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Health & Wellness · February 22, 2022

Conscious sedation during implant fittings

Dental implants Melbourne is not a trivial procedure. As dental care goes, it is probably one of the most intensive and invasive procedures that can occur in a standard clinic. It exists right on the very border between dental procedures and oral surgery. It wasn’t too long ago that dental procedures of this intensity required full sedation and were locked into operating theatres as that was the only environment where an anesthesiologist could monitor a fully unconscious patient.

Twilight sedation

What makes oral implants possible in local clinics is twilight sedation; this allows a patient to still be conscious during a procedure but also calm and without any discomfort. Although the patient can respond to instructions and answer questions, they will be unaware of the procedure the entire time that they are under twilight sedation. This high level of suggestibility and associated cooperation is very useful for surgery but comes with its risks. Patients must have a trusted escort with them on the way home afterwards and should not make any major decisions whilst under the influence of the sedative.

The administration route for twilight sedation is intravenous and is often called IV sedation in many practices.

What’s the difference between local anaesthesia and sedation?

Anaesthesia and sedation can be misused and are quite often used intertagably in normal conversation within clinical practice, but there is a very important distinction between the two. Local anaesthesia involves blocking the pain receptors in a part of the body or the whole body; it does not necessarily involve the depression of breathing or a reduction in consciousness. It only disrupts communication between the nerves in that area and can be used to block signals downstream of a particular set of nerves as in the case of an epidural.

On the other hand, sedation reduces the perception of pain by suppressing consciousness; it brings about intense relaxation and is not applied to a specific part of the body. Technically speaking, there is no such thing as local sedation.

Depending on the location and intensity, both local anaesthetic and sedation can be dangerous, but there is a bias to focus on anaesthesia above sedation as it tends to be easier to manage dosages. This is what led local numbing drugs like lidocaine to largely replace sedatives like nitrous oxide, allowing for a good level of communication between patient and dentist at all times during the procedure.

However, this has not been particularly useful for nervous patients as numbing agents have little to no calming effect. Furthermore, having parts of their body temporarily numbed does little to deal with the extreme anxiety they may be having over the condition. Many clinics will provide an additional ‘calmative’ to very distressed patients in the form of an anti-anxiety medication, such as benzodiazepine, to be taken orally. This mixes the functionality of local numbing whilst inducing a relaxed mindset in the patient for the duration of the treatment.

DISCLAIMER

Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.

 

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