Question: Is Valium still used for oral sedation at the dental office?

Answer: While valium remains a medication used in oral sedation dentistry, its effectivess as well as the longevity it provides makes it not the best choice. Valium is typically part of a prescription regimen that is used but not used exclusively. Most dentists will prescribe valium the night before the dental appointment to help the patient sleep the night before; however, Triazolam (aka Halcion) is usually given the day of the dental appointment to help heighten the level of anxiolysis/sedation for the patient. Adding additional sedatives to the regimen also warrants that the dentist is monitoring specific vital signs such as blood pressure, pulse, respirations and O2 saturation.

Question: Why do I have to be monitored during sedation...my dentist used to give me Valium and never had to monitor before?

Answer: This is very common question especially since monitoring was not alway considered a standard until recently. Most patients that undergo sedation typically are administered multiple medications for not only preparation for the visit but during the visit. A common example is a patient who elects for oral sedation and is prescribed Valium the night before and Triazolam/Vistaril the day of the appointment. In this particular situation, the Valium is used to assist with sleep the night before since most patients have a great deal of anxiety leading up to the appointment. The valium, too, will stay in your body much longer than some of the other medications which can help prolong and strengthen the level of sedation when given with other medications.

The triazolam/hydroxyzine is typically given the day of the apppointment which increases the level of "anxiolysis" or sedaton effects for the patient. While the valium alone does not typically have much effect on the patient in re: vital signs and level of consciousness, additional meds such as triazolam can heighten the sedation to a point where we can see changes in a person's breathing or blood pressure. As the sedation becomes greater the more relaxed a patient can become but also the muscles in the airway and others used for breathing. This is the answer to the original question because sedation can affect the respiratory ability of a patient, it is absolutely imperative that patients are monitored to detect for even the smallest of changes.

By monitoring blood pressure, pulse, oxygen saturation, respirations and sometimes heart rhythms, we can deliver safe levels of sedation to a patient without being as concerned about what may happen in response to the administration of multiple oral medications. Monitoring is an ABSOLUTE must!

Hope this helps!

Dr.G

You Really Can Live Better Through Dentistry

Did you know that a healthy mouth means a healthy body...a healthy heart...even a healthy sex life? It's true! And just by changing certain habits related to oral hygiene you can improve the health of your mouth and teeth and lessen your risk for a whole host of illnesses.

"You cannot be healthy with an unhealthy mouth any more than one can be healthy with an infected foot," says Richard H. Price, DMD, spokesperson for the American Dental Association and a former clinical instructor at the Boston University Dental School.

He's absolutely right.

Researchers at the ADA have found that periodontitis (the advanced form of periodontal disease that can cause tooth loss) is linked with health problems, such as cardiovascular disease. It appears that bacteria in the mouth may cause inflammation throughout the body, including the arteries. Gingivitis (oral inflammation due to bacteria) may also play a role in clogged arteries and blood clots, possibly increasing your risk of a heart attack or stroke.

Healthy Mouth, Healthy Love Life

There's nothing like bad breath to turn off the opposite sex. 22-year-old UK superstar Joss Stone famously remarked, "There's nothing worse than bad breath. I've snogged people with bad breath who smelt of (cigarettes) and beer and it made me feel sick.

Joss isn't alone. A report from a US mouthwash company revealed that nearly three quarters of the people polled said they wouldn't let a person they found attractive kiss them if they had bad breath. Plus, simply worrying about your partner smelling and/or kissing your malodorous mouth can take the joy and spontaneity out of your sex life. Good oral health literally 'takes the worry out of being close' as they used to say in the Ban deodorant ads. So improving your sex life means doing things that improve your blood flow, and that means taking care of your teeth and gums.

Attention Mothers-to-Be

Pregnant women with periodontitis may be at increased risk of delivering preterm and/or low-birth-weight infants. The theory is that oral bacteria release toxins, which interfere with the growth and development of the baby. At the same time, oral infection can cause a mother to produce labor-triggering substances too quickly, potentially triggering premature labor and birth.

And some studies suggest that periodontitis can make it more difficult for people with diabetes to control their blood sugar!

Yikes!

Your Dentist is Also Your Doctor

Your mouth is a window into what's going on in the rest of your body, detecting the early signs and symptoms of systemic disease -- a disease that affects or pertains to your entire body, not just one of its parts. Many diseases, including diabetes, often first become apparent as oral problems. In fact, according to the Academy of General Dentistry, more than 90% percent of all systemic diseases produce oral signs and symptoms.

So what does the health of your mouth have to do with your overall health? In a word, plenty. It's just one more reason that regular dental check-ups are so important.

Question: Can Sedation Dentistry eliminate the need for needles?

Answer: No, local anesthesia is still necessary to provide pain control. Sedation dentistry helps promote anxiolysis, the reduction of anxiety before a dental procedure. While it helps with anxiety, it does not prevent pain, only the anticipation of pain. Interestingly, sedation dentistry has been shown to decrease the typical amount of local anesthesia needed to provide pain control. There are many patients who pursue sedation dentistry because they have difficulty getting numb or simply do not like discomfort of the injections. Talk to your dentist about how sedation dentistry can help decrease the fear of injections while providing superior pain control.

Does Dental Insurance Cover Sedation Procedures for Dental Work?

It varies from insurance company to insurance company and from procedure to procedure. Most dental insurance companies will cover multiple extractions under IV sedation and certain surgical procedures; however, routine dentistry such as cosmetic work and fillings are not typically covered. Insurance companies will also only cover up to a certain amount of time so if you had dental work that would take 3 hours...your insurance company may only be responsible for 1-2 hours leaving the patient responsible for the remaining time.

Talk with your dentist about your coverage and or contact the insurance company. Questions you should ask your insurance company:

1. Is oral, IV, or laughing gas sedation a covered service?

2. If so, are there limitations on sedation based on procedures and amount of

work that is needing to be done?

3. Is there a frequency or time duration limit on the sedation?

4. Do they require preauthorization before treatment is performed?

5. What is my financial responsbility for the sedation portion of the dental work.