We understand that dentistry might be an unpleasant experience for some. Fortunately, sleep dentistry can be used in order to make the experience less unpleasant.
A. Levels of Sleep Dentistry
- Iatro Sedation: This is a term coined by late Dr. Nathan Freedman that describes a series of systemic questions that would help alleviate the patient’s fear of dentistry and provide reassurance for the upcoming dental work. Dr. Zadeh taught this technique at USC School of Dentistry from 1986-1990.
- Nitrous Oxide Inhalation Sedation (Laughing Gas): This technique is very useful for both children and adults. Its major advantage is that it leaves the system within minutes after the mask is removed, allowing the patient full autonomy almost immediately.
- Oral Sedation: This is the technique used by those who do not have intravenous sedation certification but allows them to produce some level of anxiolytics. Oral Sedation is highly limited in efficacy because of unreliable absorption of the medication and the delayed onset of action.
- Intravenous Sedation: The most effective of these methods is the use of intravenous (IV) sedation. IV Sedation is different from general anesthesia, for the drug of choice, Midazolam (Versed), does not produce general anesthesia and any pain control must be achieved by local anesthesia (shots). Reflexes remain intact during a sedation procedure and patients often fall asleep by themselves. Versed slows down and/or prevents short-term memory from converting to long term memory. As a result, patients often do not recall their experience while under the influence of this drug the next day.
- General Anesthesia: This is the ultimate “sleep” dentistry available. Due to the fact that patients’ reflexes are inhibited and breathing is affected, anesthesia needs to be administered by a separate anesthesiologist. This makes the procedure twice as expensive and difficult to schedule. In the opinion of Dr. Zadeh, unless in very special medically compromised individuals, it is not necessary to use general anesthesia for dental surgery.
B. Safety of Sleep Dentistry
At Zadeh Dentistry we use a pulse oximeter and other measures mandated by law to ensure patient safety during sedation. Dr. Zadeh has not had a single emergency or near-emergency situation with IV Sedation. We have a full arena of up-to-date emergency medications and equipment necessary for IV Certification and advanced cardiac life support. We discuss all safety procedures with our patients well in advance of any sleep dentistry operations.
C. When is Sleep Dentistry Necessary?
In our office, there are two categories of patients that qualify for IV Sedation. The first are those that are so apprehensive about getting dental treatment that they would not allow dental work without being “put to sleep”. The others are those that have procedures of three hours or longer. In these cases, IV Sedation helps to avoid extreme fatigue and muscle spasm of the jaw that occurs from prolonged opening of the mouth