Posts for tag: sedation dentist

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By drglasmeier
September 13, 2011
Category: Uncategorized

Can I drive if I am given sedation drugs before my dental appointment?

Under NO circumstances can you drive with any sedation drugs in your system. Sedation drugs not only relax your muscles but it can impair your judgement, your reflexes, and awareness. Operating heavy machinery, exercising, decision making is discouraged while potentially under the influence of sedation drugs.

What if I am only taking a valium? My dentist used to give me a valium the night before, can I still drive myself?

Valium is used as a sedative and sometimes as a sleep agent therefore not recommended. If you were involved in an accident and were under the influence of valium, you would be liable/responsible regardless of how you feel. Think of it like only having 3 beers and saying           "I feel fine....I can drive home". Do NOT take any sedatives/sleep agents if you plan to drive yourself to a dental appointment.

Question: Who is not a candidate for oral and IV sedation?


Answer: The following is a list of individuals who would not be candidates for sedation and includes but not limited to:


1. Diabetics- unless blood sugar is well controlled and patient is compliant with dietary and prescription regimens. Type II are typically better candidates as patients with Type I (insulin dependent) typically experience larger fluctuations in blood sugar and need a quicker response to this fluctuation.


2. Liver and kidney diseases. Patients with liver and kidney disorders are usually not great candidates for sedation because their ability to metabolize drugs is altered or compromised. These metabolism deficiencies can lead to patients hypo or hyperresponding to medications and will also shorten or prolong the response to the medications. Patients with these disorders need clearance from their physician prior to sedation.


3. Thyroid and adrenal disorders. Patients with altered responses to stress, altered metabolisms can affect the response to sedation. Patients that are taking steroids on a regular basis can also have adverse reactions because their body is not conditioned for stressful situations. Patients with these disorders or anything else endocrine in origin should consult their dentist and physician for any proposed sedation treatment.


4. Pregnancy- Patients who are pregnant are not good candidates due to the teratogenic properties of sedation medications but also due to the altered metabolic demands of a fetus on a mother's body. If absolutely necessary, the 2nd trimester is the best choice but I would prefer to defer sedation or any unnecessary dental treatment until after pregnancy.


5. Medications/recreational drugs- Patients that take mind altering medications such as antidepressants and anti-anxiety medications can also respond very erratically or not at all to sedation medications. Patients typically don't respond as well because the body has been conditioned to process mind altering medications that fall along the same categories of sedative medications. Recreational drugs is a huge contraindication as the response is totally unpredictable and could be potentially life threatening.


6. Respiratory- This is the biggest and most frequent complication I run into. Factors such as Asthma, COPD, sleep apnea, sickle cell disease, bronchitis, sinus infections, etc. All sedation medications have some sort of respiratory depressing effects that control a person's breathing. Sedation medications can severely hamper the body's ability to maintain normal breathing and furthermore should be taken with caution. An example of someone who is not always a good candidate is someone that snores on a regular basis as this is already an indication of someone who may be developing respiratory problems.


While this is not an all inclusive list, these are the most frequent disqualifying conditions for sedation dentistry!



Question: Are there ways to do dentistry with out the pain or a needle or sound of a drill?


Answer: Yes there are, but they are somewhat limited in what they can treat. For example, to not need a needle for treatment either the cavity has to be very small or the dentist uses something called "Air Abrasion" or "Laser Dentistry". These are technologies that enable the dentist to fix cavities without using a needle or drill however they are not as effective when the cavities are deep (close to the nerve) or the tooth is sensitive.


I think an injection is much better for pain control and is better for eliminating the "what if I feel this". An injection can almost be next to painless and the discomfort can be controlled by

1. The strength of the topical gel

2. The manner the injection is given by the dentist.


I have a very simple rule...if I can't get you numb, I will not work on you that day...sometimes people just don't numb up well and it's hard to explain why but rest assured that if you are uncomfortable then I am too so I will not make you do anything that is uncomfortable! We generally have great success in getting you more than adequately numb which gives you a very comfortable, pleasant experience. Nitrous oxide(laughing gas) will often help drown out some of the sounds of the drill and also with analgesia(pain relief) during the procedure.


Regarding the sounds of the drill, we always play music while we are working..I don't like the sounds any better than my patients do? I love music from the 80s and 90s so there is always music in the background or we will play whatever music you like. We also play movies if you prefer to listen to a movie and if that's not enough...I might even sing or dance for you!


Back to the original question, the use of injections(i.e. the needle) as well as the handpiece(i.e. drill) is sometimes unavoidable no matter how gentle we are. If this is a concern, then sedation dentistry may be a great way of assisting in eliminating the apprehension/anxiety of these procedures as well as waking up and not remembering what happened.