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Dentists Offer an Array of Dental Sedation Options
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.
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.
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.”
What else do dentists think about sedation dentistry?
- “I would lose over half my practice without dental sedation.” (Arkansas dentist)
- “It makes for really easy visits and incredibly appreciative patients.” (California dentist)
- “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 sedation is my favorite because of total reversibility.” (California dentist)
- “I don’t agree with the use of dental sedation.” (Florida dentist)
- “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)
- “I feel too many dentists are treading in an area where they are not well trained.” (Pennsylvania dentist)
- “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)
Read the complete Sedation Denistry: From Nitrous Oxide to Conscious Sedation to Anesthesia survey results
Post a comment
March 27th, 2008 at 9:42 am
Um your “pie” diagram is incorrect. Valium Is an OCS…..
March 28th, 2008 at 10:32 am
Indeed it is, but the question was phrased so as to differentiate between those doctors who offer only Valium and those who use more advanced meds (like third- or fourth-generation benzodiazapines) in OCS treatment.
April 7th, 2008 at 9:16 pm
I am a pediatric dentist and I do use ocs, nitrous, and general anesthesia in my office and hospital setting.
Most dentist are NOT properly trained in airway management and emergency procedures. Simple weekend classes are not enough to teach how to quickly react if the patient crashes. As a pediatric dentist I did go thought extensive anesthesia rotations ( at least it was a strong part of my program) and it did teach me how to be more conservative, especially in a non hospital setting. With sedations when things go wrong and the dr. is not well trained the results can be fatal. We had enough deaths in dental offices already and that is why certain states are imposing the regulations these days!
It is very difficult to do surgeries and monitoring at the same time. There is a reason we have anesthesiologists who monitor patients diligently. The reason is— IT IS IN THE BEST INTEREST OF THE PATIENT! IT IS SAFER FOR THE PATIENT!
Even some oral surgery practices use anesthesia services and these specialist are indeed very well trained in anesthesia and airway management. I am not by far trying to diminish general practitioners out there I think most of them do a great job in treating their patients by different modalities, but you have to realize as a specialist we do have more training and in most cases know better when to stop and not take the unnecessary risks. A lot of times some people who practice out there don’t know what they don’t know and that gets them in trouble.
August 14th, 2008 at 2:08 pm
… very well said Ellen Polsky … there is no doubt an anesthesiologist should be considered for any case where the operating dentist is not an oral surgeon. The basic training an oral surgeon receives regarding anesthesia (6 months of residency) should be the minimum required to conduct moderate to deep sedation. For complex cases (ie anything more than routine 3rd molar extractions) a wise oral surgeon and/or dentist should request the assistance of an anesthesiologist or CRNA. I predict once JCAHO begins evaluating dental offices (and it has already begun in New York State) anesthesiologits / CRNAs will become a mainstream part of oral surgery and dental procedures performed under sedation & GA. This is in the best interest of all parties involved regarding safety, efficacy and overall patient standard of care.