Category Archives: Sedation & Comfort Options

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Dental implants and pain–Man from Wheaton reports

So what is it like to have a dental implant placed? This short video shows a man from Wheaton describing how it was to have the dental implant surgically placed, ant the subsequent crown placed.
His dental implants were placed using the more modern “flapless” approach, vs. the older method where the gums had to be “pulled back” to place the dental implants. Most patients report that they “just took a couple of asprin that night,” or “their dental implants were painless.” Better methods of pain control and surgical technique have greatly diminished pain and discomfort in dental implant surgery. This case was for a single dental implant crown to avoid having a dental bridge. More involved cases now utilize complex CT scans and imaging software to use this “flapless” approach.

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Moderate Dental Sedation–New State Regulations-Pt. 2

The next pertinent definition changed in the new State of Illinois regulations (April 2010) on dental sedation is:

“Moderate Sedation” or “Conscious Sedation” means a pharmacologically
induced depressed state of consciousness …under which an individual retains
the ability to independently and continuously maintain an airway and respond
appropriately to light tactile physical stimulation and oral verbal commands….
Moderate sedation (conscious sedation) must be administered by an individual
qualified under this Section…. The drugs and/or techniques used must carry a
margin of safety wide enough to render unintended loss of consciousness
unlikely.”

The educational requirements, staffing, equipment, and safety requirement are much more stringent. The dentist must have his Advanced Cardiac Life Support (ACLS) designation, and maintain a log of his training updates. Currently about 1 to 2% of Illinois restorative dentist have this extra sedation Certificate (Sedation Permit A).
The majority of the cases are performed using IV, or intravenous, dental sedation methods. Pills, IM intramuscular medications, or gas is sometimes also used as an adjunct (often for anxiety control prior to starting the IV).

The primary advantages of this over the minimal dental sedation is:
1) Fast adjusting of the level of sedation for the patient’s comfort
is possible(30 sec, vs. 30-60 min. with pills)
2) Higher educational requirements
3) Higher safety requirement with monitoring, equipment, and training
4) Greater levels of comfort and amnesia
5) Pain medication in addition to sedative can be administer via the IV in place
6) If needed antiemetics (anti-nausea) medication can be administered via the
IV if needed.

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Minimal Dental Sedation–New State Regulations-Pt. 1

The State of Illinois has just adapted new guidelines on dental sedation. For the most part, they mirror the guidelines on dental sedation set forth by the American Dental Society about a year ago and change the educational requirements and even definitions e used describing dental office sedation.
Let’s look at the first pertinent definition-minimal sedation. According to the state’s new published guidelines:

“Minimal Sedation “or “Anxiolysis or Mood Altering Sedation” means a
Pharmacologically induced, altered state of consciousness (altered mood; reduced
anxiety) where an individual is awake but has decreased anxiety to facilitate
coping skills, retaining interaction ability.”

A general dentist may do minimal dental sedation, but only with extra education, staff training, and monitoring equipment.
Let’s look at the elements of the definition. First “minimal sedation” means that the effect is minimal. Gas nitrous oxide or sedative pills are used. Onset of these agents is 30 to 60 with pills, although incremental dosing is now permitted (April 2010). (Please be aware that if a person requires more sedation it will take this 30-60 min. time for effect!). “Anxiolysis” from Latin literally means the “dissolving of anxiety.”
The definition of minimal sedation also states that the “an individual is awake but has decreased anxiety.” This means that the person is aware at all times, but usually has less anxiety.
If a patient goes to a dentist who promises “pill sedation” it is minimal sedation. They may have decreased of no memory of the procedure, but by legal definition of their limitations, will be aware during the procedure. Nowhere is the definitions is “painless dental visit” or “painless dentistry” mentioned.
The next level of dental sedation is moderate sedation—see next blog or our website for information on dental sedation options, methods, and associated technology for dental comfort.

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Is there a “Cookie-Cutter” Solution for Dental Fear & Anxiety?

Of course not! Here is an example; Marsha V. from Naperville came in about 2 months ago. Her dental needs were extensive and had significant with difficulty sleeping last for over 3 months before coming into the office. We discussed all alternatives for both treatment and dental comfort. Marsha needed 8 crowns, 2 roots canals, 2 extractions, and several filling immediately.
She had delayed treatment for many many years with a high fear quotient. She wanted to try oral pill sedation.
Here’s the problem. After the traditional protocol of oral sedation was started, Marsha did NOT feel comfortable with starting the appointment. Her response was “I wanted to be less aware than this—can you give me more medicine?” The problem with being insufficiently comfortable with oral sedation is it takes 45-60 minutes for next dose to take effect. Then there is too little time to complete the treatment.
We decided to start IV sedation. The effect was immediate and we were able to complete treatment as planned. What would have been adequate oral medicine for many patients was completely insufficient for her.
But that was for extensive treatment. For her next cementation visit, we were able to finish with simple oral sedation. So here is another story of different protocols for different visits. EVERY PATIENT AND EVERY APPOINTMENT MUST BE CALIBRATED FOR INDIVIVUAL NEEDS AT ALL TIMES. Having all options is the key to providing this option.

Bio of Dr. Thomas R. Gibbs, DDS, FAGD, FDOCS, FICOI
Dr. Gibbs graduated at the University of Illinois School of Dentistry in 1980. He holds memberships in the: American Dental Association, Chicago DentalDr-PhotoGibbsT Society, Academy of General Dentistry, American Dental Society of Anesthesiology, Dental Organization for Conscious Sedation, American Academy of Cosmetic Dentistry, and International Congress of Oral Implantologists.
He is one of the earliest members of the American Academy of Cosmetic Dentistry and has had training at some of the most prestigious training institutes such as the L.D. Panky Institute for Advanced Education, California Implant Institute, Misch International Implant Institute, and the Las Vegas Institute for Advanced Dental Studies (LVI).
He also has earned honorary fellowships in the Academy of General Dentistry (FAGD), and the International Congress of Oral Implantologists (FICOI). In 2007 Dr. Gibbs achieved another honorary designation by receiving his certification in Advanced Cardiac Life Support (ACLS). This, along with substantial advanced education and case submission for pier review, has earned him an additional fellowship in the Dental Organization for Conscious Sedation (FDOCS).
He provides general dentistry, cosmetic dentistry, sedation services, and dental implants.

Please Leave Us a Comment!

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Is Painless Anesthesia (Painless Dentist) the Work of the Devil?

I’m sitting is a 3 day meeting on complications in dental sedation and compromised patients while I ran into this wild quote from the first president of the American Dental Association back in 1860. This clearly shows how the concept of pain control and anesthesia has progressed!
William Henry Atkinson, originally a physician,felt that to eliminate pain is “to do the work of the devil!”

“I think anesthesia is of the DEVIL, and I cannot give my sanction to any Santanic influence which deprives man of the capacity form recognizing the LAW. I wish there were no such thing as anesthesia. I do not think man should be prevented from passing through what God intended them to endure.” Sacred Pain

Dr. Gibbs provides sedation dentistry, comfortable dentistry, implant dentistry, and cosmetic dentistry for patients in the Chicago area. He sees patients from Wheaton, Naperville, Lisle, Glendale Heights, Lombard, Schaumburg, Roselle, Elmhurst, Chicago, Hoffman Estates, Warrenville, and Downers Grove. Contact us at SmileGlenEllyn.com Also visit us for information on implants and relaxed sedation dentistry at YouTube LiveWithoutDentures He also publishes a separate informational websie on dental implants at chicagoimplantdentistry.com

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Dental Sedation Safety–IV Sedation, Oral sedation, Patient Safety

The Dental Organization for Conscious Sedation just completed its first annual Sedation Dentistry Safety Week! 
This is important as patient safety should always be first priority in
patienPrettySmilet care.  Topics included "The Sedation Dentist Safety
Checklist."  There are many things that all competent sedation dentists should do (and you should make certain that your dentist is doing). 
1)   Upmost is training.  The doctor should be trained minimally in
oral conscious sedation by a competent organization.   To be more
certain about sedation effectiveness, the doctor should be trained in
IV sedation and properly certified to perform these services.  We
HIGHLY recommend that the patient verify the training of the provider.
2)  Equally important is continuing education.  Medicine, pharmacology,
and dentistry are constantly evolving and the education must be updated!
3)  The staff should also be trained not only in life support, but in
emergency procedures.  Monthly training should continue to assure that
skills are “kept sharp.”  We have our staff trained with IMEP—the Institute of Medical Emergency Preparedness, which also send out monthly office "drills" to keep skills up-to-date.
4)  The doctor should also maintain his skills in emergency medicine. 
I would recommend for most to have their ACLS certification (advanced
cardiac life support certification)
.  Group such as American Dental Society of Anesthesiology also have advanced traing and even "human simulation" training for sedation dentistry doctors.
5)  Second the office should have the proper medications to use as needed—and they need to be up to date (not expired).
6)  The patient’s medications may need to researched to verify that no
drug interactions exist that may preclude a safe and effective visit.
7)  Certain equipment is essential to monitor the patient’s condition during the entire procedure and during
recovery.  Most essential is the pulse-oximeter which monitors the
pulse, blood oxygen, and blood pressure.  Many of the worse “accidents”
have occurred when these simple vital signs are not carefully monitored.
8)  Keeping the patient’s medical history completely updated so that the proper protocols are maintained at all times.
9)  Working with the patient’s physician as needed to verify and clarify the patient’s needs and condition.
10)  Should the patient’s physical or mental condition not be suitable for in-office sedation, the proper referrals to hospital or physician assisted procedures must be performed.

Patient’s have the right to speak freely to their health care providers about their concerns and safety.

  Dr. Gibbs provides sedation dentistry, comfortable dentistry,
implant dentistry, and cosmetic dentistry for patients in the Chicago
area.  He sees patients from Wheaton, Naperville, Lisle, Glendale
Heights, Lombard, Schaumburg, Roselle, Elmhurst, Chicago,  Hoffman
Estates, Warrenville, and Downers Grove.  Contact us at SmileGlenEllyn.com  Also visit us for information on implants and relaxed sedation dentistry at YouTube LiveWithoutDentures  He also publishes a separate informational websie on dental implants at chicagoimplantdentistry.com

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Oral Sedation and IV Sedation–Two Cases rom Elmhurst & Naperville

    In a recent post I related about a patient from Naperville wanted oral sedation, but ended requiring IV sedation.  Does it ever go the other way?  Fortunately yes!  The point is everyone responds differently to medication, and even differently each appointment depending on a variety of factors.  Some people will take "Just on little pill" and be "flat out."  Other take four pills (the maximun allowed by protocols) and feel "almost normal." 
    We often "pre-medicate" the very apprehensive patients wanting IV sedation with oral medication.  Today we had a patient form Elmhurst wantingIV sedation, but she was sufficently comfortable to complete treamtnet after just the oral dose.  Point is, we have to be prepared with all the means for their comfort at all times, and we do not know when the "just a little" will work! 

 For more information see our dental implant site at SmileGlenEllyn.com, and visit other blog articles in this site. Dr. Gibbs provides sedation dentistry, comfort based dentistry, implant dentistry, and cosmetic dentistry for patients in the Chicago area. This includes Wheaton, Naperville, Lisle, Glendale Heights, Lombard, Schaumburg, Roselle, Elmhurst, Chicago, Hoffman Estates, Warrenville, and Downers Grove. Contact us at LivewithoutDentures.com. Also visit us for information on implants and relaxed sedation dentistry at YouTube LiveWithoutDentures

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Request for Video on Sedation Dentistry –Naperville Patient

Yesterday we posted a video on Comfortable Relaxed Dentistry and almost immediately received a request from a Naperville lady for MAXIMUM comfort–sedation dentistry.  There are several options for you "high fear–high need" people.  Watch this short video and leave us a comment!

  Dr. Gibbs at his West Suburban Center for Cosmetic Dentistry, Dental Implant, and Sedation Dentistry
has made a special  (short 6 min.) video that describes all the ways we
can help.  You no longer have to give up hope for comfortable dental
visits!

JUST CLICK HERE TO SEE THIS SHORT VIDEO.  PLEASE SHARE WITH ALL THOSE PEOPLE YOU KNOW WHO ARE LOOKING FOR RELAXED, COMFORTABLE DENTISTRY!

  Also visit us for information on implants and relaxed sedation dentistry at YouTube LiveWithoutDentures  See our dental implant site at SmileGlenEllyn.com, and visit other blog articles in this site. Dr. Gibbs provides sedation dentistry, comfort based dentistry, implant dentistry, and cosmetic dentistry for patients in the Chicago area. This includes Wheaton, West Chicago, Naperville, Lisle, Glendale Heights, Lombard, Schaumburg, Roselle, Elmhurst, Chicago, Hoffman Estates, Warrenville, and Downers Grove. Contact us at FearLessDentalCare.com.

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Dental Laser for Comfort, Fearful Patients, Gum Lifts (gummy smile), Root

Laser-energized water (Hydrokinetics™) gently washes away tooth decay with incredible accuracy. The dental laser can replace the drill in most dental procedures and treatments. The Waterlase Dentist Laser used by Dr. Gibbs does away with the whine of the drill and smell of drilled enamel. Because Dr. Gibbs uses a laser, there is no heat or vibration reducing the dependence on needles and anesthesia.waterlase laser  This comes closer to the ideal in dentistry of “painless!”  The the no-pain, no-drill Waterlase can be used for:

    * Root Canals
    * Decay Removal
    * Cavity Preparation
    * Smile Design
    * General soft tissue procedures
    * General dentistry for enamel and dentin

In addition to the Waterlase laser, the doctors at SmileGlenEllyn use a laser for some tooth whitening, soft tissue "gum lifts" and gum recontouring, and cavity dection!  This is truely technology for YOUR advantage and COMFORT!

  Also visit us for information on implants and relaxed sedation dentistry at YouTube LiveWithoutDentures  See our dental implant site at SmileGlenEllyn.com, and visit other blog articles in this site. Dr. Gibbs provides sedation dentistry, comfort based dentistry, implant dentistry, and cosmetic dentistry for patients in the Chicago area. This includes Wheaton, West Chicago, Naperville, Lisle, Glendale Heights, Lombard, Schaumburg, Roselle, Elmhurst, Chicago, Hoffman Estates, Warrenville, and Downers Grove. Contact us at LivewithoutDentures.com.
Waterlaselaser

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Dental Fear & Apprehensive Patients—Heal Faster

    Research at the University of Illinois has shown that patients, who expected pain, were frightened of the needle or dentists healed faster.  According In these patients, the corticosteroids levels are higher.  The researcher, Dr. Engelhand, believes that short burst of these steroids with acute stress are beneficial toward healing and limiting inflammation. 
     Dr. Gibbs provides sedation dentistry, comfort based dentistry, implant dentistry, and cosmetic dentistry for patients in the Chicago area.  He sees patients from Wheaton, Naperville, Lisle, Glendale Heights, Lombard, Schaumburg, Roselle, Elmhurst, Chicago,  Hoffman Estates, Warrenville, and Downers Grove.  Contact us at SmileGlenEllyn.com  Also visit us for information on implants and relaxed sedation dentistry at YouTube LiveWithoutDentures