Posts for tag: Lavergne sedation dentistry

Question: Can sedation help if I have a really big gag reflex?

 

Answer: Yes, sedation can minimize and often times completely eliminate it completely. The gag reflex refers to the response cause when the tissue in the back of the throat is irritated. There are multiple nerve endings located in the back of the throat and the "uvula", the flap of tissue that hands down in the throat and vibrates when a person says "ahhhhh". When foreign objects come in contact with this area such as impression material, filling material, cotton, the gag reflex is stimulated further producing a vomiting response. There is a great deal of variety of the intensity in gag reflex from person to person.

 

There are multiple treatment modalities to help improve or lessen the gag reflex. Topical anesthetic spray can be used at the back of the throat producing numbness or suppression of the gag reflex within seconds and up to 15-20 minutes. Nitrous oxide, aka laughing gas, can also work on the higher centers of the brain to also help with reducing gagging. If topical spray and laughing gas are not sufficient, oral and/or IV sedation can likely remove all the normal gag reflex reactions. With sedation, the muscles in the mouth and throat are more relaxed decreasing the likelihood of a gag reaction.

 

With sedation, routine dentistry, impressions, extractions, etc. can be accomplished in a short amount of time while minimizing the gag reflex often encountered in patients.

What are the most commonly used medications in IV sedation?

 

Typically there is a combination of medications(sedatives and narcotics) used to achieve sedation in order eliminate anxiety as well as providing pain control. The types and amounts greatly depend on the length of the procedure, the medical history of the patient, and the types of procedures.

 

Usually a combination of sedative(benzodiazepines) such as Versed or Valium will be given to help with anxiety control. In addition, a pain medicine is administered along with the sedative to help with pain control but to also further assist with the sedation process. Usually, Demerol or Fentanyl are the pain medications administered IV.

 

Other IV meds sometimes used in IV sedation are Phenergan(to offset nausea from the other medications), and Dexamethasone (steroids that control postoperative swelling/inflammation). Propofol, is also a commonly used IV medication to assist with the sedation but is only indicated in very short procedures and has very limited use in dentistry because of the dangers if not used appropriately.

 

IV sedation is very safe an in fact, is much safer than oral sedation as IV sedation relies on medications being placed through the IV so the effects can be felt much faster, be better controlled, and easier to reverse should an emergency occur. Ask your dentist about the types of sedation he/she offers and how it can benefit you!