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Anxiety Free Treatment

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Anxiety Free Treatment

The Virginia Board of Dentistry created the “Policy on Administering Schedule II through VI Controlled Substances for Analgesia, Sedation and Anesthesia in Dental Offices/Practices”. Here is an extract of the definition of terms:

  1. Anxiolysis” means the diminution or elimination of anxiety through the use of pharmacological agents in a dosage that does not cause depression of consciousness.
  2. Conscious sedation” means a minimally depressed level of consciousness that retains the patient’s ability to independently and continuously maintain an airway and respond appropriately to physical  stimulation and verbal commands, produced by pharmacological or non-pharmacological methods, including inhalation, parenteral, transdermal or enteral, or a combination thereof.
  3. Deep sedation/general anesthesia” means an induced state of depressed consciousness or unconsciousness accompanied by a complete or partial loss of protective reflexes, including the inability to continually maintain an airway independently and/or respond purposefully to physical stimulation or verbal command and is produced by a pharmacological or non-pharmacological method, or a combination thereof.
  4. Inhalation analgesia” means the inhalation of nitrous oxide and oxygen to produce a state of reduced sensibility to pain without the loss of consciousness.

The complete document can be found on the Virginia Board of Dentistry website.

Methods of Anxiety and Pain Control

Excerpt from the ADA “Guidelines for the Use of Sedation and General Anesthesia by Dentists”
(As adopted by the October 2007 ADA House of Delegates)

Analgesia – the diminution or elimination of pain.

Local anesthesia – the elimination of sensation -especially pain- in one part of the body, by the topical application or regional injection of a drug.

Minimal sedation – a minimally depressed level of consciousness, produced by a pharmacological method, which retains the patient’s ability to independently and continuously maintain an airway and respond normally to tactile stimulation and verbal command. Although cognitive function and coordination may be modestly impaired, ventilatory and cardiovascular functions are unaffected. Nitrous oxide/oxygen may be used in combination with a single enteral drug in minimal sedation.

Moderate sedation – a drug-induced depression of consciousness during which patients respond purposefully to verbal commands, either alone or accompanied by light tactile stimulation. No interventions are required to maintain a patent airway, and spontaneous ventilation is adequate. Cardiovascular function is usually maintained.

Deep sedation – a drug-induced depression of consciousness during which patients cannot be easily aroused but respond purposefully following repeated or painful stimulation. The ability to independently maintain ventilatory function may be impaired. Patients may require assistance in maintaining a patent airway, and spontaneous ventilation may be inadequate. Cardiovascular function is usually maintained.

General anesthesia – a drug-induced loss of consciousness during which patients are not arousable, even by painful stimulation. The ability to independently maintain ventilatory function is often impaired. Patients often require assistance in maintaining a patent airway, and positive pressure ventilation may be required because of depressed spontaneous ventilation or drug-induced depression of neuromuscular function. Cardiovascular function may be impaired.

To get further information, please review the Anesthesia Guidlines from the Americal Dental Association.