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Sedation Dentistry in Great Neck

Safe & Effective General Anesthesia & Sedation

Oral sedation is an anxiety management technique that combines the use of oral medication with, sometimes, nitrous oxide. This combination is meant to induce a state of relaxation and comfort. Also known as laughing gas, nitrous oxide produces significant benefits in patients who have mild fear and anxiety about their procedures. It is also extremely versatile as it can be used for both adults and children, depending on the patient's behavior and anxiety levels. Typically, we recommend that oral sedation is not used for very young patients.


What is Intravenous Moderate (Conscious) Sedation?

This type of sedation dentistry uses intravenous agents with, sometimes, nitrous oxide. It is highly advantageous for patients suffering from mild fear or anxiety of dental procedures and is typically a more reliable method than oral sedation. This is also an excellent option for patients who are about to undergo a significant amount of dental work in fewer visits than normal. Patients who utilize intravenous moderate sedation generally remember little to nothing about the dental procedure they had performed.


What is General Anesthesia?

General anesthesia uses one or a combination of inhalation agents and intravenous sedation to put the patient to sleep for the duration of their dental procedure. This technique is typically recommended for patients who are unable to cooperate during dental treatments, suffer from severe dental phobias, are very resistant children, are young children, or require a significant amount of dental work. This technique may be necessary for certain dental procedures.


Which medication or technique will be administered to my child?

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, our dentist anesthesiologist, will be administering the anesthesia, he will discuss the anesthetic technique, pre-anesthesia instructions, post-anesthesia instructions, and medical evaluation if necessary. All of your questions will be answered during this consultation. This consultation can be done in person at our office, over the phone, or through the use of Skype or FaceTime.


How will my child or I be monitored during sedation or general anesthesia?

During sedation or general anesthesia, the doctors providing the anesthesia/sedation care monitor patients 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 and a member of the New York State Board for Dentistry of the New York State Education Department. He is Past Chair of the NYS Board for Dentistry and Past Chair of its Committee on Anesthesia. Specific types of monitoring that may be utilized, depending upon the level of sedation and the agents administered are pre-tracheal stethoscope, end-tidal gas analysis, pulse oximetry, EKG, blood pressure, temperature, agent analysis, and BIS. BIS, which monitors the level of consciousness, is one of the newest types 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 tend to wake up faster with fewer side effects because of this determination.


Who may benefit from these techniques?

  • 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 without the use of local anesthesia. 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, such as extractions. Patients that have these problems are well treated with moderate sedation (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 moderate (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 moderate (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 moderate (conscious) sedation or general anesthesia. This enables the patient to combine multiple visits into one.
  • Special Needs Patients (including patients who are physically and mentally challenged):
    It is not unusual for special needs patients (patients with a diagnosis of autism or PDD) to require general anesthesia for their treatment. Many of these patients are treated without moderate (conscious) sedation or general anesthesia because the dentists at 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, our 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 countless people who have medical problems that include, for example, a neurological or cardiac diagnosis. Patients with various neurological disorders have uncontrolled movements which can make dental treatment without general anesthesia or sedation impossible. Patients who suffer from cardiac problems are better treated through sedation, which can lessen cardiac stress during treatment. Intravenous antibiotics may be used in some instances where cardiac problems exist. Dr. Epstein can administer these intravenous antibiotics for dental treatment provided in this office.

Do dental specialists provide specialty dental services in this office?

Dr's. Mary George and Gina Sajnani are pediatric dentists who provide pediatric dental care for patients and administer oral moderate (conscious) sedation, intravenous moderate (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.


When will a patient be discharged after receiving sedation or general anesthesia?

Patients who 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.


Who administers the sedation or general anesthesia?

  • 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 our dentist anesthesiologist, will provide this service. Dr. Epstein received 2 years of general anesthesia training and has been providing this type of service in private practice since 1981. Dr. Ralph H. Epstein is licensed by the New York State Education Department to administer intravenous sedation and general anesthesia.

The Distinctive Difference

Ways We Deliver the Highest Quality Care
  • Dentistry For the Whole Family

    We believe that all patients deserve the highest standard of care, from children to adults.

  • A Heart For Special Needs

    We are well trained and experienced in treating patients of all ages with special needs.

  • Board-Certified Anesthesiologist

    We offer sedation & general anesthesia with a board-certified dentist anesthesiologist.

  • Everything Under One Roof

    Newly renovated facility includes nine comfortable and high-tech treatment rooms & operating room.