Dental phobia is very common. Reports say that 50% of the people in this country don’t visit a dentist out of fear. And we now through the concept of sedation can get these people to come in. We’ve seen people that have never had dental work come through dentistry and want to have more of it. It’s something that allows people that are very anxious, very fearful, it allows them to come in and have dentistry done.
People come in and tell us that they’ve had their hands to the chairs and they’ve had experiences that were very painful and that the dentist didn’t stop, and we’ve heard many many stories of past histories of things that have had, sometimes through just perception, sometimes they’re real. Many times they’re actual stories that have happened. And in the back of their mind this is what dentistry has always been. But it’s no longer like that, and we can go ahead at Aesthetic Dental Care of New Jersey we can change that, we can go ahead and get them comfortable, we can do the things that they never had before.
Sometimes they’re real, sometimes they’re not. But perception is real. And so even if people remember something that happened many many years ago people go ahead in the back of their mind have something that they think of and relate to a bad experience. It’s deep seeded and sometimes it takes a lot to overcome that fear. Good news of the day is that at Aesthetic Dental Care of New Jersey we conquer the fear. There is oral conscious sedation that’s available through a pill form and there’s IV sedation that is delivered by an anesthesiologist who will monitor the patient. And sometimes people just come in and want to have the edge taken off and we use nitrous oxide for that which is just simply another vehicle that allows us to go ahead and deliver the care for someone who’s not petrified but just want to take the edge off. Things have changed in dentistry over the years that probably we don’t even do things the same way that we did them 5 years ago so let alone 20 years ago. And we’ve come a long way in dentistry. The philosophy is that if you can get into the door we’ll help you get the work done.
You must find someone who has had both the training and the experience. We’ve done a lot of training with the Docs Society which is the oral conscious sedation people that do a lot of training. We’ve done courses at Mt. Sinai Hospital in New York. We continue to do training sessions there. And we continue to keep abreast of what’s happening with the sedation dentistry end of it. If they’re really interested in just being a little bit uncomfortable, they’re really not that anxious, they may have someone deliver some nitrous oxide to them. If they’re feeling that they want to have much more comfort than that they should look for someone who’s trained in conscious sedation, someone who’s had the experiences, someone who can develop a relationship with them based on trust that they know how to do this. If they’re very very fearful then we go to the next step which is the IV sedation with Dr. Atlas. That is something that helps people that either have had extremely bad experiences or just very painful, fearful experiences, and we can overcome that.
Oral sedation is based on giving people some pills, some liquids, that are medications that they swallow and we go ahead and monitor them just again as if it were in a hospital, we’re monitoring them constantly, and everybody reacts a little bit differently to the medications and so we have to go ahead and spend the time delivering these medications. They usually are along the lines of either halcyon or triazalam, visceral, different medications that will keep people awake yet sedate. People that are having oral sedation are not being knocked out. People think that sometimes they want to be sedated to a point where they’re asleep, this is not sleep dentistry. So they’re still in control, sometimes people want to be in control of things. So they’re still awake, they’re still aware, we’re still carrying on conversations, it’s just that they’re very comfortable, the anxiety level drops immensely, and they’re still able to communicate and they are in control but they’re just much more relaxed.
Poor candidates for oral sedation are medically compromised patients, they are people that have a history of smoking, people with drug abuse. These are people that are harder to sedate with oral sedation. That’s when we bring in Dr. Atlas, and Dr. Atlas will then give them IV sedation which basically will put them to sleep and he will monitor them for their medical benefit.
An oral sedation appointment may be just an appointment for as little as maybe a cleaning for some people. It may be a limited type of situation where we’re doing just one root canal. Or it may be somebody that wants the edge taken off because it’s a long appointment and we might be doing 5 or 6 hours worth of dentistry. It may be for veneers, it may be for root canals, it may be for an entire plethora of dentistry all at one time. The nice feature of sedation dentistry is you can keep the patient in the chair for many hours and keep them comfortable, whereas without it it might be a long day if they’re gonna be in the chair for 5 or 6 hours.
IV sedation is delivered by the anesthesiologist through medications where he starts an IV and the medications are injected. It’s a much deeper sedation than oral conscious sedation but the nice thing is that we have the anesthesiologist who’s monitoring the patients and can go ahead and deliver the medical care that’s necessary. On occasion we’ve had people that’ve had blood pressure that’s gone way up during a procedure. Physician is right there to deliver medication, drops the blood pressure, and we’re good to go.
In New Jersey at Aesthetic Dental Care we can go ahead and deliver the IV sedation to people that are extremely fearful or medically compromised. There are some people that are not good candidates for oral conscious sedation. Heavy smokers, people that have had different things going on in their life that don’t allow us to predictably sedate them with oral conscious sedation can be predictably sedated with IV sedation.
If a patient’s not a candidate for IV sedation then they might be a candidate for hospital dentistry, and there have been a few of those that have gone beyond the level that we feel comfortable at Aesthetic Dental Care in Fairfield delivering in a dental setting. They may be very compromised but need the dentistry and they may need to be in a hospital situation. It could be that they have bleeding issues or any assortment of problems that we may not be able to treat here. But for the most part over the years I would say we’ve been able to treat most of the fears here and do it successfully.
Typical IV sedation appointment at Aesthetic Dental Care is where people will come in, they’ll be delivered here by someone who may stay and wait for them. The patient will be brought back, Dr. Atlas will do a full history and assess the patient. He’ll have already spoken to them so he’ll already know some of the problems going on and he may have already spoken to their physician, their cardiologist or their internist, and he may have already gotten a heads up that there might be something that needs some input from another physician. They’ll go back, they’ll be placed onto monitors, they will have the IV sedation, they will feel no pain. They probably will remember very little if anything of the appointment and it’s very quickly reversed and the patient can be woken up and within minutes they can be leaving.
