Dental treatment in the drowsy sleep


Treatment in the twilight sleep

Treatment in drowsy sleep General anesthetic Dentistry Laughing Dentistry

We try to respond to our patients in particular.

Many patients tell us that they have not gone to the dentist for years because of fear or not. They are ashamed of their teeth and their dental fear! We can say: These fates are more common than you think! For most patients, going to the dentist is more or less difficult!

We try to give special consideration to these patients and, before any treatment takes place, to take part of their anxiety through counseling and education.

Twilight Sleep in Dentistry – Questions and Answers

What is the difference between twilight sleep and general anesthesia??

In contrast to general anesthesia, no artificial respiration is necessary during a twilight sleep. They breathe of their own accord, but are in a relaxed and fearless twilight sleep.

How does twilight sleep??

When analgesic sedation – or even drowsiness called – is administered to you by a specially trained specialist dentist monitoring the cardiovascular functions painkillers (analgesics) and tranquilizers or sleep aids (sedatives) via a venous access.

What brings the twilight sleep?

If you take a nap, you will be given strong sedative medications. This leads to a deep state of relaxation, which makes the treatment pleasant. The drugs have an anxiolytic effect and let you sleep, d. H. You can not remember the treatment.

In addition, we also administer medication to avoid pain and swelling after the procedure. Overall, the entire healing phase becomes more comfortable for the patient.

Is the twilight sleep paid by my health insurance?

Private health insurance companies cover the costs for treatment in twilight sleep depending on the insurance contract.

In case of uncertainty, we ask you to clarify this in advance with your insurance.

Insured persons of the statutory health insurance companies do not receive a subsidy for twilight sleep.

Can I go home right after the twilight sleep?

After a twilight sleep, we need to monitor her for about 2 hours in practice.

Please always bring an accompanying person to the practice, as they are are not suitable for traffic and business for 24 hours after the twilight sleep!

What should I pay attention to before drowsy sleep??

For a treatment in twilight sleep you should appear sober, d. H. Do not eat solid foods 6 hours before treatment and stop smoking.

2 hours before treatment you should not drink any more fluids.

Prescribed medicines can be taken with a sip of water.

Get treated for treatment and organize a companion in the practice throughout the treatment.

What do I have to consider after the twilight sleep?

Due to the strong medication, you are not fit for traffic and business for 24 hours after the twilight sleep.

During this time you should not be alone at home or take care of children on their own responsibility.

An attendant should wait for you during the surgery and then bring you home.

Otherwise, the normal postoperative behavioral measures apply.

General anesthesia in dentistry – questions and answers

When is a general anesthetic necessary??

In patients with severe dental phobia, mental disabilities, intolerance to local anesthesia and similar conditions, dental surgery should be performed under general anesthesia.

The general anesthetic takes place in your practice?

Specialized rooms for general anesthesia treatment are needed so that the interventions can be carried out in practice. As well as a recovery room in which you can rest relaxed after anesthesia and recover.

Since we do not have the necessary premises available, we can only offer you a drowsy sleep anesthetic, which is performed by an experienced anesthesiologist.

What should I consider before anesthesia??

Do not eat solid foods 6 hours before anesthesia and no fluids 2 hours before. Let an escort bring you to the practice and pick you up there again. They will not be roadworthy for 24 hours. Please plan this one!

How safe is anesthesia??

Modern anesthetics and very well-trained anesthetists make treatment under general anesthesia a safe procedure.

Who pays the costs for anesthesia treatment?

Only in a few cases are dental treatments under general anesthesia paid by the statutory health insurance.

These are children under the age of 12, people with intolerance to local narcotics, people with mental disabilities and phobics. The costs for the dental treatment are taken over according to the usual guidelines.

Nitrous Oxide Treatment: Nitrous Oxide in Dentistry – Questions and Answers

What is nitrous oxide?

Nitrous oxide (N2O) is a colorless gas. Medical nitrous oxide is a stable, inert, colorless and odorless gas that is heavier than air.

It is one of the greenhouse gases. However, according to UN data, medical N2O emissions account for only 0.05 percent of total greenhouse gas emissions and are not included in climate protection measures.

Since when nitrous oxide is used in medicine?

The analgesic and sedative effect of nitrous oxide was first discovered in the 18th century by Joseph Priestley.

The first dentist to use nitrous oxide as an anesthetic was Horace Wells of Hartford, Connecticut. The dentist used the nitrous oxide from 1844 on tooth extractions, after he happened to observe its analgesic effect at a carnival event.

Prior to the routine introduction of local anesthetics, the analgesic effect of nitrous oxide was more in the foreground. Today it is the anxiolytic property. Almost 90 percent of dentists in the US now use nitrous oxide.

Laughing gas is a real alternative to intubation anesthesia?

Nitrous oxide also has an anxiolytic (anxiolytic) effect and a mild analgesic and sedative (calming) effect. The willingness to treat is increased and an existing dental fear reduced.

Phobics, people with disabilities and children who are overwhelmed with the treatment are difficult to treat. Often this can only be done in general anesthesia, which is associated with high personnel, organizational and material costs.

In co-operative patients, laughing gas sedation, also called “minimal sedation” or “conscious sedation”, can be an alternative.

How does nitrous oxide??

Fear, tension and malaise give way to a calming sense of security. Simultaneously with anxiety, sensitivity to pain also decreases.

The gagging is also extremely reduced.

About the mixing ratio of oxygen nitrous oxide, the dentist can change the intensity of nitrous oxide sedation and adjust individually to the patient.

After completing the dental treatment, the patient inhales pure oxygen for about five minutes. Thereafter, the effect of the nitrous oxide is completely eliminated.

Nitrous oxide is harmful?

Since nitrous oxide in the human body does not enter the metabolism, but is completely exhaled, it has no after-effects when used correctly.

How is nitrous oxide administered?

About a small nasal mask. After a few breaths it starts to work. Patients describe a feeling of lightness and relaxation. The patient is always responsive during the treatment! It is not anesthesia.

Can nitrous oxide be dosed individually?

In any case, nitrous oxide is the only safe sedation that can be used without the presence of an anaesthesiologist and that can be adapted to the needs of the patient both in length and depth.

In contrast to Germany, inhalation sedation with nitrous oxide and oxygen is a very common method in Anglo-Saxon and Scandinavian countries.

How is the treatment with nitrous oxide in children??

The goal is easy sedation while preserving consciousness.

The child should therefore have open eyes and respond adequately to instructions. If the child does not catch a cold, treatment begins lying down: the nitrous oxide is child-friendly as a support that makes “strong and courageous” and feels like “diving in the sea” or “floating like an astronaut in space”. Then the child should no longer speak or breathe through the mouth, just listen. There are signs agreed.

The pulse oximeter (a device for measuring pulse rate and oxygen saturation in the blood) is applied. Depending on the age and height of the child “total flow” is set with 100 percent oxygen, nose mask attached and breathing bag checked for correct flow, shut off at the end of treatment nitrous oxide and given five minutes of oxygen.

The child may leave the practice in parental care shortly after treatment.

Laughter gas is suitable for every child?

The willingness to cooperate (compliance) and emotional maturity of the child must be so pronounced that it voluntarily lays down on the treatment chair, puts on the nasal mask and breathes exclusively through the nose. This is usually the case from the age of four.

Compulsion should never be used!

When treating with nitrous oxide, neither the local anesthesia nor the usual psychological behavioral measures such as Tell-Show-Do (TSD), distraction, hypnotic speech patterns, etc. is dispensed with.

Nitrous oxide is particularly suitable for cooperative children who have to undergo prolonged dental treatment (surgical procedures, pulpotomies, pulpectomies).

Laughter gas is also suitable for adolescents and adults?

Nitrous oxide sedation is particularly useful for anxious and impatient patients in the sense of a Behavior Management Problem (BMP), for certain mentally or physically handicapped patients, for stress relief in mild cardiac problems and asthma, for patients with gagging or for profound local anesthesia can be achieved.

When should nitrous oxide not be used?

Contraindications for N2O sedation are: chronic obstructive pulmonary disease (COPD), severe mental behavioral disorders, pregnancy (first trimester), treatment with bleomycin sulfate, patients with increased cerebral pressure, myasthenia gravis, multiple sclerosis, habitual oral respiration, non-cooperation in severe Disability, severe cold, otitis media.

How safe is nitrous oxide for the patients?

Laughter gas sedation is considered a safe method to calm anxiety patients in the dental office.

For the effective use of nitrous oxide, a significant safety effort is required.

The equipment used by the dentist usually can not deliver more than 50 percent nitrous oxide. This means that at 50 percent nitrous oxide, at the same time 50 percent oxygen is inhaled. In children, 20 percent of nitrous oxide (with 80 percent oxygen) is often enough to be cooperative in the treatment.

Consciousness is maintained and the protective reflexes remain intact under laughter gas sedation. The reduction of the sense of time and the relaxed state allow the child to accept even longer treatment times. It also reduces the dental fear.

Is a special training necessary for the use of nitrous oxide?

Yes. Adequate theoretical and practical training can be acquired in Germany or abroad. The BuKiZ recommends a multi-day course with practical exercises and emergency management.

How safe is nitrous oxide for the practice staff?

While it is almost safe for the patients with careful implementation and good training of the users, there may be some potential for damage over a long period of exposure of the dental staff. Therefore, in nitrous oxide sedimentation, it is important to reduce contamination of the working environment, which is possible efficiently by various methods.

For which treatments is the use of nitrous oxide sedation recommended?

Basically, you can use the nitrous oxide sedation well in all dental treatments. In the USA, nitrous oxide sedation is very often also used for professional teeth cleaning.

How much is a nitrous oxide treatment??

The sedation with nitrous oxide is not a benefit of the statutory health insurance. It is usually settled by means of an analogue position of the fee regulation for dentists (GOZ 2012).

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