How dental treatment is carried out during sleep for children and adults – articles from the medical directory on dentistry Sirius-Dent

Types of sedation methods in dentistry

Sedation is the duration of the patient’s presence in the operating room. It consists of many components: a local anesthetic ensures pain, and a hypnotic (hypnotic) puts the patient to sleep, removes fear and anxiety.

The types include intravenous (propofol, ketamine, dexdor) and inhalation sedation (sevoflurane, methoxyflurane, nitrous oxide, etc.). The most commonly used anesthetic of the first type, which is known as Vikorista, is propofol. It ensures sleep and awakening (7-10 minutes after administration), also has a good degree of sedation and is widely used in medical practice. Inhalation sedation will ensure good muscle relaxation and smoothness (one or two breaths are enough). The patient usually becomes unconscious, rather than relaxed and does not concentrate on the pain.

They also include superficial sedation – the reduction of fear and stress in the patient, drug-induced sleep, which is transmitted by hypnotics without opioids, and deep sedation, which results in hypnotics and opiates. Come on. In some cases, during sedation, do not use painkillers, because the dentist needs to know how the patient reacts during the procedure.

What is medicated sleep?

Medication-induced sleep results in increased awareness of the patient, decreased pain sensitivity and suppressed reflexes. This allows the dentist to carry out complex manipulations, as well as work with small children or patients with cognitive impairment, without having to follow the doctor’s commands. Medication-induced sleep is safe for patients of all ages, including children, and the type and dosage of the drug is individually selected by the anesthesiologist.

Indications for teeth cleaning in the world

Dental cleaning under sedation is beneficial for both the doctor and the patient. In accordance with the European Convention on Human Rights, every patient has the right to suffer from illness within the hour of prompt treatment. In addition, sedation in dentistry is carried out in case of obvious medical conditions:

• the need to carry out a procedure that is unacceptable for the patient, which involves relaxation of the chewing muscles;
• the presence of pathology of the scapular joints, as a result of which the person cannot fully open the mouth and will require additional muscle relaxation;
• risk of vomiting reflex during the hour of empty mouth work;
• the need to remove deep cracks;
• organic brain damage with severe cognitive dysfunction and light absorption (cerebral palsy, severe autism spectrum disorder);
• anaphylaxis (serious allergic reaction) to local anesthetics.

Medical contraindications for dental treatment include, first and foremost, allergic reactions (up to anaphylactic shock and loss of fluidity) to the drug that is being tested. Such episodes are actually quite rare, and about any episode before treatment, it is possible to conduct an allergy test, which indicates a person’s reaction to specific skins. The world standard internal test, at the hour when a dose is injected into the papule to remove the drug, and 25 weeks of caution. If the papule is red or enlarges, there may be a medical centerally detected allergy, then replace the drug with another one. It is also possible to develop so-called pseudo-allergies if the reaction is caused not by the active drug itself, but by its components (for example, preservatives) – then it is necessary to take drugs from a different manufacturer. In case of any emergency, the dentist may begin to sing, what is the time and ability to work.

Contraindications for teeth cleaning in sleep

Understand absolute and obvious medical contraindications before treatment. The following are absolute contraindications:

• acute myocardial infarction 3 months before treatment;
• acute stroke within 6 months;
• «all-out shlunku» syndrome;
• hypertensive crisis;
• bleeding into the vulva or intestine.

It is strictly contraindicated before dental treatment at night, which is associated with excessive bleeding (hemophilia) or the capture of fluids that thin the blood (after the same heart attack and stroke). It is necessary to discover special methods for preparing such patients, which will primarily complicate the work of the surgeon and increase the time required for treatment.

Treatment of medicated sleep in pediatric dentistry

If your child has problems with baby teeth (caries, periodontitis), don’t worry until she continues to suffer from pain and become susceptible to the fact that the tooth falls out on its own. Baby teeth should heal as quickly as they are permanent, and so that the baby does not worry or cry, the procedures should be carried out at night. Thus, the dentist has enough time to immediately carry out a decal manipulation: extract a tooth or a splint, treat a folded caries, perform plastic surgery on a bridle, etc. For young patients, we use inhalation anesthesia, so the baby falls asleep after inhaling the drug, and does not feel or remember all the treatment. All manipulations of the child’s body are controlled by a pediatric anesthesiologist. In this way, the child will be less afraid of the dentist and the next time will come calmly.

How to perform dental cleaning in your sleep

Before starting dental treatment under anesthesia or sedation, after performing an analysis along with standard safety monitoring, we recommend the Ministry of Health and the European Association of Anesthesiologists: anal anal From blood, ECG, coagulogram and fluorography, collected by a flow tract. If we speak about a person who suffers from chronic illness, additional tests are required (for example, in case of illness, there is no trace of creatinine production).

Anesthesia and sedation vary by dosage and combination of drugs. Depending on the specific situation, we practice offensive methods. Thus, tooth extraction under general anesthesia in Odessa is considered if the planned procedure lasts for more than 1.5-2 years: for example, if it is necessary to remove all wisdom teeth and a few other teeth.

We also use anesthetic anesthesia for major surgical and reconstructive procedures in the area of clefts and necks (fractures, injuries, multiple fractures), bone tissue transplantation, folding implantations, which include cyst plastic surgery, reposition, visualization no teeth, installation of several implants, etc. In such situations, anesthesia is the safer option for the patient.

In addition, it is also possible to clean teeth for children under anesthesia.

As we speak about pure implantation and the installation of one implant, the operation is carried out under sedation, so that the patient, at the hour of implantation, will not hear the sound of an ultrasonic saw and the unpleasant sound of being twisted. bath of the implant at the brush. Sedation during dental implantation is required immediately:

• the vein is catheterized;
• monitoring is installed according to the safety protocol (cardio, respiratory, saturation, arterial pressure);
• After injection of propofol, the patient falls asleep for 30-40 seconds;
• The dentist starts work. If depulpation of the teeth is necessary, a local anesthetic should be administered, as well as manipulations that do not affect the nerves of the teeth (superficial filling, cleansing of stones), sedation itself is sufficient to relieve fear and palpitations laziness;
• During the stage of the operation, the anesthesiologist carefully reduces or changes the anesthesia;
• after the empty mouth is completed, the drug is administered;
• After 7-10 weeks after the infusion, the patient is discharged.
• For 10 minutes, you will be fully informed and go to a special ward, where you can drink 1-2 glasses of water and wait until the weakness and dizziness have passed.

Propofol has an anti-indigestion effect and does not give such side effects as watering, swelling and falling. Caution after anesthesia/sedation lasts 1.5-2 hours. As long as there are no common side effects, the patient can safely go home.