Sedation dentistry has become very popular over the past several years, although the discovery of it occurred in the early 1800s. What is sedation dentistry really? Plainly stated, sedation dentistry uses different types of medications to reduce anxiety and create relaxation in the fearful dental patient. The intent of this article is to be informative to patients, and to allow an understanding of the different levels of sedation for the adult patient and the type of license that a dentist must have to administer them. There are guidelines for the levels of sedation that are set forth by the American Dental Association (ADA). The statutes and rules are mandated by the Department of Health, and vary by state. Since this article will be published in Florida the information will be derived from the Florida Department of Health the division of the Board of Dentistry.
In order to gain a better understanding of sedation dentistry it is important to first understand some key terminology:
Once there is an understanding of the basic terms used in sedation dentistry, it is easier to understand the following levels of sedation:
The most common routes employed in dentistry to administer sedation are the following:
The Florida Department of Health (DOH) the division of the Board of Dentistry governs the practice of Dentistry in Florida. In order to practice certain types of sedation, the dentist must either be a licensed Oral Maxillofacial surgeon or carry a permit granted by the DOH.
Minimal Sedation does not require a dentist to have any type of sedation permit. However, the dentist is only allowed to administer one sedative pill OR one narcotic pill pre-operatively. Also the dentist may not at anytime induce the patient into a moderate or conscious sedative state. CPR certification is required. To administer nitrous-oxide the treating dentist must have course work in nitrous-oxide training.
Moderate Sedation (conscious sedation) requires the dentist to have a Conscious Sedation permit. As well, the dentist must have an Advanced Cardiac Life Support (ACLS) certificate. A dentist with this permit is prohibited to administer the following drugs; propofol, methohexital, thiopental, etomidate, and ketamine. A dentist whom holds this permit may also administer Minimal Sedation and Pediatric Conscious Sedation (not discussed in this article).
Deep Sedation and General Anesthesia requires the dentist to either be trained as an Oral Maxillofacial Surgeon or have a General Anesthesia permit. As well, the dentist must have an Advanced Cardiac Life Support (ACLS) certificate. A dentist whom is either a surgeon or has a general anesthesia permit may administer any other type of sedation and may use all general anesthetic drugs.
Sedation Dentistry is a safe and effective method to treat the apprehensive patient or patients with special needs. It is important it is performed by a properly trained and licensed dentist on patients whom are not at risk for medical complications.
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