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Serenity of sedation

5/12/2014

By RANDY GONZALES

rgonzales@dailynews.net

Some people have avoided going to the dentist for years -- even decades.

But with oral-conscious sedation, that anxiety is tempered, allowing patients to get needed dental work completed.

There are different levels of sedation, said Dr. Jeffrey Lowe of Lifetime Dental Care, 2701 Sternberg Drive.

"There's three levels of help for patients for anxiety control for having dental procedures done," Lowe said.

"The first level would be nitrous oxide, better known as laughing gas. It does make you laugh, makes you giggle a little bit," Lowe said. "I explain it to patients it's like having a couple of cocktails. It just takes the edge off, makes you feel kind of happy. But you still have all of your senses intact."

The next level is when the patient takes anti-anxiety pills the night before the appointment and the next morning, an hour before the appointment. Once the patient arrives at the office, the level of consciousness is gauged, to determine whether more medication is needed before starting the procedure.

"Oral means just pills," Lowe said.

The next level is IV sedation, where an anesthesiologist is present to provide medication intravenously.

"That's our big gun," Lowe said. "We want to make sure they are out and comfortable."

However, at no time is the patient completely asleep; that's why it's called oral-conscious sedation. Lowe said a slap on the knee could make a patient more alert.

Lowe said nitrous oxide was the only level of help for a patient when he got out of dental school in 1997. Approximately 10 years ago, deeper levels of anxiety control were able to be used with patients. Lowe estimated 20 percent of his patients need some level of anxiety control, with 10 percent of them using either pills or getting an IV.

"I think that's the biggest benefit of offering sedation through our practice, has been to help people that would not have normally gone in," Lowe said. "They would be a statistic. They would be in an emergency room, racking up health care costs, fighting an infection in their mouth that could be prevented with even routine dental care, but too scared to even get that."

Cindy Reed, Russell, was one of those patients. She avoided going to the dentist for years after having a bad experience as a child.

"Going to the dentist as a kid, I didn't like it," Reed said. "I didn't like the dentist, and I just never got over that."

Reed liked the fact that by using medication to control her anxiety, all of her work could get done in one appointment.

"I don't want to have to worry about going in for multiple visits," she said before her appointment last month. "I'll have less anxiety this way."

Technology also helps prevent multiple visits. A crown now can be made in the office during the appointment, for instance.

"We are able to take care of 20 years' worth of needed dentistry and neglect in one appointment with the technology," Lowe said.

As a safety precaution, there also is monitoring equipment to take the patient's vital signs during the appointment.

After appointments, patients typically sleep through the day. When Lowe calls that night to check on them, patients have no memory of the procedure.

Giving patients their health back is a powerful experience, he said.

"You're talking about people that felt there was no hope, there was no option, they were destined one day to go to the hospital, get all their teeth pulled out, get a set of dentures," Lowe said. "Now, they have a whole new appreciation, and opportunity, to rectify not only their dental health, but how connected their mouth is to their whole body, and affect their overall health and wellness."