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Sedation
and General Anesthesia
- What is Oral
Sedation?
- What is
Intravenous Conscious Sedation?
- What is
General Anesthesia?
- Which
Technique or Medication will be administered to my child?
- How will my
child or I be monitored during sedation or general anesthesia?
- Who may
benefit from these techniques?
- Do Dental
Specialists Provide Specialty Dental Services in this Office?
- Why choose to
have treatment with general anesthesia in our office rather than the
hospital?
- When will a
patient be discharged after receiving sedation or general anesthesia?
- Who
Administers the sedation or General Anesthesia?
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What
is Oral Sedation? |
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Oral sedation
is a management technique that utilizes oral medications and sometimes
nitrous oxide (laughing gas) to create a state of conscious sedation
(relaxation and at times unawareness). This technique is
adventageous for patients that have mild anxiety and fear. This
technique may be used for children and adults depending upon the
behavior of the child and level of anxiety of the adult patient.
Oral sedation is not recommended for very young children. |
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What
is Intravenous Conscious Sedation? |
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Intravenous
conscious sedation is a technique that utilizes intravenous agents and
sometimes nitrous oxide to help relax a patient that is anxious.
This is a good technique for patients that have mild to moderate
anxiety or fear of dental procedures. This technique is also
advisable for adult patients who require a great deal of dental
treatment and wish to have more treatment completed in fewer
visits. Patients treated with conscious sedation usually have
little to no memory of the dental procedure being performed. |
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What
is General Anesthesia? |
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General
Anesthesia is an anesthetic management technique, which uses
intravenous and/or inhalation agents to render a patient completely
unconscious (asleep) for the dental procedure. This technique
is recommended for very young children, the very resistant child,
severe dental phobics, and special needs patients who are unable to
cooperate for dental treatment. |
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Which
technique or medication will be administered to my child? |
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The pediatric
dentist treating your child will discuss with you which of the
techniques and medications are most advisable for your child. If
Dr. Epstein, a dentist anesthesiologist, will be administering the
anesthesia he will also discuss the anesthetic technique,
pre-anesthesia instructions and medical evaluation if necessary.
All of your questions will be answered during this consultation. |
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How
will my child or I be monitored during sedation or general anesthesia? |
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During sedation
or general anesthesia, the doctors providing the care monitor as
required by the New York State Education Department and adhere to the
guidelines of the American Academy of Pediatric Dentistry (AAPD) and
the American Dental Association (ADA). Dr. Mary George has been
Chairperson of the AAPD Subcommittee on Sedation and a member of the
Committee on Anesthesia for the ADA. Dr. Ralph Epstein has also
been a member of the Committee on Anesthesia for the ADA.
Specific types of monitoring that may be utilized, depending upon the
level of sedation and the agents administered are: pretracheal
stethoscope, end-tidal gas analysis, pulse oximetry, EKG, blood
pressure, temperature, agent analysis and BIS. BIS, which
monitors the level of consciousness, is the newest type of
monitoring. Although many hospitals are still not utilizing this
technology, BIS monitoring more accurately identifies the point at
which the patient has no recall and therefore allows the correct
amount of anesthesia to be administered. Patients wake up faster
with fewer side effects because of this determination.
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Who
may benefit from these techniques? |
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- Very young
uncooperative children who require multiple fillings
may be unable to sit for treatment. By providing dental care
with general anesthesia, all of the child's
treatment can usually be completed in one visit. This allows
the child to experience minimal discomfort and to return in six
months as a good dental patient.
- Fear, Anxiety and
Phobia:
One of the major reasons
why patients don't go, or delay going to the dentist is severe
fear and anxiety. In some cases, patients have a dental
phobia and refuse to go to the dentist until they are in so much
pain that they have no other choice. Their treatment by this
time is usually irreversible treatment, such as extractions.
Patients that have these problems are well treated with conscious
sedation or general anesthesia. We also have great success
working with psychologists who have a special interest in treating
patients with dental fears and
phobias.
- Low Pain Threshold
& Inability to get Numb:
There are many patients who have a low
pain threshold and others who are unable to get numb with local
anesthesia injections. These patients are good candidates
for intravenous conscious sedation. In some
situations, general anesthesia may be recommended.
- Extensive
Treatment:
Child and adult patients who require a great amount of dental care
can have that care provided in a shorter amount of time under conscious
sedation or general anesthesia. For example, if a
patient has several teeth that require root canal treatment, all
these teeth can usually be treated in one visit while the patient
is treated with conscious sedation or general anesthesia.
This enables the patient to combine multiple visits into one.
- Special
Needs Patients (Physically and Mentally Challenged):
It is not unusual for special needs patients: (ie,
Autistic ,PDD) to require general anesthesia for their
treatment. Many of these patients are treated without
conscious sedation or general anesthesia because the dentists of Distinctive
Dental Services of New York, P.C. are well trained and
experienced in treating special needs patients. When general
anesthesia is required, one of the pediatric dentists
can provide the dental care while Dr. Epstein, a dentist
anesthesiologist, administers the general anesthesia. When
adult patients require general anesthesia Dr. Zimbardi and Dr.
David, our general dentists, will provide the dental care.
- Medically
Compromised:
There are many people who have medical problems that include for
example, a neurologic or cardiac diagnoses. Patients with
assorted neurological diagnosis have uncontrolled movements which
make dental treatment without sedation or general anesthesia
impossible. Patients with some cardiac problems are better
treated with sedation, which can reduce cardiac stress during
treatment. Due to some cardiac problems patients may require
intravenous antibiotics. Dr. Epstein can
administer these antibiotics for dental treatment provided in this
office.
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Do
Dental Specialists Provide Specialty Dental Services in this Office? |
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Drs. Mary
George, Paul Elkin, and Dr. Chris Chen are pediatric
dentists who provide pediatric dental care for patients administered
oral conscious sedation, intravenous conscious sedation and general
anesthesia. When other dental specialists are required to
provide dental services under sedation or general anesthesia we can
arrange to have those specialists provide care during the scheduled
anesthetic. These specialists include endodontists, oral
surgeons and periodontists. |
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Why
choose to have treatment with general anesthesia in our office rather
than the hospital? |
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Your dental
treatment is a priority in our office. Treatment with general
anesthesia is easier to schedule in our office and can be scheduled
early in the morning. Unfortunately, dentistry in the hospital
operating room is not a priority and therefore treatment may not occur
until the afternoon. The dental materials used in our
office are of the highest quality. When the dentists are
providing dental care with general anesthesia in our office they are
sitting down as they typically provide care; in the hospital they are
standing around an operating room table, which makes treatment more
difficult to perform. Most radiographs taken in our office are
digital, which means less radiation and an increased ability to
diagnose problems. If your child is being treated with general
anesthesia in our office you can be with him or her until they fall
asleep. When the treatment plan is fully developed you will be
informed of the treatment required. Our staff will keep you
informed of the progression of treatment and when the treatment will
be completed. When your child awakens from the general
anesthesia you can be with him in our recovery room.
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When
will a patient be discharged after receiving sedation or general
anesthesia? |
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Patients that
have received sedation or general anesthesia in our office are
discharged only when they have met strict discharge criteria. The dentists
providing care to the sedated or anesthetized patient will be in
contact with you following the procedure. They can also be
contacted in the office or through the answering service.
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Who
Administers the sedation or general anesthesia? |
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- Oral
Sedation:
All of the dentists in our office have postgraduate training and
many years of experience in administering oral sedation
- Intravenous Sedation and General
Anesthesia:
Dr. Ralph H. Epstein, a dentist anesthesiologist, will provide
this service. Dr. Epstein received two years of general
anesthesia training and has been providing this type of service in
private practice since 1981. He is licensed by the New York
State Education Department to administer intravenous sedation and
general anesthesia. Please click on About
Our Dentists to read more about Dr. Epstein's professional
background as a dentist anesthesiologist.
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173 East Shore Road
Suite 201
Great Neck, New York 11023
(516) 487-8110
FAX(516)487-8394 |
300 Garden City Plaza
Suite 100
Garden City, New York 11530
(516) 294-6288
FAX(516)294-5254 |
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info@ddsny.com |
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