Oral Or I.V. Sedation

Posted on Jul 26, 2016 by William J. Claiborne, DDS MS

Whether a patient has fear or anxiety associated with dental visits or merely wishes to be more relaxed during a long procedure, sedation options can help greatly.

In our office, we offer oral or I.V sedation to accompany many procedures. While both are beneficial to quelling anxiety, tension, stress or even intense feelings of fear, each has its advantages as well as limitations.

For individual who have trouble relaxing in a dental chair or even feel anxious or fearful, oral sedation is often sufficient. The medication is in pill form and taken before the patient leaves their home. A companion will drive you to our office. By the time you arrive, you’ll feel very relaxed and groggy. A trained staff member will escort you to a treatment suite where you’ll be made comfortable.

Oral sedation’s intensity increases gradually, so by the time you are seated in the treatment chair, you should be very relaxed. The staff member will attach safety monitoring equipment and will check this carefully throughout your procedure.

Injections are given to sedated patients once they are fully relaxed and in a state near to ‘dozing.’ However, even in this state, a patient can respond to simple requests, such as “Turn a little more towards me.” While you’ll be able to respond, you likely won’t remember any of the procedure afterwards.

Once your procedure is completed, you’ll be monitored for a brief recovery period. A bonus of oral sedation is its quick recovery. After your companion returns you home, you may want a short nap but many patients are fine after several hours.

While oral sedation provides a very relaxed, near dozing state, I.V. sedation puts you in a complete sleep state. This is sometimes referred to as “twilight sleep.”  I.V. sedation is ideal for people with higher levels of fear or dental phobia. A dental phobic is an individual who has such deep-seated fear that just the thoughts of walking into a dental office causes sweating, crying or rapid heart rate.

I.V. sedation is delivered through an I.V. drip, or intravenously. It takes effect rather quickly and patients nod off within minutes. This is when numbing injections are administered and, once they’ve had time to take effect, treatment begins.

Typically, you’ll be able to respond to simple requests while under I.V. sedation. However, I.V. sedation generally erases all (or most) memory of treatment afterward. A few adults vaguely recall hearing a voice but most remember no part of their procedure. For patients with high fear, this is a desirable effect of the drug.

Once your companion returns you home, you’ll nap for a time. I.V. sedation does require a longer recovery time. After a nap, you may feel groggy or hazy for several hours but should start to regain your focus by that evening. You’ll be given post-op instructions that include cautions during recovery when sedation is used. Driving or using appliances or machinery is highly discouraged and can be dangerous to you and others.

Whether given oral or I.V. sedation, your comfort and safety is a priority at all times. And, while sedation is helpful when fear or anxiety exist, some people who have no fears at all request sedation for its ability to relax them during lengthy times in a dental chair.

Achieving a healthy, confident smile can occur in comfort! Never hesitate to ask us about comfort options if you feel these may help create a better experience during your treatment. Call 828-274-9440.

 

Problems Experienced When Jaw Bone Shrinks

Posted on Jul 05, 2016 by William J. Claiborne, DDS MS

When natural teeth are lost, there are a number of ways to restore the appearance of your smile. However, there is only one way to maintain dependable, secure biting and chewing – Dental Implants. Here’s why…

Natural tooth roots provide stimulation to the jaw bone, which preserves its ability to maintain a healthy mass. When tooth roots are missing, the jaw bone loses the stimulation needed to keep blood flow active. Over time, this results in ‘resorption,’ or a decline in bone mass.

The resorption process causes the gum ridge to flatten. The pressure on the gum ridge from wearing dentures actually accelerates the rate of bone loss. For those who sleep in their dentures, this 24/7 pressure speeds the rate of bone loss even more.

When a denture is first made, it is designed to conform to the unique contours of the bone ‘arch’ where tooth roots were once positioned. The reason that denture wearers commonly experience movement or slips is because the denture’s foundation is shrinking. Even with the help of adhesives or pastes, this dwindling foundation means a denture is likely to move while eating.

A new denture may fit securely for the first five years. However, as the jaw bone continues to lose height, relines may help on a temporary basis. As bone loss continues, relines to your denture or partial will need to be done at more frequent intervals each time.

One year after natural teeth have been extracted, denture wearers average losing about 25 percent of this bone ridge. After three years, the average decline in bone is approximately 60 percent. Biting becomes risky. Chewing is more difficult. The biting force of natural teeth is about 250 lbs. while an average denture wearer is able to apply about 5 lbs. of force.

Want to see the extent of resorption you’ve experienced? Begin by looking in the mirror without your denture in place. Your mouth may appear sunken-in with your chin more pointed than before tooth loss. Other signs of bone loss include deep wrinkling around the mouth, the corners of the mouth turning downward (even when smiling), and jowls from the detachment of facial muscles.

There is a solution to the ongoing challenges of bone loss. Today’s implant dentistry offers excellent options to replace missing teeth and overcome the problems associated with bone loss (even when bone loss is severe). Implant systems such as All-On-4 can be positioned in minimal bone using just four implants. Placed at specific angles, All-On-4 can support a full, non-removable denture in minimal bone.

There are many reasons so many adults are now choosing Dental Implants for tooth replacement.  They halt the process of bone loss while restoring chewing comfort and confidence when speaking or laughing.

A Periodontist specializes in the treatment of gum tissues as well as the diagnosis and placement of Dental Implants. Although the failure rate of Dental Implants is rather low, having a successful outcome can greatly depend on the Doctor who selects and places your implants.

Begin with a consultation by calling 828-274-9440. I’ll be happy to answer your questions and discuss our many comfort options, including Oral and I.V. Sedation.

Sedation Can Help Relax Dental Patients

Posted on Jun 10, 2016 by William J. Claiborne, DDS MS

In our office, many procedures involve incisions into tender gum tissues. As a Periodontal practice, it is necessary to penetrate periodontal tissue in order to treat some levels of gum disease. It is also necessary to open up gum tissues to place dental implants. And, in repairing gum recession, performing gum grafts or recontouring gum tissues, incisions may be part of the process.

We pride ourselves on providing optimal comfort to all patients – for any procedure. However, we are aware that many people have developed gum disease or lost natural teeth as a result of dental fear. Being afraid of dental visits prevents a great many adults from having regular dental care. As a matter of fact, it is estimated that nearly 70% of American adults have some level of dental fear.

Just as a general dentist does prior to a filling or extraction, we use novocaine to numb the areas in the mouth being treated. However, we also offer I.V. sedation to help patients be totally relaxed throughout their procedure.

For fearful patients, I.V. sedation (also known as ‘twilight sleep’) places them in a sleep state prior to and throughout their procedure. Although the patient may be able to respond to my request to things like, “Turn your head a little towards me,” they are essentially sedated to the point of snoozing. This removes the anxiety of anticipating things such as sounds or smells that may evoke thoughts of pain.

Another benefit of I.V. sedation is its ability to erase most or all memory of the procedure afterwards. While a few patients may remember hearing my voice a time or two, the time is generally erased from their memory. All most remember is a peaceful sleep.

I.V. stands for intra-venous, which is translated as “in the vein.” The sedation is administered by a drip into a vein, typically in the arm. Patients are in a sleep-like state very quickly thereafter. Throughout your time, you will be closely monitored by a trained staff member who uses advanced safety equipment.

Once your treatment is completed, the I.V. is removed and you will be monitored for a recovery period in our office. Your companion will then return you home where you will relax or even nap for a brief time until you feel back to normal. We do advise that I.V. sedated patients avoid driving or using machinery for 24 hours.

Some patients who have no dental fears prefer the relaxation effects of I.V. sedation. Certain procedures that require lengthy appointments can be tiring and I.V. sedation is an advantage to the patient in being comfortable while in a dental chair in one position for long treatments.

Our ultimate goal is to restore our patients to a healthy, confident smile. We believe this can be accomplished with gentle hands and a respectful environment. In many situations, sedation can be advantageous to providing a positive experience and successful outcome.

If you have dental fears or wish to discuss comfort options related to periodontal or dental implant procedures, feel free to call us at 828-274-9440.

 

Dental Fear?

Posted on Jun 25, 2015 by William J. Claiborne, DDS MS

It’s not surprising that the percentage of American adults with some level of dental fear (estimated at 75%) nearly parallels the percentage of adults ages 65+ who have some level of gum disease (70%), the nation’s leading cause of adult tooth loss.

The high number of adults who have dental fear is also likely related to the prevalence of tooth loss in mature adults.  Those born before 1949 have the highest percentage of lost teeth and being totally toothless (25%). Could this be because the 65+ age group endured dentistry in a time when patient comfort was very different than what is expected today?

Most of today’s 35 and under adults have experienced dental care by modern dentists who are more attuned to a patient’s need for comfort. However, for adults in the 65+ age group, a greater number can recall traumatic experiences in the dental chair. These often carry over into adulthood, making a trip to the dentist overshadowed by the perception of pain.

Dental fear deters people from having regular dental check-ups. Lack of regular dental care leads to the formation of cavities, gum disease, tooth loss and health risks from oral bacteria, which can trigger systemic inflammation. The bacteria of periodontal (gum) disease can enter the bloodstream through tears in diseased gum tissues. The bacteria moves through the body, creating inflammatory reactions have been linked to heart disease, diabetes, stroke, arthritis, preterm babies and impotency.

For a large percentage of aging adults, dental fear plays a key role in the frequency of dental visits. If fear has kept you from regular dental visits, regardless of your age, you will find the majority of today’s dental environments are highly sensitive to your comfort throughout each visit. Although sedation options are an appealing way for fearful patients, we believe that finding a dentist or dental specialist whom you trust will help you conquer your fears and achieve the smile you desire.

Most patients who have avoided dental care have some level of gum disease. Until your gums are healthy, no dental procedure is going to provide long-term benefits. Begin with a periodontal exam by a specialist in Periodontics. Once your mouth is restored to a healthy state, we can make recommendations to help you with other needs for a confident smile.

Decades of dental fear isn’t going to disappear in a blink of an eye. Getting over it requires a pace you feel is right for you. If preferred, begin with a consultation appointment. Knowing you are empowered to control this pace may help you move through it comfortably.

Call (828) 274-9440 to discuss your needs or to arrange an appointment.