Sedation Dentistry

Nitrous Oxide – Laughing Gas

Nitrous Oxide is a sweet-smelling, non-irritating, colorless gas which you can breathe.

Nitrous Oxide has been the primary means of sedation in dentistry for many years. Nitrous oxide is safe.

The patient is able to breathe on their own and remain in control of all bodily functions.

The patient may experience mild amnesia and may fall asleep, not remembering all of what happened during their appointment.

There are many advantages to using Nitrous Oxide

  • The depth of sedation can be altered at any time to increase or decrease sedation.
  • There is no after effect such as a “hangover”.
  • Inhalation sedation is safe with no side effects on your heart and lungs, etc.
  • Inhalation sedation is very effective in minimizing gagging.
  • It works rapidly as it reaches the brain within 20 seconds. In as little as 2-3 minutes its relaxation and pain killing properties develop.

Reasons to not use Nitrous Oxide

You should not utilize Nitrous Oxide if you have been diagnosed with chronic obstructive pulmonary disease (COPD). Though there are no other major contraindications to using nitrous oxide, you may not want to use it if you have emphysema, exotic chest problems, M.S., a cold or other difficulties with breathing.

You may want to ask your dentist for a “5 minute trial” to see how you feel with this type of sedation method before proceeding.

Oral Sedation

Do you experience high levels of anxiety when visiting the dentist? You may be a candidate for Sedation Dentistry. Dr. John Moreau is Board Certified to administer (oral conscious) sedation, commonly referred to as “Sleep Dentistry.”

Sedation Dentistry

Advantages to patients include:

  • Treatment is completed when you are in a more relaxed mood.
  • You will have less difficulty sitting through a lengthy procedure.
  • Multiple treatments and full mouth restorations can occur at during the same visit.
  • Less discomfort after treatment.

Anti-Anxiety Pills

The most commonly prescribed dental related drugs that treat anxiety belong to the “benzodiazepine” family. Drugs such as Valium, Halcion, Xanax, or Ativan. These drugs decrease anxiety by binding and toning down activity within “fear” receptors in the brain.

There are two different types of Benzodiazepines:

  • Sedative-Hypnotics: These drugs induce calm, including drowsiness and even sleep. This sleep state is actually a form of hypnosis which is a form of physiological sleep.
  • Anti-Anxiety Drugs: These are drugs which relieve anxiety and induce a state of calm and relaxation.

While benzodiazepines act as sedatives AND anti-anxiety drugs, some are highly targeted at areas within the brain which focus on sleep. Others act in a more specific way and target fear centers in the brain.   In most cases, higher doses act as sedatives and induce sleep, while in lower doses, they reduce anxiety without sedation.

Benzodiazepines are also Central Nervous System (CNS) depressants (i.e. there can be a decline in blood pressure and breathing). It is important to note that they shouldn’t be mixed with other CNS depressants such as alcohol. Its important that you utilize the dose your dentist or doctor recommends. It is possible to overdose, and overdoses could lower your breathing to dangerously low levels, which could result in coma or death.

Please note that you shouldn’t travel on your own after you’ve taken any of these drugs. Make sure you have an escort, even if you traveled by bus or foot! It’s easy to become disorientated.

When not to take benzodiazepines:

Some of these drugs can affect your liver and heart. It’s important to check with your practitioner and/or pharmacist.  You should be sure to inform your doctor or dentist if any of the following apply: known allergy to the drug, narrow-angle glaucoma, pregnancy, severe respiratory disease (COPD), congestive heart failure (CHF), impaired kidney or liver function, depression/bipolar disorder/psychoses, chronic bronchitis and some other conditions. It’s also important to let us know if you are taking other medications. There could be possible drug interactions.

What to expect

1. Welcoming Visit – We gather information regarding your health and discuss with you your wants and desires.  If you’re comfortable, we’ll take x-rays and look in your mouth.  But you will never be judged or embarrassed.

2. Preparing for your sedation visit – We’ll give you a prescription for a sedative to take the night before your first appointment to guarantee a good night’s sleep and to make sure you wake up relaxed.

3. Arriving for treatment – Your companion will bring you to the office.  Additional medications will be provided to create the ultimate in relaxation.  Your experienced sedation team will monitor you throughout your entire visit.

4. Going home with your new smile – Your companion will take you home and stay with you until you’re completely recovered from your sedation medication.

5. The next day – Most patients feel no discomfort or residual effects from the dental visit and you’ll be thrilled with all the compliments you’ll get.

IV Sedation

Intravenous Sedation (“Twilight Sedation”)

Our office offers our patients the option of Intravenous Sedation, also referred to as Dental Intravenous Anesthesia, or “Twilight Sedation,” for their dental treatment. This is what sets our office apart from other dental practices; it is our niche.

Intravenous Sedation or “twilight sleep” helps you to be comfortable and calm when undergoing dental procedures. Your treatment can be completed for you under intravenous sedation, if you so desire. Intravenous sedation or “IV sedation” (twilight sedation) is designed to better enable you to undergo your dental procedures while you are very relaxed. It will enable you to tolerate as well as not remember those procedures that may be very uncomfortable for you. IV sedation will essentially help alleviate the anxiety associated with your treatment. You may not always be asleep but you will be comfortable, calm and relaxed, drifting in and out of sleep – a “twilight sleep”.

If you choose the option of intravenous sedation your IV sedation/anesthesia is administered and monitored by a CRNA, therefore eliminating the costly expense of having your treatment carried out in an operating room or same-day surgical facility.  We have partnered with Micki Mac, LLC and JLM Anesthesia, LLC, whose CRNA’s remain present during the entire procedure, monitoring and adjusting levels easily for the needs of each patient.

How is the IV Sedation Administered?

A thin needle will be introduced into a vein in your arm or hand. The needle will be attached to an intravenous tube through which medication will be given to help you relax and feel comfortable. At times a patient’s vein may not be able to sustain a needle for the length of the procedure. In this case, the medications will be administered and the needle retrieved. Both scenarios will achieve the same desired level of conscious sedation. Once again some patients may be asleep while others will slip in and out of sleep. Some patients with medical conditions and/or on specific drug regimens may only be lightly sedated and may not sleep at all.

The goal of IV sedation is to use as little medication as possible to get the treatment completed. With IV sedation, a constant “drip” is maintained via the intravenous tube. At any time an antidote can be administered to reverse the effects of the medications if necessary. IV sedation is very safe!

Along with IV sedation there are also different “levels” of sedation available to you in our office. There is nitrous oxide analgesia and oral sedation or nitrous oxide in combination with oral sedation – basically we can tailor the anesthesia to your need or desire. Once again, all modalities are administered and monitored by a CRNA in the safety and comfort of our office environment.

Sedation dentistry is also a great option for the elderly, the disabled, or simply- the fearful!

Sedation Dentistry for the Elderly

As we age, our oral health becomes more important than ever. Periodontal disease can lead to bone and tooth loss, which affects nearly every part of our daily lives. To lead full and active lives, we need our teeth and gums. They allow us to enjoy food, support speech and good conversation, and facilitate digestion. Drs. Moreau and Moreau are dedicated to treating elderly patients with care and commitment to comfort and health.

Elderly patients as a group tend to avoid dental visits for a variety of reasons, including: more pressing medical concerns, anxiety about treatment, the hardship of transportation, or fixed incomes. Once their oral health has reached an unmanageable point, fear and embarrassment further keep these patients away from the dentist.

For elderly patients embarrassed or fearful of their current oral state, sedation dentistry provides the opportunity for Drs. Moreau or Moreau to treat these conditions while the patient remains relaxed and unaware until “awaking” to an improved oral state!

Sedation Dentistry for the Disabled

It may be especially difficult for people with disabilities to obtain access to proper dental care. They must find a dentist who is skilled and compassionate, and who can provide services for which some dentists may not be qualified. At Unforgettable Smiles, we provide the expertise, state-of-the-art-equipment, and dedication to assisting special-needs patients necessary to ensuring great oral care for our patients.

Disabled patients may face added challenges in maintaining their oral health. Their disability may make it difficult to brush or floss regularly; they may also suffer a severe gag reflex, or dry mouth as a result of medication. Drs. Moreau and Moreau meet these challenges with sedation dentistry for the disabled.

Sedation Dentistry for the Fearful

If you suffer from dental phobia- fear no more! At Unforgettable Smiles, we are committed to understanding the very real nature of your fears. Not only will our staff treat you with delicacy and care, but IV sedation will allow you to experience dentistry in a whole new way. While engaging in a pleasant sleep-like experience, Drs. Moreau and Moreau will be hard at work making sure you “wake up” with the results you desire.