Some dental patients welcome the dental experience. But for others, even the mere thought of sitting in a dental chair sends their anxiety levels skyrocketing. Yet for most of us, we can tolerate dental work, but we don’t want to experience pain in the process. Regardless of which group you fall into, you will want to know more about sedation and deep sedation, how it works and what you benefit from undergoing anesthesia.
What Are the Different Degrees of Sedation?
- Class I (Anxiolysis) – Commonly know as “light sedation”, anxiolysis is most frequently administered by inhaling nitrous oxide. During this sedation, the patient is awake and aware but in a slightly relaxed state.
- Class II (Conscious Sedation) – During this type of sedation, patients will be awake and able to respond to commands, but will be in a state of extreme relaxation. Conscious sedation can be administered through nitrous oxide or oral sedation and is defined as “an induced controlled state of depressed consciousness”.
- Class III (Intravenous Conscious Sedation) – Class III sedation maintains the patient between an unconscious and conscious state and is administered intravenously. Patients in Class III sedation will be able to respond to physical or verbal stimulus.
- Class IV (Deep Sedation) – Reserved for major surgery, deep sedation patients and will not respond to commands or stimulus and will not experience any pain or have any recollection of the procedure. Class IV Deep Sedation is administered intravenously.
What is Deep Sedation
Deep Sedation is a Class IV anesthesia administered intravenously by a licensed and trained Oral Maxillofacial Surgeon. Deep sedation places the patient in a non responsive, unconscious state. Patents in deep sedation will not remember the procedure or experience pain and many describe the experience as being asleep as time passes at a rapid rate. Though the anesthesia administered by the oral surgeon may vary, it usually contains a mixture of various drugs such as Versed and Fentanyl Citrate.
What Are The Benefits Of Deep Sedation?
For patients who have deep dental anxiety or phobia’s, deep sedation allows these patients to receive the dental treatment needed in a relaxed and comfortable state. Patients under deep sedation will have no memory of the procedure and experience no pain. Because the anesthesia is administered intravenously, the Oral Maxillofacial Surgeon can safely administer the drug at a precise and accurate level to maintain the patient in this state for as long as is necessary. This allows the oral surgeon to complete more work in a single appointment. Deep sedation also works as a moderate anesthetic to aid in pain control both during and after treatment.
Who Can Administer Deep Sedation?
Only surgeons who are trained and licensed to administer Class IV anesthesia can administer general anesthesia and deep sedation. General dentists are trained and licensed to only administer local anesthesia and Class I and Class II sedation which includes nitrous oxide (laughing gas). For unconscious sedation, addition training and licensing is required above that which general dentists achieve. Oral Maxillofacial Surgeons, like Dr David Smoot, have completed additional medical training in addition to their dental education, which allows them to safely administer Class IV deep sedation.
Is Deep Sedation Safe?
When properly administered and monitored by a certified, trained, and competent Oral Maxillofacial Surgeon, deep sedation is a very safe and effective sedation option. Prior to deep sedation, the oral surgeon will conduct a comprehensive evaluation of the patient’s current and past medical history to ensure the patient is a safe candidate for deep sedation. Throughout the deep sedation process, the Oral Maxillofacial Surgeon and a dedicated team will monitor the breathing and heart rate of patients to ensure they are maintained within safe parameters. During the process, the Oral Maxillofacial Surgeon maintains equipment to monitor the sedation process and the patient’s vitals and has on hand equipment and drugs in case of any emergency.
Oral surgeons have been specifically trained in medical school to administer deep sedation and must maintain a license to administer this level of anesthesia. Check and make sure that your Oral Maxillofacial Surgeon has a current Anesthesia Class IV Permit which allows them to administer deep sedation. In addition, your oral surgeon should have passed an Advanced Cardiovascular Life Support Program administered by the American Heart Association. Dr. David Smoot holds both a Anesthesia Class IV Permit and has completed the Advanced Cardiovascular Life Support Program.
Am I A Candidate For Deep Sedation?
- Experienced difficulty in the past getting numb or becoming lightly sedated.
- Anxiety about dental treatment.
- Complex dental procedures.
- Limited time to complete dental care.
- Sensitive teeth or gums.
- Had traumatic dental experiences in the past.
- Dental and surgical phobias.
- Physical imitations such as back and neck problems that may inhibit treatment.
- Sensitive gag reflexes.
- Difficulty controlling movement.
- No heart, liver or lung complications.
- No history of adverse reactions to anesthesia.
- No medical complications due to extreme old age.
Those patients who would be candidates for deep sedation include those who have:
Will My Insurance Cover Deep Sedation?
Though it depends on the specific insurance plan, most insurance plans cover deep sedation. Check with your insurance provider to ensure they cover deep sedation prior to your visit to an oral surgeon.
What Are The Common Side Effects Of Deep Sedation?
- Retrograde amnesia – Little or no recollection of the treatment and experience.
- Decreased post-operative soreness – With decreased soreness, patients may recover faster.
- Hiccups – A small percentage of patients will experience hiccups following deep sedation. The hiccups usually cease after a few minutes.
- Dry Mouth – Sedation decreases the saliva flow in a patient. Following surgery the patient may experience dry mouth but will return to normal saliva flow once the sedation wears off.
- Shivering – Most patients will experience shivering while deep sedation wears off. This is normal and is the body’s way to increase blood flow which has been reduced during the sedation process.
Though some may not experience any side effects at all, other may experience some of the following:
Will I Feel Any Pain?
With intravenous deep sedation, patients enter a state of extreme relation and comfort while in a semi-conscious or a “dream like” state. During the treatment, patients will not experience nay pain or discomfort and when they awake from sedation, they will not have any memory of the procedure.
What Can I Expect After the Sedation?
Patients recovering from surgery while deep sedation wears off, will be monitored by a team of caregivers. Though this process varies from patient to patient, most patients will have a relaxed experience while the anesthesia wears off. Patients who have received deep sedation will not be able to or allowed to drive themselves homes after surgery and will be required to have a driver. Strenuous and hazardous activities as well as driving should not be allowed for the remainder of the day. Patients can eat light meals, such as toast and soup, following deep sedation. If nausea occurs, patients are advised to lie down and drink water or a light carbonated beverage. Never drink alcohol or take additional medications not prescribed by your oral surgeon following treatment. Most of all side effects that follow deep sedation will be gone within 24 hours.
What Are My Payment Options?
- Insurance – At the time of your consultation, please provide the appropriate insurance information as well as your insurance ID number. Prior to treatment, we require the patient to cover the expected co-insurance cost. Please check the list of the insurance providers and plans we accept or call us at (801)264-8504.
- Care Credit – The Smoot Center for Oral Surgery offers another payment option through Care Credit. This is a healthcare credit card that can be used as a payment option for certain expenses not covered by insurance, or to bridge situations when desired care exceeds insurance coverage. It’s an easy and robust option which allows you to get the care you need when you need it. Patients can apply for Care Credit by going to the website at www.carecredit.com or calling (800) 677-0718.
- Check (with valid ID)
- Visa, Mastercard, Discover
The Smoot Center for Oral Surgery not only provides the best oral surgery treatment, but also provides a variety of easy payment options so you can get the care that you need: