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May 2008 | Dental Products Report
Chairside Confidential | Office-based sedation

Easing patients fears


Office-based sedation is one way to help patients overcome their anxieties and get the dental treatment they need.

By Anthony C. Caputo, DDS, Director, Anesthesiology, Scottsdale Center for Dentistry

 

  
  

It is well known that fear and anxiety result in patients delaying dental treatment or avoiding it completely. Globally, approximately 10% of the world’s population reportedly has high dental fear or anxiety. In the United States, it is estimated that 15% of adults experience high dental fear or anxiety. These studies do not include related data for children.

In recognition of the millions of patients with dental fear, anxiety or phobia, numerous options and treatment approaches available to successfully treat fearful patients. So, does the ability to provide an adjunct treatment approach allowing patients to receive dental care that was previously avoided mark a new era in dentistry? No, not really.


The Anesthesia Option

For decades, dentists have provided some level of pain, fear and anxiety management for patients. Since 1949, dentists have been formally trained in anesthesia and able to provide the full range of sedation and anesthesia care. Dentists also have received training through residencies or continuing education programs to provide different levels of sedation and anesthesia. There is tremendous support for dentists to possess the knowledge and training necessary to provide effective, safe sedation or anesthesia for patients.

  
 How to minimize risk when sedating patients

• Use only drugs and techniques you’re appropriately trained to use.

• Conduct a pre-operative evaluation of eachpatient consisting of at least a thorough review of medical and dental history; a focused clinical examination; and consultation, when indicated, with appropriate medical and dental personnel.

• Conduct physiologic and visual monitoring of the patient.

• Have appropriate emergency drugs, equipment and facilities available.

• Maintain fully documented records of drugs used, dosage, vital signs monitored, adverse reactions, recovery from anesthetic, and if applicable, emergency procedures employed.

Source: The American Dental Association Policy Statement: The Use of Sedation
and General Anesthesia by Dentists.
Photo: Getty Images/Stockbyte
 

Though not a new concept, there are many people, both dentists and patients, who are not aware of the dentist’s ability to provide sedation or anesthesia in an office-based setting. Over the past two decades, there has been a tremendous surge in the provision of office-based anesthesia (OBA) in medical and dental settings. In part, this has been because of the significant rise in healthcare costs and the resultant shift in providing more office-based procedures. This also has been the result of more and more dentists seeking education and training so that they can provide sedation for their patients. So, it’s not so much a new era, but it is certainly a different one.

Patient Benefits

The result of the increased awareness of sedation and anesthesia services available is positive for patients. Providing OBA services is safe and economical, and there is no question that the provision of any level of anesthesia service for a dental patient is more cost-efficient than the same service provided in a surgery center or hospital environment. Though some argue that OBA services are not typically covered by insurance, the same is true of anesthesia provided in the surgery center or hospital environment with regards to dentistry. With the appropriate education and training, it is possible for dentists to provide a safe, successful procedure for their patients.

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