I just returned from the AAE meeting in Boston and one of the lectures I went to was on oral sedation given by Dr. Michael Silvermann (DOCS Education). I want to share just a couple of things that I thought were relevant to all dentists using nitrous oxide and/or prescribing anxiolytic drugs.
1. Safe Sedate Dental Mask – new single use nasal mask used for nitrous oxide that significantly reduces leakage of nitrous oxide and therefor exposure of dental professionals.
2. When administering nitrous oxide, we all had a patient who doesn’t get the effect for a while saying “crank it up doc”. The reason may be simple: we must not forget to start our patients on 100% oxygen for 3 min to flush out nitrogen out of our patient’s blood stream. (nitrous “bounces” off of nitrogen and cannot have an effect). Then we can start our patients on 25% nitrous and then go up slowly as necessary never exceeding 50%. Oxygen flush should be given at 6 liters/min.
3. Sometimes dentists prescribe Valium for anxious patients. From the medico-legal perspective, if oral valium is prescribed/given the morning of dental visit for sedative purposes, then a clinician should use monitoring protocols for minimal sedation (consider pulse ox and BP readings every 5 min). Also, an informed consent for the procedure should be obtained in advance. For more information on regulations for specific states check out this link: Dental Sedation Regulation for Your State.
For more information on continuing education on sedation dentistry visit DOCS Education website.