Dental treatment under sedation – relatively new phenomenon. Previously, going to the dentist caused a nervous tic in a person of any age and level of courage, since anesthesia was carried out only locally (and then with the banal "Lidocaine", which does not work for everyone), and then it was necessary to courageously endure torture of different levels, considering the time the procedures are completed. Now humane dentists perform complex or especially painful manipulations under sedation, which is still a novelty for domestic patients. Many even confuse the concepts of sedation and general anesthesia. Estet-portal.com will help you figure out what the difference is, and whether it is worth resorting to sedation during dental procedures at all, and in what cases it is useful, and in which – contraindicated.
Treatment and extraction of teeth under sedation: arguments for and against
First of all, let's explain what sedation is and how it differs from general anesthesia. Sedation is achieved with the use of mild sleeping pills. When sedated, the patient is also relaxed and also falls asleep. However, his consciousness does not turn off and it is easy to wake a person at any moment. But general anesthesia is permissible only in a hospital if there is an intensive care unit nearby. Although an anesthesiologist is present during the operation in both cases.
During sedation, depending on the dosage of the drug, it is possible to introduce the patient into a state of "nirvana", but without a hypnotic effect, that is, in general, the person will be able to respond to the doctor's commands, but will be in the most relaxed ("vegetable") state.
The sedation effect can have three levels of depth:
1. Light (superficial relaxing).
2. Deep sleep (however, the patient retains the ability to wake up immediately).
3. General dental anesthesia.
Sedation is also divided into inhalation, oral and intravenous.
Inhalation is performed according to the type of general anesthesia: the patient is put on a mask with nitric oxide – and he falls asleep. The depth of immersion in sleep is regulated by devices. Gas from the body after waking up is excreted in a few minutes. At a certain concentration, a person hears a doctor. In the oral route, the patient takes pills that give an average level of relaxation. The ability to hear the doctor is preserved.
In the third method, a sleeping pill is injected and causes very deep sleep. The patient does not hear the doctor and cannot follow the commands.
It is worth noting that sedation during dental treatment has a calming effect, but does not fully relieve pain.
Therefore, in parallel with sedation, the dentist performs local anesthesia in the oral cavity.
Special preparation for such manipulation is not required – it is enough not to eat or drink alcohol, coffee, strong tea and soda 4 hours before the start. After the operation, it is better to take a taxi home, as within 10 hours all reactions can be slowed down.
Indications for dental procedures under sedation:
- severe dental phobia (fear of dental treatment);
- allergy to classic local anesthetics;
- cardiovascular diseases;
- respiratory diseases pathology;
- endocrine disorders;
- disorders of the immune system;
- very pronounced gag reflex;
- oncology;
- diabetes mellitus;
- major operations and surgical intervention after them.
Sedation surgery is allowed for patients with cardiovascular pathologies, as it is mandatory in the presence of an anesthesiologist and with a heart monitor, on which the doctor will monitor the patient's pressure, heart rate, and ECG during the procedure.
There are, of course, contraindications to dental treatment in a dream:
- pregnancy and lactation;
- bronchial asthma;
- diseases of the nervous system ;
- circulatory pathologies;
- chronic diseases in the acute stage;
- influenza and acute respiratory infections;
- ENT diseases, adenoids or difficulty breathing;
- mental illness;
- drug addiction and alcoholism.
When it comes to the arguments for and against sedation for treatment or extraction of teeth, the list is serious from both points of view.
- soft entry into sleep and soft awakening; - no nausea and gag reflex to drugs;
- fear and psychological discomfort are completely defeated;
- if the patient – a pronounced psychosomatic type, then this is an ideal type of dental anesthesia for him;
- the depth of sleep can be varied by the doctor at the request of the patient;
- the maximum number of manipulations can be performed in one operation, since the patient can sleep up to 8 hours without waking up ;
- sedative drugs are quickly excreted from the body, which gives minimal harm to the nervous system;
There are fewer arguments against dental sedation, but they are still serious enough that they should not be ignored.
Disadvantages of sedation in dental treatment:
- With a certain degree of relaxation, the patient may lose control of his body, that is, he will hear the doctor's commands, but will not be able to follow the doctor's instructions, thereby complicating it work (for example, he won’t even be able to open his mouth wider so that there is better access to the problem tooth).- There is a small risk that a patient who is too relaxed may begin to choke on saliva or working fluids, which causes additional stress for the dentist, who performs an operation.
In any case, the attending physician should first collect the patient's history and interview him in detail in order to objectively weigh the pros and cons of dental sedation. Have a comfortable treatment!
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