New look pain relief - sedation in dentistry for children and adults needs an explanation of what it is, what the price is and reviews about it. A strong fear of dental sanitation causes a real phobia that disrupts the process of timely filling of teeth. Patients will be happy to go to the doctor again if the first time the procedure was painless, without trauma to the nervous system.
Modern methods of pain relief can turn a trip to the doctor into a pleasant, exciting journey. Local anesthesia allows you to remove painful sensations for an hour or more, but the patient feels all the activities carried out by the doctor.
Actions of the dentist during treatment:
All this does not allow you to relax, but only exerts psychological pressure. Deep anesthesia in this situation turns off a person’s consciousness and allows all procedures to be carried out. But for children they recommend a gentle method that is easy to use for doctors - this is sedation.
Sedation eliminates stress and nervous tension, but pain sensitivity is preserved, so it is necessary complex application these two methods. The patient does not feel discomfort and pain, being conscious, his emotions are dulled and he can relax.
Sedation is understood as a set of actions aimed at aligning psychological state person and putting the patient into a light nap. For these purposes, approved, harmless drugs are used that relieve anxiety and facilitate work within the dental field.
Anesthesia happens:
The advantages of this type of anesthesia are:
The entry of drugs into the body:
Intravenous sedation should be performed by an anesthesiologist. Before performing any type of anesthesia, the doctor clarifies the presence of previous and concomitant diseases, allergic reactions.
Additional blood testing:
It is necessary to do an electrocardiogram and get an answer from a cardiologist. A small dose of a sedative before administering local anesthesia is called premedication.
The most widely used method for relieving anxiety is oxygen sedation. It is used in adults and in pediatric practice. Only the anesthesiologist, based on the results of the examinations, decides what the drug will be, its volume, and the duration of the procedures. For adults, intravenous sedation is more often used.
Children are given an oxygen-nitrogen mixture through a nasal mask, leaving access to the oral cavity. Sedatives are not used here, but the effect is the same - calm and absence of irritants. It is important to carry out sedation while the baby is in a good mood; the hysteria that has begun will not stop under the influence of drugs.
Doctors do not recommend sedation for children during acute stage chronic diseases. Since it increases intracranial pressure, it is not recommended for patients with epilepsy, so as not to provoke the onset of an attack. Fluctuations in intracranial pressure are harmless to healthy children, since they are not intense.
The procedure is contraindicated:
In children who do not enter into verbal contact with the doctor, sanitation is carried out under anesthesia.
Indications for this type of sedation are:
Superficial sedation is not performed on pregnant women, people under the influence of alcohol, or those suffering from neuromuscular diseases. Children with paralysis, autism and Down syndrome are more likely to need anesthesia. The disadvantages of this method are the inability of patients to control their behavior and communicate clearly with the dentist, so regular procedures become impossible for them.
The calming effect occurs immediately after removing the mask. Medical sedation requires up to 60 minutes to return to active wakefulness. There is no need to prepare for anesthesia. The patient will need to be examined according to the plan prescribed by the attending physician.
On the day of treatment, do not drink caffeine and avoid drinks containing alcohol 24 hours in advance. You can eat any food, and it is better to eat something before the procedure.
Activities after sedation:
A sleepy state and slight lethargy, an unsteady gait persists for about 4-5 hours after the procedure.
Sedation in dentistry for children is performed with intranasal nitrous oxide. The child should be happy to put on a mask from which the drug with the sweet smell of fruits will be supplied.
What happens to a child during sedation:
Dive into light sleep occurs at 100% oxygen, and then the nitrogen compound enters in small portions. After a few minutes, the volatile substances spread through the vessels, and after inhalation of the vapors ends, they leave the body. Dental centers use the most gentle method of sedation when little patient receives 100-200 ml of citrus juice with a sedative and drinks it.
How much money you need to pay for sedation depends on the clinic and its location; services vary across the country. Payment in one dentistry can be many times higher than the same procedure in another clinic.
Choose a place not by price, but by reviews and qualifications medical personnel. Remember that anesthesia can end in the wrong hands unpleasant consequences due to poor quality equipment and dangerous drugs.
Price for sedation:
In a good clinic, you are constantly monitored by an anesthesiologist, and all emergency kits are available in the office.
Video: what is sedation?
Dentist performing dental treatment
In dentistry, when treating teeth, the technique is most often used superficial sedation, in which minimal depression of the patient’s consciousness occurs, the ability to follow the dentist’s instructions and commands is not lost, and, most importantly, adequate breathing is maintained throughout the entire procedure. At the same time, after dental treatment, very few memories of the procedure remain in the patient’s memory. On the one hand, this is because sedation induces a state of deep relaxation in which perception external stimuli(light, sound, etc.) is greatly dulled, and, on the other hand, those used by themselves cause partial or complete loss of memory (amnesia), corresponding in time to the duration of action of these drugs.
Superficial sedation, like deep sedation, requires local anesthesia. Further, when we mention the sedation technique used in dental treatment, we will mean the technique of superficial sedation.
Performing sedation for dental treatment requires anesthesiological monitoring and all other components.
Examination of the oral cavity by a dentist
Depending on route of administration medicines The following types of sedation are distinguished:
1. Inhalation sedation
2. Oral sedation
3. Intravenous sedation
As a rule, a special anesthetic gas is used for inhalation sedation -. Carrying out inhalational sedation requires constant inhalation of this gas through a face mask, which is not entirely convenient, since oral cavity is the main object for the dentist's work. Nitrous oxide is also not an ideal anesthetic in terms of the ability to quickly regulate the depth of sedation; here intravenous anesthetics have the greatest advantage.
Most often, the following are used for dental treatment under intravenous sedation: benzodiazepines (in particular, midazolam), propofol, sodium thiopental, sometimes.
Superficial sedation is a fairly safe anesthetic technique. However, it also has certain (even if very minor) risks of developing complications and adverse reactions, characteristic of.
Intravenous sedation is much more effective than its other types (oral or inhalational).
There are only two disadvantages of intravenous sedation:
1. The need for intravenous access - vein puncture. If you are very afraid of the procedure, then you should choose the technique of inhalation sedation.
2. There is some probability local complications at the site of vein puncture, for example, the formation of a subcutaneous hematoma.
After dental treatment performed under sedation, you must strictly follow the entire range of recommendations for the regimen.
1. If you do not want to remember what will happen during the dental treatment procedure, if you prefer to remain outside of everything that is happening during treatment at the dentist.
2. If you experience great fear of the specifics of the dental treatment procedure (needles, “drilling”, tooth extraction), especially if you are sure that the fear will remain even despite the empathetic attitude of the dentist and the presence of effective local anesthesia.
3. If you have mental illness, You have a very big fear of dental treatment and feel that sedation will help you avoid possible problems with the mental component of your health.
1. If you are afraid of the dentist (as a person in a white coat who can cause pain). A dentist is a doctor who wants to make your teeth healthy, and not cause you pain.
2. If you feel that you will benefit more from a calm approach to the dental treatment procedure, which involves you being in a clear consciousness throughout the entire treatment, with the possibility of constant feedback with your dentist. Sometimes during dental treatment, the dentist has tactical questions, the solution of which requires contact with you.
3. If you think that sedation will do easier life» for your dentist, will simplify his work. Perhaps, in some cases, sedation simplifies the dentist’s work, but this is by no means an indication for its implementation.
Contraindications to dental treatment under sedation are: pregnancy, alcohol intoxication, depression of consciousness, allergy to the drug used.
Cure teeth without hysteria - is this possible? The child himself opened his mouth and let the pulpitis be treated while listening to a cartoon - it’s impossible! I sat in the dentist’s chair for 40 minutes and didn’t escape – it’s definitely fiction.
When parents hear such stories from their friends, it means we are talking about dental treatment for children under sedation. “Oh, no,” dad/mom will immediately think. “We don’t want anesthesia.” This is not anesthesia, or even anesthesia. This is relaxation.
This is a way to remove the psychological barrier that a child involuntarily appears when he sees a doctor. The method relieves nervous tension and relaxes. Calm means ready for treatment.
The most common choice for children is oxygen sedation with nitrous oxide. To be clear, this is akin to laughing gas. Only such a gas will not cheer you up, but will calm you down and put you into a state of drowsiness.
Your baby will be conscious, he will not fall asleep, you can and should talk to him during treatment, he will just be slightly inhibited. No reflexes are suppressed, unlike anesthesia.
Anesthesia is used in pediatric dentistry. But this requires serious reasons, thorough preparation and follow-up. In some cases, dentists issue special referrals for treatment under anesthesia. Not every clinic can provide such therapy.
Sedation cannot be called anesthesia either. It does not block pain, so the anesthetic injection is not canceled. But the calmed baby won’t even notice him.
The procedure is very common and loved by dentists, as well as parents, who have already tried it and are convinced that there are practically no risks. We leave the “practically” remark for extreme cases, because all children are different, and in any case an individual approach is needed.
Good pediatric dentists are also experienced psychologists; they know how to captivate the child, make him interested in the process, do not rush him, let him feel everything, touch the drill.
- Look, what a thing there is, have you seen fighter pilots? They wear such masks so that they can breathe at the highest altitude. Are you a fighter pilot too? Climb into the cabin of the plane, okay, and we’ll take mom with us? Then put on a mask, now the oxygen will start flowing! Ready? Let's take off!
Without screams, screams, tears or fears, your child sits in a chair, the doctor puts a mask on his nose, and after a couple of minutes you can begin treatment. Nitrous oxide - oxygen sedation (ANS) usually has a sweetish odor, children like to breathe it.
Important point! A child who is already scared and hysterical should not be sedated. This can only worsen the condition.
The effect of the drug ends the moment the mask is removed. For an hour after this, doctors advise you to sit and come to your senses, then the little one will behave as if nothing had happened. Severe consequences the procedure does not work.
In principle, no. You should not overeat before the procedure. It is better to refrain from strong emotions the day before.
If in doubt and want to be on the safe side, you should take a general blood test and do an echocardiogram. You can show the doctor your medical card or tell in detail about past or chronic illnesses.
Is it worth telling the baby about the upcoming treatment? Here each parent decides for himself.
Some experts advise not to tell anything, because they themselves will tune their patient to the desired wavelength. Some children are so anxious that they don’t trust anyone except their dad and mom. Then it’s worth informing in advance what will happen in the doctor’s office. You can promise a prize to the bravest, and when it's all over, go to the toy store.
The list is extensive:
This method is prescribed for children aged three years and older. And it is important that the young patient already knows how to talk. The dentist needs this to maintain contact.
This question should be asked to a dentist and neurologist. As a rule, without sedatives, patients diagnosed with autism, Down syndrome, children cerebral palsy have great difficulty enduring treatment. However, sedation in such cases may not be enough, and doctors decide to treat under anesthesia.
Treating your child's teeth without stress and screaming is a big temptation for parents. Are there really any negative aspects?
There is only one risk - individual reaction, most often allergic. It will appear in the first minutes, as part of premedication, the doctor will quickly stop the process and administer antihistamines.
This method of treatment is probably already practiced by all clinics that accept children. The main selection criterion for parents is reviews. And also the price.
But real reviews from those who have undergone treatment are the main argument in favor. Ask moms at playgrounds, monitor parent forums in your area. On the Mydentist portal, we also collected live responses from patients about dental treatment for children with nitrous oxide and other methods.
The cost of the service is different for everyone. Some include information for the entire procedure in their prices, others introduce an hourly fee, and others add it up along with the therapy. On average for the use of nitrous oxide in the process dental treatment(up to 30 minutes) you will pay 1,500-3,000 rubles.
A parent should not painfully decide whether or not to do this procedure. Consult your pediatrician if you have any doubts. Dentists, as a rule, are in favor with both hands. Treatment of baby teeth should not be delayed. It is useless to wait until the child grows up to this.
So, sedation, what is it? Sedation is an immersion in a state that is similar to dozing, sleep, while a person feels relaxed and calm. This effect is achieved with a small amount of medication.
IN modern medicine Today there is no need to endure the unpleasant sensations that inevitably arise during certain medical procedures. In addition to many methods of pain relief, from anesthesia and anesthesia, to a variety of painkillers used in everyday life, at home, sedation methods are also used, which are designed to relieve the patient’s panic state before undergoing procedures.
The patient, although half asleep and relaxed enough for the specialist to perform the necessary manipulations without any problems, is nevertheless conscious and, if necessary, can follow some of the doctor’s instructions.
This method has been used for quite a long time, and more than successfully, in European countries and the USA. Sedation came to us relatively recently, but is also successfully used in most clinics and hospitals.
This procedure is performed in several ways, differing in technique. Medical sedation can be divided into
This type is suitable for treating children under sedation. It is used here for the analgesic effect. local anesthesia, and for direct sedation - nitrous oxide and oxygen, which enters the body through a special mask. It, in turn, is only part of a special device that will prevent an overdose if necessary. The degree of sedation achieved by this method is characteristic of local anesthesia. 
The patient, when performing this method, should not have a cold, nasal breathing should function normally.
How is this type of sedation done? After putting on the mask, the person first receives 100% oxygen, and nitrous oxide is added gradually. As nitrous oxide is added, relaxation begins to be felt. At the end, the patient is shown a simple oxygen mask again.
Intravenous sedation is a method in which the drug enters the body intravenously, as the name suggests, or more precisely, the injection is made into a vein located in the cubital fossa. The needle remains in the vein throughout the procedure, taped to the arm with special adhesive tape. This measure is necessary for the use of additional injections designed to increase the degree of sedation, as well as for the use of resuscitation agents. 
The use of this method during surgery, along with relaxation, also causes memory loss (amnesia). After administering the medication, a simple test is performed to determine the depth of immersion. You can tell whether the method worked by the incoherence of your speech and the inability to reach the tip of your nose.
Preparation consists of the fact that before starting the procedure, the doctor looks medical card patient, checks for tests required for intravenous sedation ( General analysis blood, biochemical analysis blood, coagulogram, ECG, tests for HIV, HbsAg, HCV, Rw).. Throughout the entire procedure, strict monitoring is carried out to ensure that a drug overdose does not occur. For this purpose, as well as to provide urgent assistance, must be available necessary equipment. Recovery after using this method lasts about an hour.
How often can deep sedation be done? Doctors do not impose restrictions on the frequency of using this method, since modern medicine does not use addictive medications.
Drug sedation. It is used mainly in cases where the patient is panicky about the upcoming medical intervention. Here tranquilizers are used, such as, for example, Valium (the day before, at night) and temazepam (immediately before the procedure). The drugs are taken orally, through the mouth.
The difference is this:
Practically not identified. A reaction to the drug used may occur, so discuss with your doctor in advance the medication that will be used.
The method is used in a variety of medical interventions where the patient needs to be calm, but at the same time remain conscious and listen to the doctor's instructions. The use of sedation is used in dentistry, ophthalmology, and during various operations. plastic surgery, for endoscopy, gastroscopy, colonoscopy, as well as in many other medical fields. Sedation is also used in intensive care units.
What is it? The Rass and Ramsey scale is used by anesthesiologists to assess the depth of sedation of a patient. Both tables were created through the joint efforts of many doctors, pharmacists and nurses. What are they for? When using sedative methods, strict control over the patient’s condition is necessary so as not to violate the dosage of the medication in any way. Condition monitoring is precisely carried out according to these two lists of indicators.
Rass or Richmond Agitation-Sedation Scale:
|
State |
Description |
|
| Buinoe | Extremely aggressive behavior, dangerous | |
| Strong excitement | Prevents procedures from being performed, removes tubes or catheters, dangerous | |
| Excited state | Frequent erratic movements or inability to put on a respirator | |
| Anxiety | Anxious but not aggressive | |
| Calm | ||
| Drowsiness | Sleepy, but awakens (ten seconds), responds to voice | |
| Light sedation | Brief (less than ten seconds) awakening with opening of eyes to voice | |
| Moderate sedation | No reaction to voice (does not open eyes) | |
| Deep sedation | Reaction (movement) to physical impact | |
| Inability to wake the patient | There is no reaction to either voice or physical impact |
I created this project to in simple language tell you about anesthesia and anesthesia. If you received an answer to your question and the site was useful to you, I will be glad to receive support; it will help further develop the project and compensate for the costs of its maintenance.
Tatyana 03/15/2019 11:39
Good afternoon Please tell me what type of sedation will be better for colonoscopy? The woman is 78 years old, there are possible adhesions or polyps in the intestines, so carrying out the procedure without this will be very painful, and she will not agree. We would choose inhalation, but it is contraindicated when high blood pressure. With intravenous sedation, it turns out that additional anesthesia is also needed. Thank you!
Dmitry 02/25/2019 11:08
Good afternoon, please tell me, is it necessary to have an anesthesiologist present when giving inhalation sedation to a child?
Irina 10.21.2018 20:04
Good evening. Tell me if it is possible to order drugs for sedation. Or maybe there is another way. I have allergic reaction for almost all drugs used in dentistry. I am planning to get implants. But everyone refuses me. Where they got it, the price was simply astronomical.
Today, when carrying out this or that treatment, the patient does not have to endure pain. He offers anesthesia, anesthesia, and sedation. Last word probably new to you. Let's expand on this concept as widely and popularly as possible.
Sedation - what is it, many patients want to know. This is immersion in a state similar to drowsiness, sleep. The person is relaxed and calm. This effect is achieved by introducing a small proportion of drugs. The patient, which is important, is conscious and can follow some of the doctor’s instructions.
To achieve a state of sedation in a patient, the following drugs are used:
Cases when it is prohibited: epilepsy, sensitivity to drugs, severe somatic diseases, acceptance the day before alcoholic drinks, drugs, nasal congestion, pregnancy.
This type of sedation - what exactly is it? The drug enters the body intravenously - a needle is inserted into a vein in the cubital fossa. It is specially fixed in this position throughout the entire procedure - for the administration of additional injections and resuscitative drugs if necessary.
Effect: relaxation, amnesia. To be allowed to use this method, the patient needs to undergo a series of tests and an ECG. Special equipment is needed that prevents overdose and helps to provide emergency assistance. Recovery after intravenous sedation takes about an hour.
Advantages and disadvantages of the method:
Dental treatment under sedation relieves young patients of unnecessary stress and prevents fear of people in white coats from arising. The procedure helps you not even feel the pain of an injection with a local anesthetic.
During sedation, the role of the dentist is important - he needs to constantly monitor the child’s behavior, set him in the right mood, and establish a trusting relationship. During this procedure, he sits calmly in the dental chair for up to an hour, which contributes to better work for the specialist - he does not need to rush, be distracted, or reassure the patient.
Contraindications:
Sedation in dentistry is a chance to get rid of dental phobia, children's fears of doctors. The effect of the procedure smoothes out all unpleasant impressions: smells, sounds, doctor’s manipulations. After it, the memories are completely erased. Dental treatment under sedation is also recommended for people suffering from mental illness.
Contraindications for adult patients:
Sedation - what it is, we have looked into it in detail. For adults, this procedure helps not to put off visiting the dentist for fear of getting discomfort, pain. And in young patients, it does not allow them to develop a feeling of fear in front of the doctor’s office.
