Plaza of Cosmetic Dentistry
Dr. Joseph Goodman, D.D.S D.M.D.
Q.) Why are people put to sleep for their dental treatment?
People are put to sleep in our office for their dentist to solve special concerns. For those who are very anxious or fearful, the patient will not be awake during the procedure, thus allowing him or her to relax and follow through with needed treatment.
For people who need extensive work, being asleep allows us to perform more procedures, whether you are doing several root canals, a full mouth reconstruction, or removal of your wisdom teeth. Patients who have special needs may be unable to cooperate with requirements to remain still for long periods of time.
Q.) What types of anesthesia are available?
We provide different levels of anesthesia, all in our office: General Anesthesia, Twilight Sleep, and/or Nitrous Oxide sedation. We routinely use a combination of medications, usually a long-acting tranquilizer plus narcotics administered intravenously, plus Nitrous Oxide gas and Oxygen to supplement the intravenous drugs. We have an experienced anesthesiologist come to our office and monitor you, while Dr. Goodman performs all necessary procedures.
Q.) What is the difference between General Anesthesia and Twilight Sleep?
As we give more medication, the patient goes through different states of relaxation. The patient can choose to only have nitrous oxide (commonly called laughing gas) for a very relaxed state. However, the patient is still awake and aware of his or her surroundings. As we give medications, the patient becomes more relaxed and may think he or she is sleeping (Twilight Sleep) but actually does not remember being awake. As we give more medication, the patient gently slips into a state of general anesthesia where he or she is completely asleep and totally unaware of the surroundings.
Q.) Will any dentistry be done on my first visit?
No, on your first visit the doctor will want to focus on getting to know you, consult with you about any concerns, fears or problems, give you a full dental examination, and create a dental treatment plan.
Q.) If I need a lot of work, how many appointments will I need?
Depending upon your particular situation, your dental needs can be treated in as little as one visit. We will discuss this with you in preparing your dental treatment plan. If you need a lot of work done, we can also have a dental specialist come to our office, such as a root canal specialist or an oral surgeon.
Q.) If I receive General Anesthesia, how long will it be before I can resume normal activities?
Usually we give a long-acting tranquilizer during treatment so the patient will sleep comfortably after he or she leaves the office. You should rest and relax the first day after treatment; and most people return to normal activities on the second day after treatment.
The most commonly used technique used in conscious sedation dentistry is inhalation sedation with nitrous oxide and oxygen (N20-02) or "laughing gas." The goal is that with laughing gas the patient can eliminate dental anxiety, making the patient more comfortable while Dr. Goodman is able to more effectively complete the planned dental care procedure while you are sedated. Consult with us to find out if this pain-free procedure is right for you. A small rubber inhaler will be placed over your nose and adjusted so that you feel completely comfortable. At this time, you will be breathing 100% oxygen.
Once the patient is comfortable breathing oxygen, the sedation dentist, Dr. Goodman will gradually introduce nitrous oxide. Over the next three to five minutes, the patient will be asked, "What are you feeling?" as the amount of nitrous oxide is slowly increased. The signs and symptoms that most patients experience when receiving laughing gas include an initial feeling of lightheadedness, which gradually leads to an all-over feeling of warmth. Many persons mention a comfortable "vibrating" or "humming" sensation. It is common to feel one's fingertips and hands become "numb." This same sensation may develop in the mouth, which is a benefit to the sedation dentist (and patient) during the dental care treatment. Some patients will mention that their arms and legs feel "very light." Interestingly, other patients will say that their arms and legs feel "so heavy I can't even move them." If either of these occurs to the patient, it is perfectly normal. The individual might notice that he or she is perspiring a little, too; this is a normal effect of nitrous oxide and oxygen dentistry. The sedation dentist will talk with the patient throughout the dental care procedure and the individual will be able to respond without any problem. This is a major advantage, and a safety feature, of conscious sedation using laughing gas. If, at any time during the procedure, the patient feels that he or she is getting too much nitrous oxide or begins to feel uncomfortable, the patient should tell the dentist immediately and within seconds the dentist can adjust the flow of gases, and the patient will feel more comfortable again. At the conclusion of the sedation dentistry treatment, the patient will once again receive 100% oxygen (for a minimum of three to five minutes). At the end of this time, the person should feel absolutely back to normal. If he or she still feels even a little bit sedated, the dentist should give the patient oxygen for a few more minutes. In some situations where a patient recovers more slowly, he or she might be required to have an escort (friend or relative) drive the patient home. Laughing gas inhalation sedation is highly effective in the management of mild to moderate levels of dental anxiety. It also is an excellent technique for persons who are extreme gaggers; laughing gas usually eliminates or minimizes gagging in most patients. Finally, laughing gas is highly recommended for apprehensive patients who have medical problems such as angina pectoris, persons who have had a heart attack, or persons with high blood pressure, asthma or epilepsy. Inhalation sedation dentistry should not be used with persons who are claustrophobic or with persons who are unable to breathe through their nose.
Please discuss these topics with Dr. Goodman before treatment using laughing gas begins.