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There is some controversy with sedation done in a dental office. I know many people who have done it and have obviously come through fine but I feel uneasy with it. Maybe because I have a very low resting pulse rate to begin with and other health issues. I heard oral sedation can be in fact more dangerous than IV.
I was researching and it doesn't seem to be any Dentists that actually do oral sedation in a hospital setting. I don't feel comfortable with a trained nurse. What do people do under these circumstances?
Oral surgeon here. I do these extractions, bone grafting, implants (and more) in hospital settings when needed, but the majority are done in my office. The decision making involves a consultation where the medical history is reviewed and an examination is performed to find any red flags to office-based treatment. The majority of otherwise healthy patients can safely undergo this treatment with IV sedation in an office setting. When concerns are identified, consultations are requested from specialists in cardiology, pulmonology, hepatology or whatever is needed. Only after all the information is obtained do we make a decision for office vs hospital setting. Sometimes the safest option is local anesthesia (awake) in the office. This becomes difficult when there is dental anxiety and the patient demands to be "asleep". I often get pushback from patients when I decide their care is best offered in a hospital setting because of the increased expense. No, medical insurance doesn't suddenly pay for your dental treatment just because it was performed in a hospital. I get referrals from over 3 hours away for these procedures because I am one of the few oral surgeons willing to leave my office and go to the hospital when needed. And yes this costs more.
My bias is that I have trained specifically in IV sedation in a way that allows me to obtain a state license to administer sedation and even general anesthesia in my office. Not all dentists do this. I undergo regular audits and office visits by my state dental board, my state medical board (I have an MD also), and my national oral surgery society to verify that we are in compliance with every single anesthesia safety regulation. This is expensive and I have to close my office and still pay my staff for these regulatory visits. We have emergency drills to simulate emergencies with cardiac issues, breathing problems, allergic reactions, syncope, and a list of other issues. I have an emergency crash cart 20 feet away at all times with airway, cardiac, and pulmonary equipment which I have fortunately never needed. There are endotracheal tubes in case I have to intubate someone. Yes, I have intubated numerous people in hospital settings. To keep my skills sharp, when I do a case in the hospital I will sometimes ask the anesthesiologist to let me intubate my patient. Many dentists have only intubated a mannequin during anesthesia training. I have intubated these mannequins also and find them vastly different from a human.
But this isn't about me. This is about you....and feeling comfortable with the care offered to you. If you don't feel comfortable with your doctor then you should shop around to find someone you are comfortable and trust, regardless of office versus hospital setting. I will say that it is difficult to find someone willing to cancel patients in their office for an afternoon to do something in the hospital which takes 3 hours that can be provided in the office in 30 minutes.
I would just get lots of nitrous, if they crank it up enough you don't care what they do to your teeth
I have a resting pulse rate between 48-50 so I am nervous about a lot of stuff like that. I know know how I am going to go through with this to be honest.
But this isn't about me. This is about you....and feeling comfortable with the care offered to you. If you don't feel comfortable with your doctor then you should shop around to find someone you are comfortable and trust, regardless of office versus hospital setting. I will say that it is difficult to find someone willing to cancel patients in their office for an afternoon to do something in the hospital which takes 3 hours that can be provided in the office in 30 minutes.
It would take longer than 30 min to do my dental work. The one dentist said it would take an hour. That is a long time to sit there hearing someone hammer out a tooth.
Hearing all this sounds pretty tough, OP have you considered a consult with alternative dentist? They do things differently in some ways. Our area has many alternative type doctors etc. Don't know about where you reside...but a thought.
Upper tooth extraction that has a curved root, bone graft and implant.
Are you getting that all done at once? If not, it will be multiple visits/sedations.
I had a tooth pulled (probably not a cured root) and bone graft done at one visit and the implant placed at another visit. I wasn't sedated, however I've had a lot of dental work done thru the years so I guess I'm used to it. I just ask for extra numbing shots!
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