)
- "I think the profession is missing the boat concerning IV sedation....I wouldn't work without it. Three cases this morning. This is my 40th year using IV." (General dentist)
- "IV sedation has enhanced my practice and created a niche that is keeping me busy!" (Michigan dentist)
- "IV sedation is much more controllable than oral sedation! I can titrate the amount of meds the patient receives and can easily administer reversing meds if needed knowing the effect is immediate. The amount that people charge for oral sedation is almost what I charge for IV sedation without the benefits." (Michigan dentist)
- "I have been doing oral sedation for the past 30 years but the best thing I ever did was get IV sedation training in 2003. I've never looked back since. Now, we treat many patients that other dentists can't or won't treat in my area. I never fight with a patient anymore, literally or figuratively. Oral sedation is limited to their getting a decent night's sleep before their appointment and the next morning to take the edge off of getting their IV started. It's just too unpredictable and far too light to handle the patients who come to me for sedation dentistry." (General dentist)
Sedation could be dangerous
- "I don't agree with the use of dental sedation." (Florida dentist)
- "I feel too many dentists are treading in an area where they are not well trained." (Pennsylvania dentist)
- "Only highly skilled and educated dentists should use these mechanisms. This usage requires that all dentists who chose to use such treatments undergo, at the least, a dental anesthesia residency." (New York oral and maxillofacial surgeon)
- "With some of the practitioners I've seen, conscious sedation is a catastrophe waiting to happen." (New York dentist)
Training programs are so-so
- "I have not had what I feel would be adequate training for deeper levels of sedation. I feel some training program spend too much time on marketing aspects rather than patient selection and health history." (North Carolina dentist)
- "I took a course for recertification and they literally crammed one day of useful information into a three day marathon of promotion and sales." (Colorado dentist)
- "Courses are too expensive for course length. More dental schools should offer courses." (Kentucky dentist)
Legal issues
- "I'd love to do more, and I feel hog-tied because of state laws. I spent a lot of time and money to learn about it only to learn that I couldn't legally do what I was taught." (Pennsylvania dentist)
- "We actually use a M.D. board certified anesthesiologist, not a dental anesthesiologist, as they are (legally speaking) better to have liability transferred to their license when problems arise." (Nevada dentist)
Dentists' favorite drug cocktails
- "My favorite is Mepergan Fortis + Ativan + N2O, 20-30 minutes later. I use a Pulse oximeter at any signs of sleepiness." (Arkansas dentist)
- "I start with a small dosage of Vistaryl and Atropine in the same syringe. This is followed by another small syringe of 50mg. of Nembutal. And then a 3cc syringe of half Versed, half Fentanyl. That is my basic method....with variations depending on my patient." (General dentist)
- "I use NO2/O2, then IV diazepamthen, local anesthesia, then incremental Brevitol as needed."
- "Triazalam." (Washington dentist)
- "Versed/Fentanyl/Diprivan" (Pennsylvania oral surgeon)
Note: Survey sample included 152 respondents.
