Dentistry, Dentist,

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Dentistry, Dentist,

  1. 1. <ul><li>Horace Wells </li></ul><ul><li>William TG Morton </li></ul><ul><li>William Halstead </li></ul><ul><li>Niels Jorgensen </li></ul><ul><li>Amer Dental Society of Anesthesiology </li></ul><ul><li>Amer Society of Dentist Anesthesiology </li></ul>(Wells) (Halstead)
  2. 2. Anesthesia = Greek An = without aesthesis = sensation <ul><li>Dentistry is concerned with pain and anxiety relief before, during, and after the procedure </li></ul>
  3. 3. <ul><li>Amides vs Esthers </li></ul><ul><li>Common Property: Block Na entry at start of AP Main Difference: Onset & DOA </li></ul><ul><li>Newest Local : ARTICANE </li></ul><ul><ul><li>DOA ¼ as xylo </li></ul></ul><ul><ul><li>4% solution </li></ul></ul><ul><ul><li>Fast on & off </li></ul></ul><ul><ul><li>Good for deep bone penetration </li></ul></ul><ul><ul><li>May work well in “difficult” patients </li></ul></ul><ul><li>Reports of persistent unexplained paresthesia, dysesthesia, & allodynia </li></ul>
  4. 4. <ul><li>Anxiolysis </li></ul><ul><li>- only conscious sedation </li></ul><ul><li>- Patient awake, responds to commands </li></ul><ul><li>- Anxiety decreases </li></ul><ul><li>Conscious Sedation </li></ul><ul><li>- Minimal depressed L.O.C. </li></ul><ul><li>- Anxiety decreases </li></ul><ul><li>- Maintain own airway </li></ul><ul><li>- Respond to verbal & physical stimuli </li></ul><ul><li>Deep Sedation </li></ul><ul><li>- Depressed LOC </li></ul><ul><li>- Patient not responsive to verbal & physical stimuli </li></ul><ul><li>- Need AW assistance </li></ul>
  5. 5. <ul><li>Benefits: </li></ul><ul><li>Acceptable </li></ul><ul><li>Low Cost </li></ul><ul><li>Safe </li></ul><ul><li>Drawbacks: </li></ul><ul><li>Variable reaction </li></ul><ul><li>Inability to titrate </li></ul><ul><li>Prolonged D.O.A. </li></ul><ul><li>Limited & variable effectiveness </li></ul>GA: 18 hrs didactic; 20 documented patient cases; permit
  6. 7. <ul><li>Benefits </li></ul><ul><li>Quick on & off </li></ul><ul><li>Titrate </li></ul><ul><li>Predictable </li></ul><ul><li>Safe & inexpensive </li></ul><ul><li>Drawbacks </li></ul><ul><li>Skill Set </li></ul><ul><li>Increased liability </li></ul>GA: 60 hrs didactic; 20 clinical cases; permit; equipment; site visit
  7. 8. Onset (min) DOA (hr) Dosage (mg) Valium 1 – 2 1 – 2 5 – 10 Versed 1 1 1 – 2 Fentanyl 1 1 .025 –.050
  8. 9. <ul><li>Patient is unconscious, unresponsive, and is unable to perceive or respond to stimuli </li></ul>
  9. 10. <ul><li>Joseph Priestly 1775 </li></ul><ul><li>Will not General Anesthesia </li></ul><ul><li>Will mild pain relief </li></ul><ul><li>Benefits </li></ul><ul><li>Onset is swift & potent </li></ul><ul><li>No long-term effects </li></ul><ul><li>Drawbacks </li></ul><ul><li>Disorientation, blurred vision, variability </li></ul><ul><li>Î pain threshold, hallucinations </li></ul>
  10. 11. <ul><li>10 – 15% of patients are afraid to go to the dentist </li></ul><ul><li>30% of people avoid dentist because of fear </li></ul><ul><li>Sedation dentistry will set your practice apart </li></ul><ul><li>Sedation dentistry gives the patient an option </li></ul><ul><li>Sedation dentistry can increase net income </li></ul><ul><li>5,000 patients seek out Sedation dentistry per week in the USA </li></ul>
  11. 12. <ul><li>Get An Education </li></ul><ul><li>Prepare the Office </li></ul><ul><li>Marketing </li></ul><ul><li>Follow Through </li></ul>

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