Oral sedation is a less effective means to sedate patients. The patient takes a pill and in 30 minutes, they get some effects of sleepiness. Due to the fact you swallow a pill and it takes a half-hour to kick in, makes oral sedation less predictable and more dangerous for the patient. If you must wait for sedation, the clinician may give more than the patient can handle and thus, the patient can get into respiratory depression without the dentist being aware of it. Since there is no venous access to combat drugs given quickly, patients could be at serious risk of complications and death. Minor effects of this type of sedation usually give the patient minimal sedative effects but it is less costly.
General sedation is the most effective means to sedate but the patient should be intubated with a machine to help them breathe. This type of sedation usually happens in a hospital setting as the equipment is more robust. The complications can occur more often with this type of sedation, and usually requires a nurse specializing in this type of sedation to be present to monitor the patient’s vitals. Since the patient is totally unconscious, procedures are done without a local anesthetic. This is the most expensive means to sedate a patient.
Moderate sedation allows patients to be sedated in a dental office setting. This requires the dentist to have completed rigorous training to show competency and re-certification to show competency. Unlike oral sedation, the dentist has access to a vein, where the drugs are given, and effects are spontaneous, thus the sedation is safer and more controlled. If a patient becomes too sedated, drugs can be given to reverse the sedation and if the patient has other complications, the dentist can counter-act them by administering drugs to help the patient. In our office we have dental assistance specially trained to monitor patients during sedation, this again requires rigorous training to show competency (to my knowledge, no other general dentists have required this of an assistant). The cost is significantly less than general sedation but more than oral sedation.
The South Dakota Board of Dentistry has asked Dr. Kusek to be one of the evaluators for other offices getting their licenses for sedation. He has also been appointed to the Sedation committee for the State Board of Dentistry for ten years (the first and longest-standing general dentist on this committee). To learn more about Kusek Family & Implant Dentistry’s sedation process call our office at 605-371-3443.