Providing Dental Care
Specific Treatment Considerations
Behavior Management: Sedation
Most patients with physical and mental disabilities can be routinely
managed in the dental office with conventional techniques such as local
anesthesia, and perhaps nitrous oxide conscious sedation. For some patients
this approach is inadequate.
Sedation and behavior management should generally be accomplished in consultation
with the patient's physician, family and caregivers to determine the appropriate
approach. In any case a step-wise approach should proceed from least restrictive
to most restrictive methods.
Note: Many State Dental Boards require dentists
to obtain certification to utilize sedative techniques such as IV sedation
or general anesthesia.
Oral sedation with Valium, Xanax, chloral hydrate, or hydroxizine may
be helpful in reducing patient anxiety during dental treatment. Considerations
include:
-
will patient take medications orally?
-
who will administer medications?
-
who will monitor the patient before, during and after the appointment?
-
what are the potential drug interactions?
-
have you consulted with the patient's physician?
-
has informed consent been obtained?
Intravenous sedation requires an appropriately trained team and appropriate
monitoring equipment. The team must be prepared to respond to allergic,
respiratory, and/or cardiac complications.
