Sedation Dentistry

Sedation will put your mind in a pleasant place, and help to create the most comfortable dental experience possible. Sedation has several benefits:

  • Relieves anxiety
  • Hours seem like minutes
  • Relieves discomfort from keeping the mouth open
  • Diminishes gagging
  • Diminishes pain perception

Dr. Cyra is one of only a few general dentists in the State of Wisconsin skilled and licensed to provide IV sedation to patients.

Sedation is often used with oral surgery procedures and can be very helpful for other procedures. Following are examples of procedures for which sedation can be helpful.

  1. Root canal treatment, especially molar root canals which often require longer appointments
  2. Crown and bridge treatment for patients with gagging difficulty or with TMJ pain
  3. Cleaning teeth. Ordinary cleaning can be difficult for a handicapped person. We have experience using sedation to clean the teeth of patients with Down Syndrome and Cerebral Palsy
  4. Long restorative appointments
  5. Pediatric dentistry
  6. Periodontal surgical procedures

Patients who would particularly benefit from sedation:

1. Patients with anxiety about dental procedures. Sedation relaxes and relieves fear. The sedative agents also create anterograde amnesia, which is a temporary diminishing of memory of events occurring while the sedation is in the system - usually 1 to 4 hours. That means we can administer the sedation, do the dentistry and at the end of the appointment the patient will have very little memory of it. Our patients tell us it is a great dental experience.

2. TMJ and jaw pain patients. We are able to treat patients with time consuming procedures who otherwise could not be treated. Jaw joint problems ordinarily would cause too much discomfort for the patient to be treated, but sedation makes it possible and comfortable.

Safety and Dr. Cyra's Qualifications

IV sedation is a very safe procedure when administered by a trained professional according to established guidelines. Dr. Cyra was trained in IV sedation in a hospital-based program and is licensed by the State of Wisconsin to provide all types of conscious sedation. In accordance with Wisconsin State requirements, he maintains current certification in advanced cardiovascular life support. Vital signs are continuously monitored and Dr. Cyra is assisted by staff that has special training in sedation assisting by the American Dental Society of Anesthesia.

How does Sedation Work?

(Warning: Reading beyond this point may by itself cause sedation, and you should not drive or operate heavy machinery while reading this)

In sedation dentistry, we administer drugs that have a calming, sedative effect that helps put the patient in a comfortable state for the dentistry to be done. There are several ways we typically do sedation ranging from a light dose "to just take the edge off", to intravenous sedation, in which drugs are administered through an IV line where we have the best ability to fine tune the sedative level for the best effect. For the best effect for adults, IV sedation is usually recommended. We insert an IV line into the arm and administer the pharmaceuticals in small increments, until a pleasing level of sedation is reached. During the entire time, vital signs are continuously monitored. After sedation is achieved, anesthetic is delivered to numb the procedure area. Because we wait until sedation to deliver the anesthetic, there is no anxiety or discomfort associated with this. During the procedure, Dr. Cyra and the patient are able to communicate, although it isn't likely that the patient will remember the communication. This is not a general anesthetic so the patient is conscious but may fall asleep. Even if asleep, the patient can easily be aroused and the protective reflexes remain intact. The sedative agents are short acting and as they wear off more can be added to keep the patient at a comfortable level.

We use a combination of pharmaceuticals for IV sedation. Midazolam is our primary sedative agent. It relieves and reduces anxiety and is a muscle relaxant. These are properties helpful for the patient with TMJ problems or difficulty keeping open. With an IV line in place, we can add an anti-inflammatory agent, which directly reduces pain due to inflammation. We may add an opioid agent to directly relieve pain, provide a sense of well being, reduce restlessness, and provide post-operative pain relief. We also often add an antihistamine for enhancement of the sedative agents and reduction of saliva and nasal secretions.