At first I didn’t hear it, but then it happened again...a giggle. Then another giggle. We had just completed a 1½-hour restorative appointment. I was taking off my gloves in preparation to talk to the patient’s driver in the waiting room when I first heard it. The third giggle became a cascade of giggles that quickly dissolved into laughter. The patient’s laugh was beginning to affect my assistant, who now was starting to laugh herself. I glanced at the patient with an inquisitive look.
“Doc, that was awesome,” she chuckled, “I can’t believe how easy that was.”
Now, I was smiling…
Welcome to oral conscious sedation. The laughing patient had been a nervous wreck when we sat down to treatment plan her condition a few weeks ago. She had avoided dental treatment her entire adult life because of a bad experience in the dental chair as a child. She was so anxious that she could not sit in the operatory when we met to plan out the phases of her treatment. She had shown up for the preoperative appointment in tears. Now, however, she was laughing.
Stories like this are commonplace in a practice that uses oral conscious sedation. Multiple studies have shown that roughly one-third of all Americans will not go to the dentist due to fear and anxiety. There are 3 main barriers to a patient seeking dental treatment: time, money, and fear. By removing one of those barriers, fear, a practice can expand.
Relieving patient anxiety is one of the big benefits of oral conscious sedation, but there are several more. We’ve all experienced a nervous patient who interferes with the quality of the treatment by moving around, talking, or being overly sensitive. By using oral conscious sedation, many of these factors are mitigated and the practitioner can concentrate on providing a high quality of care. Additionally, by removing some of the patient’s fear and anxiety, the practitioner can provide expanded services and procedures for the patient.
Retrograde amnesia is also a big practice builder. Many of the sedation drugs used in oral conscious sedation will cause amnesia of the procedure. Quite frankly, most patients would prefer not to have lasting memories of procedures such as crown preps, extractions, implant placement, and endodontic therapy. If a patient can walk away from the procedure without concrete memories of the treatment, they are more likely to let their friends know about the positive experience they had at your office.
Anytime a patient is going to be sedated, safety must be the most important item on the dentist’s mind. Oral conscious sedation is very safe when you strictly follows rules about patient selection, patient monitoring, and dosing protocols. When these are closely followed, oral conscious sedation can be both rewarding and reliable.
If you are considering incorporating oral conscious sedation into your practice, begin by taking a course that checks off all your state board’s regulations for minimal sedation/anxiolysis. A good oral conscious sedation course should leave you respectful of how to sedate patients safely and confidently while providing this remarkable service to your patients.
You may even get your patients laughing.