Tuesday, March 5, 2013
Some people are scared of the dark, others are scared of heights and then there are people who are afraid of the dentist.
Maybe it’s the odd-looking tools or the idea of having a person put their hands into another person’s mouth, but often times people don’t have much positive to say about a trip to the dentist’s office.
For those anxious about getting any work done to their mouths, different types of sedation dentistry are becoming more widely available, which make a trip to the dentist less scary and sometimes even relaxing.
“We have a lot of people who just feel very anxious; they can’t get their dentistry done any other way, so it works really well,” said Dr. Les Miller, dentist at Lawrence Dental Solutions.
What is sedation dentistry?
Lawrence Dental Solutions is just one of many Lawrence offices using Jeff Glasgow and his business, Advanced Specialty Anesthesia, to sedate patients through an IV for appointments with patients who are uncomfortable with dentists.
Sedation dentistry uses drugs or techniques to calm a patient during a dental appointment. It is possible to sedate the patient through either an IV, technique or through oral sedation.
With IV sedation, which is Glasgow’s specialty, the patients are still awake and responsive, and they’re aware of pain; however, they aren’t as anxious and typically don’t remember what happened after the sedation is over.
Nitrous oxide, or laughing gas, is commonly used in dentistry, and Lawrence Dental Solutions has used it for more than 30 years. IV sedation is newer and has been available through Dr. Miller for five years.
“Oral (anesthesia) is generally not as predictable in getting results that you need,” Miller said. “I think IV is safer because it is controlled. If you give something and you want to change the effects, you can give it immediately and it changes immediately.”
Miller and other dentists who use IV sedation have a CRNA come to the dentist’s office and take care of the patients’ anesthetic needs, including administering the anesthesia, watching vital signs and being sure the patient is never at risk.
Miller likes working with patients who are sedated through IV because it lets him focus strictly on the dentistry rather than having to worry about the sedation and patient’s safety.
“When one person is just focused on doing the dentistry and one on anesthesia, it’s just a great situation for the patient,” Glasgow said.
Glasgow started Advanced Specialty Anesthesia after hearing from friends who were scared to visit the dentist and talking to dentists who wanted a CRNA to come to their office for patients who were hard to perform dental work on.
“We have been very successful because we follow strict guidelines and we’re very meticulous as far as how we do it and really provide a lot of safety precautions into what we do,” Glasgow said. “We put the patient’s safety at the highest level.”
Amy Franklin, dental hygienist at Dr. Joseph R. Gatti’s Advanced Dental Studio, uses natural conscious sedation as her form of specialized dentistry. Franklin has been Oraspa certified since 2008, is one of just more than 100 Oraspa certified dental hygienists in the United States and is the only person in Kansas certified through the program. She said Oraspa’s ways of relaxing a patient are more “holistic.”
“It’s about getting teeth cleaned but is also a whole-body appointment as well,” Franklin said.
Oraspa uses the five senses to relax the patient and lower anxiety. Aromatherapy, relaxing music and touch therapy, which is similar to a massage, are all used to calm the patient. Franklin even uses essential oils during the touch therapy, and the audio track is science-based audio to help relax brainwaves. The patient doesn’t take any pharmaceuticals in order to reach a state of sedation through Oraspa.
Who is it for?
Glasgow said the three main populations sedation dentistry caters to are children, people with mental disabilities and people who are afraid to have dental work done.
Miller and Glasgow said that many times people who are fearful of the dentist haven’t had a checkup in years, so their teeth need to have a lot of work done. Sedation dentistry is ideal in these situations, they said, because it allows the dentist to do as much work as possible at once, which not only helps the patient to have a healthier mouth but also keeps them from having to make multiple stress-inducing visits.
“We’re empathetic, and that fear and stress transfers to us so it makes the procedures much more difficult, and typically they fight us along they way,” Miller said. “People who are fearful are more challenging to do dentistry really well for them. It’s been very nice to be able to offer a solution for these people that are fearful.”
Franklin said a person doesn’t have to have special circumstances to receive an Oraspa cleaning, but patients who are fearful of teeth cleanings especially should consider it an option for simple procedures. The appointment takes as long as a regular cleaning and costs about $40 extra.
“You don’t have to have anxiety, you don’t have to be rich, to actually benefit from this treatment,” she said.
Typically fearful patients don’t get sedated for regular teeth cleanings because of the costs of the IV sedation, but Miller said he has had patients who, after having dental work done with the anesthesia, have gotten over their fear of the dentist, aren’t scared to go to dentist regularly and no longer need to be sedated when their mouth has to be worked on.
Patients who are unable to sit still, such as young children, are difficult for dentists to work on. Glasgow said a great advantage to IV sedation for patients is that the dentist is able to truly do their job without having to fight the patient or rush the appointment before he or she becomes antsy.
Although Miller and Glasgow both highly recommend using sedation dentistry for patients who would benefit from anesthesia during their appointment, the costs of IV sedation could be a setback.
Glasgow said that even though it is pricier than laughing gas, the patient can save money by having one longer appointment to get all dental work done. Having the CRNA travel to the dental office also allows for the same care the patient would receive in surgery and in the hospital but without paying the fees of having the care done at the hospital.