Anesthesia

Many people avoid going to the dentist because they experienced traumatic care as a child, suffered painful procedures as an adult, or are influenced by the stereotypes they see on TV and movies. Even when they experience warning signs like pain in the mouth, many people avoid seeking treatment because of the fear they experience. At our office we understand these feelings and want to help. Whether you just need a routine cleaning or a brand-new smile, we offer sedation dentistry to make your experience comfortable and relaxing.

Dr. Peavy provides many techniques to help reduce the anxiety associated with dental therapy. The newer medications make you feel very relaxed and comfortable, but it is not general anesthesia. It is a very safe way to be relaxed while you have your therapy of any kind. During and after treatment, we monitor your status with automatic blood pressure machines, pulse oximetry, and close observation by Dr. Peavy and at least one other female staff member trained in sedation and medical emergency management.

This kind of sedation is especially needed for patients with medical problems that can be aggravated by the stress of dental therapy. High blood pressure is a very common condition that is best managed with a sedation strategy. Having IV access at all times allows for the administration of many emergency medications if needed as in the case of a patient with diabetes needing a quick sugar boost.

It is possible to do more work in one visit when using this kind of conscious sedation technique, and that reduces the number of visits needed to complete your care.

We are routinely able to complete all of the therapy you need at one appointment and with high confidence say that you will not experience any pain and probably won’t remember much from your visit. Because the effect of the medications only lasts 30-40 minutes after the last dose, we can plan the case so that by the time we are finished, you will be able to walk out after resting in our recovery area for 15-20 minutes. You will need a ride home since you are not supposed to drive for 24 hours.

Anesthesia Options

The following table illustrates the choices of anesthesia and a description of the anesthetic technique.

• MethodTypes of Anesthesia
  Description of Technique
• Method Oral Sedation
  Description of Technique Our office offers oral sedation dentistry. Oral sedation is a nice way to get started when you are very nervous about the planned procedures. Once you are at the office, we will give you a tablet or two to take with a small amount of water. You can visit with your chaperone for about thirty minutes in our reception room before we escort you back to the treatment area. By this time, you should already be starting to feel relaxed. We get you all set up with a warm blanket, eye mask, and some soft music while you wait until you are ready to begin. We can always add Nitrous or other medications as needed to make sure you are feeling comfortable and relaxed. Dr. Peavy and his staff maintain a strict, “100% of the time” rule that their will be at least one female assistant present in the operatory at all times once any sedation medications have been given.
• Method Intravenous (IV) Conscious Sedation
  Description of Technique

  IV Conscious Sedation is an effective technique for managing moderate to severe dental anxiety. While not as readily available in most dental offices, we believe it is a valuable tool for ensuring a patient’s relaxation during a procedure they would not ordinarily have had done due to extreme fear.

  Prior to the procedure, drugs are administered intravenously. Drugs administered by IV are far more effective than those taken orally because the doctor can control exactly how much is administered directly into the blood stream.

  During the procedure, monitoring devices are placed on the patient to monitor their heart rate, blood oxygen levels, blood pressure, and breathing. The patient will be relaxed and comfortable, but still be able to respond to Dr. Peavy’s questions and directions. Many patients get some amnesia that makes the visit seem very brief and some patients have no recall of the procedure. Dr. Peavy and his staff maintain a strict, “100% of the time” rule that their will be at least one female assistant present in the operatory at all times once any sedation medications have been given.

  In order to provide IV Conscious Sedation dentistry, specialized advanced training and certification by the state Board of Dental Examiners was required and completed.

• Method General Anesthesia
  Description of Technique

  Dr. Peavy can provide IV sedation that is designed to make you feel more relaxed and comfortable than using only local anesthetics, but some patients desire to be more than relaxed and really want to be assured they will not feel or remember anything related to their surgical care. In those cases Dr. Peavy offers general anesthesia, and we would need the services of an anesthesiologist and could invite Dr. Dillon Atwood, one of only three dental anesthesiologists in North Carolina, to join our team to provide deep sedation or general anesthesia in our office to insure that your needs for anesthesia are being addressed. Please let us know how we can help you get the treatment you need.

  Dr. Atwood studied at Davidson College and attended the University of North Carolina School Of Dentistry before completing his postgraduate training in Anesthesiology at Lutheran Medical Center in New York City. During that time he also practiced pediatric anesthesia in Arizona and special care anesthesia at Helen Hayes Hospital in New York. He is a member of the American Society of Dentist Anesthesiologists and lectures regularly on aspects of anesthesia practice.

• Method Nitrous Oxide (N20)
  Description of Technique

  Nitrous oxide sedation is a technique that uses a mixture of nitrous oxide gas and oxygen that is inhaled through a mask that fits comfortably over your nose. It is a safe way to be mildly sedated without taking pills or having an IV. This kind of sedation is gives the patient a feeling of relaxation and has the pain reducing effect equivalent to about 50mg of Demerol. The level of sedation can be quickly increased or decreased during the procedure to suite the needs of the situation and the effects wear off within 15-20 minutes once the mixture of gasses is changed over to all oxygen. After the recovery period, patients feel back to normal and are able to drive themselves home to rest and recover. We often suggest that our patients refrain from eating 4 hours prior to the visit and bring a chaperone in case we need to add other medications to increase the level of sedation to a point where the patient feels relaxed enough to continue.

  Dr. Peavy and his staff maintain a strict, “100% of the time” rule that their will be at least one female assistant present in the operatory at all times once any sedation medications have been given.

Local Anesthetic

We also use the latest techniques for local anesthesia that reduces the “sting” of the injection by using a sodium bicarbonate buffering system (www.onset.com) and a powerful pre-injection numbing gel. Most of our patients report that they could barely tell Dr. Peavy had done the “shot”. (link to testimonials…pain free injections) Local anesthetics are used to prevent any pain during your procedure and the sedation we use helps you to feel relaxed and comfortable as well. Dr. Peavy and his staff use eye covers (spa masks) to block out the bright lights and head phones to play relaxing music to listen too instead of the usual dental sounds.

Interested in Sedation Dentistry? You May be a Candidate!

Candidates for Sedation Dentistry include people who have:

• High fear
• Had traumatic dental experiences
• Difficulty getting numb
• A bad gag reflex
• Very sensitive teeth
• Limited time to complete their dental care
• Complex dental problems
• A fear of needles and shots
• An aversion to the noises, smells, and tastes associated with dental care
• Fear or embarrassment about their teeth