Sedation is a common part of wisdom tooth extractions and implant placements. But more and more dentists are offering patients who otherwise might be anxious the option to have their dentistry performed under sedation. While death from conscious sedation during a dental procedure is rare, you want to make sure your dentist is properly trained and takes every precaution possible. You might want to have second thoughts if the dentist doesn’t require a comprehensive physical before administering conscious sedation.
Every patient needs continuous monitoring for changes in blood pressure, heart rate and oxygen levels, with a trained assistant present who keeps close records of these vital signs and medications provided. And certain guidelines should be followed, such as other ongoing health issues, allergies, weight characteristics, when the patient last ate and any other conditions that might alter the risk of complications. Steps have to be taken before, during and after the procedure to ensure the safety of the patient.
Given the risks associated with sedation, some anesthesiologists express concern that dentist might not be receiving enough training to perform well in an emergency situation. Apparently however, the lure of thousands of new found dollars has stimulated an increasing attendance in weekend courses on oral sedation. These courses promise to train dentists in how to safely administer sedation to both adults and children, in a few short lessons over one or several weekends.
The ADA supports the right of ‘appropriately trained’ dentists to use sedation or even general anesthesia to treat patients, while the American Academy of Pediatric Dentistry, has expressed concern over the use of weekend courses to adequately prepare a dentist with the emergencies that can arise through the use of oral sedatives. Weekend seminars are valuable sources of continuing education, but a single or even multiple seminars do not the appropriate expertise necessary to perform sedation dentistry. Even under the best of circumstances, maloccurrences occur.
I personally have found that the concentration required to perform excellent dentistry does not allow for proper monitoring of a sedated patient. If it’s not nitrous oxide/conscious sedation, I do not sedate patients. This is not to suggest there aren’t bona fide specialists in the field of dental anesthesiology but having the training and experience to properly handle critical, even life threatening emergencies, while a patient is sedated is paramount.
It’s the patient’s responsibility to ensure the dentist has acquired sufficient training and it is the responsibility of a parent to ask about the doctor’s credentials before allowing their child to be sedated. I cannot overemphasize the importance to seek out a board eligible or certified dental anesthesiologist if you or your child needs sedation in order to receive dental care.
You should not be afraid to ask the dentist for their credentials, and you want to be fully informed about the process before you agree to conscious sedation for you or your child. If we can be of assistance do not hesitate to contact us.
Novy Scheinfeld, DDS, PC
290 Carpenter Drive, 200A
Atlanta (Sandy Springs), GA 30328