Oral surgery & dental office sedation

leslie :-D · Jul 17, 2007

i had a major abscess that didn't resolve on abx.

inevitably, i had to go to an oral surgeon who was going to vigorously massage the area.

i had to be put under gen'l and it was absolutely fine.

i too, sought out someone with a remarkable reputation.

best of luck.

you'll do just fine.

leslie

kstec, LPN · Jul 17, 2007

Since reading a couple of articles regarding bad things happening to people with sedation, I would make sure that they show you where the crash cart is and that they a something to reverse the effects if something should happen. Good Luck

MikeyJ, RN · Jul 17, 2007

If it is a reputable dentist, I am sure they have measures set in place if someone starts crashing (I am sure that is very rare though to crash under general anesthesia unless they have some sort of allergic reaction). I went to a very reputable oral surgeon to have my 3 impacted wisdom teeth extracted and I had asked the tech what would happen if I didn't respond well, and he said they had a crash cart always on hand.

Babarnurse · Jul 17, 2007

Sistermike:

You are kidding right? going under and coming out from anesthesia is the most dangerous part of most surgeries.

With that being said, I'm sure they have policies in place for such situations.

GingerSue · Jul 17, 2007

not trying to frighten anyone,

but this is one eg when things didn't work out because of a kink in the tubing for the oxygen, the patient died in the dental surgeon's office

Therefore - what can be learned from this tragedy?

http://www.therecord.com/home_page_front_story/home_page_front_story_1096519.html

MikeyJ, RN · Jul 17, 2007

Sistermike:
You are kidding right? going under and coming out from anesthesia is the most dangerous part of most surgeries.
With that being said, I'm sure they have policies in place for such situations.

No, I wasn't kidding. I understand it is dangerous to be put under anesthesia. However, you are not going to have people having oral surgery crashing left and right. I am not saying people do not crash, but if you have competent dentists who are monitoring you throughout the surgery to quickly adjust in relation to the individuals vital signs, then you shouldn't have people crashing on a regular basis.

TracyB,RN, RN · Jul 17, 2007

Hmmm, I would check your state's website to make sure the oral surgeon was in good standing. In IL, there was a dentist using sedation, screwed up, & his YOUNG, like 6 yr old patient, died. He ended up losing his license, at least temporarily. I haven't done any follow up on the story, but it happened in Chicago.

I guess it wouldn't hurt to make sure the techs were CPR certified & if there is an ACLS certified nurse on staff.

Nitey, nitey & wakey, wakey are when the pt is most vulnerable.

Babarnurse · Jul 18, 2007

Sistermike,

With all due respect, I think you need to do more research.

It is said the best here:

Nitey, nitey & wakey, wakey are when the pt is most vulnerable.

That is a KNOWN fact of anyone who has ever worked in the OR or had any kinds of procedures.

The operative word in your post is *should*. Yes, you rarely hear of people having trouble in the dentist office, but it is STILL the most dangerous part of the procedure, no matter what the outcome.

MikeyJ, RN · Jul 18, 2007

Sistermike,
With all due respect, I think you need to do more research.
It is said the best here:
Nitey, nitey & wakey, wakey are when the pt is most vulnerable.
That is a KNOWN fact of anyone who has ever worked in the OR or had any kinds of procedures.
The operative word in your post is *should*. Yes, you rarely hear of people having trouble in the dentist office, but it is STILL the most dangerous part of the procedure, no matter what the outcome.

I am not exactly sure what we are even disagreeing on here -- I agree that the patient is most vulnerable during that time... I am not disputing that at all. And I understand it is extremely dangerous, and yes the OP should ask pertinent questions regarding the procedure and what type of measures they have set-up in the case that she crashes.

HOWEVER, I was trying to state that a healthy adult with no known allergies to the analgesics being adminsteristered should feel pretty safe in the hands of a reputable and competent dentist (or any doctor, for that matter) while being put under by general anesthesia. Although it is possible for the patient to have an adverse reaction, it is not common in healthy adults with no allergies to the medications being adminstered. But I am not disputing the fact that there is always a possibility of something going horribly wrong when being put under general anesthesia.

CRNAGAL · Jul 18, 2007

The problem with sedation/anesthesia for dental procedures isn't allergic reactions, its managing the airway. You can't assume the dentist is going to be monitoring you while he's focused on doing a procedure. And just because someone is CPR certified or has attended ACLS doesn't mean that they will be able to manage a patient who is obstructing, has stopped breathing, or has aspirated, especially in an emergent situation. Plus, in a non-hospital setting, theres nobody to call for backup, calling 911 still requires a response time. I think its fair for the OP to ask who will be monitoring her during the procedure, qualifications, etc., it shouldn't be the tech who is assisting the dentist. What drugs will be used, what monitors (if any) will be used, that kind of thing. I'm sure everything will be just fine, but it doesn't hurt to be better informed.

KellNY, RN · Jul 18, 2007

OP-you're getting general as in totally knocked out? Or are you getting sedation-kind of a twilight sleep situation?

I horribly afraid of the dentist, and I get oral sedation and NO2 for all my procedures. Even with this (ie no IV meds, totally "awake" the whole time), I have a pulse ox monitor on the whole time.

I used IV sedation when I had my wisdom teeth removed. I was hooked up to not only the pulse ox, but to a BP cuff as well. Not sure how often it went off, as I was way the hell out there, lol.