Sleep dentistry

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sleep dentistry
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Sleep dentistry has attracted a new place in the spotlight in recent times, but the experts agree that patient education is paramount when dealing with the realities of this procedure. By John Burfitt

In recent years, the promotion of cosmetic services in all its many forms has continued to attract the lion’s share of attention in terms of publicity regarding dental services.

While not on par with the interest in cosmetic dentistry, the promotion of ‘sleep dentistry’ has also emerged high on the agenda, with a new wave of advertisements and offers appearing on broadcast and social media.

Big promises made in some of this advertising somewhat temptingly implies that ‘sleep dentistry’ can be as simple as settling into the dental chair for a deep snooze while the practitioner gets to work on any procedure.

What that may sound ideal for those who battle anxiety about visiting the dentist, not to mention making the job of the practitioners that treat them easier, the reality of ‘sleep dentistry’ can be markedly different.

“The term ‘sleep dentistry’ is a misnomer,” Dr Steven Parker, who has provided oral surgical and sedation services to private practices across Sydney for over two decades, says. Dr Parker has also given lectures on the topics of sedation and anxiety control.

“It is a term that should only be used in relation to the use of intravenous sedation in dental facilities or general anaesthesia in suitably approved facilities. The use of nitrous oxide or oral sedation, if used as recommended in guidelines, does not provide the level of amnesia to justify the use of the ‘sleep dentistry’ label.

“Many patients will be relaxed, but aware, throughout the procedure and will therefore not feel they were asleep. They could justifiably argue that they were misled by false advertising.”

In the noise of slick marketing and attractive promises, Dr Parker believes it’s important that all dentists have a clear understanding of the various sedation techniques available when discussing anxiety relief with patients.

Sedation dentistry is an umbrella term for an array of techniques used to help reduce dental fear and anxiety and may involve oral, inhalational or intravenous (IV) medication.

During all sedation techniques, the patient remains conscious. This differentiates these techniques from general anaesthesia where a state of unconsciousness is the goal.

Among the many virtues of incorporating sedation dentistry into practice are decreasing the stress and anxiety some patients have about dental treatment and allowing dentists to undertake the procedures in an easier manner due to a less-agitated patient.

“It can also help with patients who have a severe gag reflex, and patients having intravenous sedation will generally have significant amnesia of the procedure and thus not have further reinforcement of their phobia,” Dr Parker adds.

Since 2007, Dr Robert Turnbull has been providing visiting and in-house dental sedation services to a range of clinics, and now leads a team of sedationists in his Sydney Dental Sedations practice.

Dr Turnbull says the demand for sedation services has increased significantly in recent times.

The term ‘sleep dentistry’ is a misnomer. It is a term that should only be used in relation to the use of intravenous sedation in dental facilities or general anaesthesia in suitably approved facilities.

Dr Steven Parker, sedation specialist

“As more dentists become aware that sedation is an option, they are keen to provide it for their patients, recognising how traumatising many dental procedures can be,” he says. “We regularly get calls from surgeries requesting sedation because patients have demanded it.”

Which is when, Dr Turnbull says, clearly explaning what is involved is essential so that patients fully understand the different offerings.

“Patients often confuse it with general anaesthesia and it can be difficult for them to get their heads around the fact they can be relaxed and comfortable for their procedure, without being unconscious,” he says. 

“I describe it like they are very relaxed, comfortable, sleepy and forgetful. So although they will doze off while we work, they are still ‘in there’ and can assist us when required, but they really don’t care what is going on.”

Such results can play a big role in changing the retention and future visiting habits of patients.

“It (sedation dentistry) provides access to patients who would otherwise avoid dentistry, while also providing the satisfaction of helping these patients undergo necessary treatment,” he says.

“Patients who have previously experienced dental sedation for their treatment will often request it again. Additionally, they will often tell their friends and family of their experience, and this can prompt others who have avoided treatment to seek help.”

Dr Turnbull believes the increase in marketing of sedation services will continue to result in an increase in demand from patients, and many practices are either embarking on new skills training in this area or partnering with a dental sedation provider.

“Contacting a dental sedation provider, such as Sydney Dental Sedations, means we can advise if your surgery, as well as the patient and procedure, are suitable for sedation, and ensure you are safely set up and have the appropriate medical emergency training,” he says. 

“Many dental sedationists do a bit of both sedation and clinical dentistry, and there is a small, but growing group who have restricted their practice to sedation. I do sedation exclusively because I think it is a great service for our fearful patients and is preventing a future generation of fearful patients.”

Sydney Dental Hospital’s head of Specialist Services Associate Professor Alex Holden touts the benefits of sedation services within dental practice.

“There is a growing expectation that your clinic is providing this service as more people are talking about it,” he says. “I always loved working this way as it offered another option of care for patients who we would otherwise not see at all.”

What he did note over time, however, was some patients would request sedation at every appointment, no matter the procedure.

“There was once a patient at a practice I worked at in the UK who had got into a routine that they would only come in for a full check-up and clean if it was done under sedation. I always felt that this was overkill. So there has be some considerations discussed, and the more you talk to the patients about what might be appropriate for them in each procedure, then the better it is.”  

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