Dental Sedate Debate

February 11, 2009 6:34:11 PM PST
About 30 percent of Americans are afraid of going to the dentist, sometimes letting dental problems linger for years without being seen -- but what if you could forget you ever went to the dentist? Now it's possible, but some dentists warn it's not without risks.Dustin Fuller is calm while he waits to see his dentist. It wasn't always this way.

"I was really deathly afraid of the dentist," Fuller told Ivanhoe.

After avoiding the dentist for 30 years, Fuller was forced here when he broke a tooth.

"Extreme fear," Fuller said. "Even just sitting there filling out paperwork the first time, I forgot my address."

He easily handled his root canal with conscious oral sedation, a new trend in dentistry.

"They remember bits and pieces, but they really don't remember details," Anna Belous, D.D.S., a dentist at Contemporary Dentistry in Rochester, N.Y., told Ivanhoe.

Dr. Belous offers oral sedation to fearful patients. They get Valium the night before and another sedative pill the day of the procedure.

"It's very well managed," Dr. Belous said. "It's very safe."

Oral surgeon Lee Pollan, D.M.D., M.S., says the trend is disturbing, and many dentists are not trained to deal with the complications.

"These drugs can depress respiration and depress cardiovascular activity," Dr. Pollan, an oral maxillofacial surgeon at Strong Memorial Hospital in Rochester, N.Y., told Ivanhoe.

If patients aren't sedated enough, dentists may give a second dose. It's not risk-free, and patients have died from sedation.

"It's very easy for a patient to slip from moderate to deep [sleep] by adding additional medications, and before you know it, you have a patient that's over-sedated and in trouble," Dr. Pollan said.

Guidelines suggest dentists undergo a minimum of 24 hours of training in sedating patients and 10 clinical experiences administering the medications. Dr. Belous says with the right training, oral sedation safe -- and she's happy to offer it.

"I think more people are aware of it," she said. "More people are eager to do this."

It costs up to $500, but patients like Fuller wouldn't be here without it.

"To sit in a dentist chair for five hours with a root canal and not realize you were there more than an hour, that's worth easily that much, if not more," Fuller said.

Oral sedation has been used for everything from routine cleanings and fillings to root canals. Some experts believe intravenous sedation is safer and more precise since it's easier to overdose when using pills. However, intravenous sedation usually requires more training than oral sedation. For additional research on this article, click here.

FOR MORE INFORMATION, PLEASE CONTACT:

Harold Messer, Office Manager
Contemporary Dentistry

Rochester, NY
(585) 244-3337
http://www.arlenemesserdds.com
http://www.ada.org

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