• Horace Wells

• William TG Morton

• William Halstead

• Niels Jorgensen • Amer Dental Society of Anesthesiology • Amer Society of Dentist Anesthesiology

(Wells)

(Halstead)

Anesthesia = Greek

An = without aesthesis = sensation

• Dentistry is concerned with pain and anxiety relief before, during, and after the procedure

Amides vs EsthersCommon Property: Block Na entry at start of AP Main Difference: Onset & DOA

Newest Local : ARTICANE•DOA ¼ as xylo• 4% solution• Fast on & off •Good for deep bone penetration• May work well in “difficult” patients

Reports of persistent unexplained paresthesia, dysesthesia, & allodynia

• Anxiolysis - only conscious sedation - Patient awake, responds to commands - Anxiety decreases• Conscious Sedation - Minimal depressed L.O.C. - Anxiety decreases - Maintain own airway - Respond to verbal & physical stimuli• Deep Sedation - Depressed LOC - Patient not responsive to verbal & physical stimuli - Need AW assistance

Benefits: •Acceptable

•Low Cost

• Safe

Drawbacks:

• Variable reaction

• Inability to titrate

• Prolonged D.O.A.

• Limited & variable effectiveness

GA: 18 hrs didactic; 20 documented patient cases; permit

Benefits

• Quick on & off

• Titrate

• Predictable

• Safe & inexpensive

Drawbacks

• Skill Set

• Increased liability

GA: 60 hrs didactic; 20 clinical cases; permit; equipment; site visit

Onset (min) DOA (hr) Dosage (mg)

Valium 1 – 2 1 – 2 5 – 10

Versed 1 1 1 – 2

Fentanyl 1 1 .025 –.050

• Patient is unconscious, unresponsive, and is unable to perceive or respond to stimuli

• Joseph Priestly 1775• Will not General Anesthesia• Will mild pain relief

Benefits

• Onset is swift & potent

• No long-term effects

Drawbacks

• Disorientation, blurred vision, variability

• Î pain threshold, hallucinations

• 10 – 15% of patients are afraid to go to the dentist• 30% of people avoid dentist because of fear• Sedation dentistry will set your practice apart• Sedation dentistry gives the patient an option• Sedation dentistry can increase net income• 5,000 patients seek out Sedation dentistry per week in the USA

1. Get An Education

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3. Marketing

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