Dental sedation

shr7 · 12-11-2009, 23:21

Good evening everyone. I have a question for the dentists/anesthesiologists on the board. Of course, anyone with personal experience is more than welcome to comment.

It is approaching that time when I need to have my third molars removed. I only need two removed on the same side of the mouth. I am chewing on the two on the other side and am able to brush and floss them without issue.

Currently, my dentist is a friend from school who is in his final months of dental school, and the only contact I have to the oral surgeon is through him. Both teeth are impacted into the gum, but I believe they are not "bone impacted". (Forgive my lack of knowledge about dentistry.)

My question is, the oral surgeon suggested Halcion (triazolam) PO and NO. Now, I have had NO only once before in my lifetime (for another tooth extraction) and I STILL remember that event. In fact that is the ONLY memory I can CLEARLY recall from when I was 12.

I'm fairly certain that the procedure will not be traumatic enough to require general anesthesia (unless it is done by a student or resident...) but is wisdom tooth removal usually performed using PO benzos and NO?

I was more leaning towards the IV midazolam route. I would just feel safer with the more predictable and titratable response of IV sedation. However, I have absolutely no experience in outpatient sedation, so I am hoping for input from those with much more experience than I.

Or, I could just man up and chew on some Motrin...

Thank you for the help.

SR

Dusty · 12-11-2009, 23:40

Is this a joke?

**Eagle5US** · 12-12-2009, 23:45

As a PhamD you should know better than to come onto an internet BBS and expect any kind of credible response. Your oral surgeon is going to give two flips what "some guy on PS.Com said"

Procedural sedation can be accomplished with any number of drugs and drug combinations. The most effective and most important one is going to be one that your SGN is both qualified to accomplish and comfortable doing.

You may like Versed, he may not. This is a conversation you should have with your SGN - not us.

Eagle

shr7 · 12-12-2009, 23:57

Quote:

Originally Posted by Eagle5US

As a PhamD you should know better than to come onto an internet BBS and expect any kind of credible response.
Eagle

You're right. I wouldn't do it for a patient, I shouldn't do it for myself. I'm sorry.

Moving out.
SR

Boomer-61 · 12-13-2009, 19:30

I hate it when my patients come into my office loaded with pages of crap they've down loaded off the internet and start dictating to me what they think their diagnosis is and what I should do about it and what approach to use and what prosthesis they think I need to implant. I have to spend the first 15 minutes after my H&P dispelling all the marketing hype and myth. Then I politely ask them if they treat their auto mechanic the same way. The answer is usually no. Then I politely tell them that they've come to our institution with a certain amount of confidence and that they should continue with that level of confidence and trust our judgement in the selection of components, the surgical approach, the post op protocol, etc.. Just let your surgeon do his/her job.

Red Flag 1 · 12-13-2009, 19:56

RF 1

Sigaba · 12-13-2009, 20:02

Quote:

Originally Posted by Boomer-61

I hate it when my patients come into my office loaded with pages of crap they've down loaded off the internet and start dictating to me what they think their diagnosis is and what I should do about it and what approach to use and what prosthesis they think I need to implant. I have to spend the first 15 minutes after my H&P dispelling all the marketing hype and myth. Then I politely ask them if they treat their auto mechanic the same way. The answer is usually no. Then I politely tell them that they've come to our institution with a certain amount of confidence and that they should continue with that level of confidence and trust our judgment in the selection of components, the surgical approach, the post op protocol, etc.. Just let your surgeon do his/her job.

Boomer-61--

What guidance would you give a layperson seeking to educate himself (or herself) so that they could talk to their doctor intelligently when it comes to the process of making a diagnosis?

For example, an elderly woman I know was mis-diagnosed by a doctor. The misdiagnosis was only corrected because the woman's daughter kept asking questions. The correct diagnosis was reached but then the wrong medication was almost given. Again, that situation was cleared up only by the daughter's additional research and questions.

If this woman had let the doctors "just do it," she might have end up with a much more complicated situation.