Conscious Sedation for the Biological Patient

By Michael Rehme, DDS, CCN
(Certified Clinical Nutritionist)

The modern day use of dental anesthesia has been effectively administered for over 50 years. Its purpose, of course, was to reduce or eliminate the painful effects associated with most dental procedures.

Local anesthetics such as lidocaine, polocaine, mepivicaine, septicaine and marcaine are routinely used in our office along with nitrous oxide (laughing gas), and valium as needed to ensure that our patients can experience a safe, and even a relaxing, dental visit.
But for those individuals who wish to complete all their dental work at one time or to successfully treat an anxious or phobic condition, conscious sedation is the preferred choice for these patients. Providing this service to our patients has been a well received addition to our practice.

Conscious sedation is defined as a technique in which the use of a drug, or drugs, produces a state of depression of the central nervous system enabling treatment to be carried out while verbal contact with the patient is maintained throughout the period of sedation.

Patients usually have no memory of the entire dental procedure. This leads the patient to think they were asleep during the treatment when, in reality, they were awake, but comfortable, at all times.

In our office, we provide a two team, multi-disciplinary approach for conscious sedation. As the dentist, I’m given the opportunity to focus solely on the dental procedures because the anesthesiologist (present during the entire procedure) monitors and attends to our patient’s sedation needs.

Midazolam (Versed) is the drug of choice for conscious sedation. In general, midazolam has a fast-acting, short-lived sedative effect when given intravenously, achieving sedation within one to five minutes and peaking within 30 minutes. The effects of midazolam typically last one hour but may persist for six hours (including the amnesic effect). Patients who receive midazolam for conscious sedation should not be allowed to drive home after the procedure.

The proper equipment must also be in place and organized for monitoring the patient’s blood pressure, pulse, respiratory rate, level of consciousness, and, most important, the oxygen saturation (the measure of oxygen perfusion inside the body) with a pulse oximeter (a machine that provides a continuous real-time recording of oxygenation).

The vital signs are monitored by the anesthesiologist before the start of the administration of medications and then continuously monitored thereafter until the procedure is completed.

Choosing the proper dental anesthesia can certainly make a significant difference in the anticipated outcome for your dental care. Conscious sedation may be the right choice for you. Our ultimate goal is to provide a safe, comfortable and relaxing environment with your dentist/anesthesiologist team working together as we perform our biological services for you.

Dr. Michael Rehme, DDS, CCN is one of the few Dentists in the U.S. that are Certified Clinical Nutritionists (CCN). He practices Biological Dentistry that includes mercury free, tooth colored fillings; healthy dental materials; balancing body chemistry; and nutritional therapy. For articles and information about Biological Dentistry and patient success stories visit www.ToothBody.com or call his office 314-997-2550. Attend a free monthly presentation and discussion by Dr. Rehme on Biological Dentistry the third Tuesday each month at 6:30 pm. Please call to verify the date and reserve your space.