Why Sedation?

     Many things in life are naturally feared. For example, public speaking, flying in aircraft, being in darkness, and seeing certain insects or reptiles commonly rank as some of the most feared things to do or see by most people.  Going to the dentist often creates similar reactions by patients, and even hearing the word "root canal" sends shivers up the spines of some people.  It is natural for a patient when hearing the news that they need upcoming endodontic treatment to possess a certain degree of anxiety towards the procedure.  Whether this fear comes from an existing psychological issue,  previous bad dental experience, or simply from never having a root canal before, many patients will put off necessary treatment for days, even months and years on end because of fear and anxiety.  Some patients often endure chronic and often severe pain in the fear-procrastination process, or extract perfectly good teeth because sedation services were simply not available.

     Sedation allows for a safe, controlled, pharmacological reduction or elimination of fear, anxiety and pain towards dental treatment.  By being sedated during your treatment, your fears and anxieties are eliminated. You feel quite relaxed, remain pain free, time seems to drift away, you are totally comfortable, and typically have little or no recall of the procedure.  Other often embarrassing issues including a bad gag reflex, excessive saliva production, and claustrophobia are also well controlled or eliminated with sedation.

     Dr. Russin and his Staff have been extensively trained, tested, and our facility inspected and licensed to provide several forms and degrees of sedation during your endodontic treatment to alleviate fear/anxiety and to prevent chronic pain, infection, and prevent loss of natural teeth.

     In the field of Dental Anesthesiology, there are several and very specific types of sedation that can be provided by properly trained dentists and dental specialists.  Each patient that is a candidate for sedation must be evaluated in advance of treatment.  A separate sedation medical history form is filled out and all current medications/doses taken by the patient are reviewed via LexiComp (TM) software, Physician's Desk Reference (PDR) or online research via RxList (TM) and others. During the examination and consultation appointment, a comprehensive radiographic, endodontic, and pulp testing examination is first performed to correctly diagnose and treatment plan the patient's endodontic needs.  Once a discussion of all endodontic needs, treatment, and prognosis is mutually agreed upon by the patient and doctor, an anesthesiology examination is then performed.

     Medical, pharmacologic, cardiac, airway, patient drug-alcohol-smoking habit(s) are all examined and reviewed.  The type of sedation requested by the patient is considered by the Doctor, and an anesthesiology treatment plan is then presented to the patient to best suit the patient's needs relative to the patient's health history and existing ASA Status.

     The choices are then made: 1) No treatment.  2) Endodontic treatment with local anesthetic only, no sedation used.  3) Endodontic treatment with local anesthetic and also utilizing: a.) Nitrous oxide only.  b.) Oral sedation (a pill or series of pills) with or without nitrous oxide.  c.) Intravenous sedation with or without nitrous oxide. 

     Medical consultation with the patient's physician(s) may be required, existing medications or doses may be modified or eliminated, dietary requirements including fasting may be necessary, and accompaniment by a second responsible adult must all be discussed.  All treatment and anesthesia benefits, risks, medical, personal, financial and insurance responsibilities are all fully discussed prior to signing a proper and well informed written consent. An appointment for treatment is then made, take home instruction sheets given, and any necessary prescriptions are dispensed.. 

   During the actual sedation-endodontic procedure, fasting requirements are confirmed, medical history updated, and baseline vital signs of blood pressure, heart rate (pulse), respiratory rate, and % saturation of oxygen of your hemoglobin (SP02).  Depending on the depth and type of sedation these vital signs will be monitored and recorded by an separate Anesthesia Assistant independent and in addition to the treating Doctor and Dental Assistant for patient safety.  Additional monitoring including electrocardiogram (EKG), and exhaled carbon dioxide (CO2 end tidal capnography).  A third "roaming" Assistant is also available during the procedure to get any necessary supplies or instruments so that none of the operating room personnel will ever have to leave the treatment room for patient safety.  A complete emergency kit of all airway, drug reversal agents, cardiac, diabetic, and allergy injectables, along with a biphasic defibrulator are closely available to the current American Heart Association's Advanced Cardiac Life Support and Basic Life Support training.   Emergency powered lighting, computerized records, digital radiographs, and written emergency protocols are also present in each treatment room of the facility in event of power outage.  A variety of "creature comforts" including blankets, neck and back pillows, and audio-TV entertainment are provided. Any X-ray protection shields during treatment are used. 

     A designated post- sedation recovery area that is electronically monitored for vital signs and emergency care  is provided until the patient is graded for release. Post operative instructions are reviewed with the patient and driver. A variety of high caloric fluids/drinks are provided to keep the patient alert. A wheelchair is available for patient transport from the office to their vehicle, if needed.

    We have recently associated with Mobile Anesthesiologists of  Tampa Bay for our more challenging and advanced anesthesia cases that require additional support.  Hector Vila, MD is a Board Certified Anesthesiologist that can provide moderate conscious sedation, airway intubation, state of the art monitoring, and nursing staff at our facility. See their web page at: www.MobileAnesthesiologists.com or contact Dr. Vila at: (727)767-4763 / Safesleep@verizon.net for further information.

     It is our goal to provide the safest possible sedation experience through proper patient medical history interview and research. State of the art education of both the Doctor and Staff with scheduled education/professional association memberships/class work-review-journal subscription/mentoring, emergency code practice requirements,  the use of extensive electronic patient monitoring, redundancy of airway/drug emergency systems, and cross-trained staff are all inclusive for the patient's safety and comfort.