Conscious Sedation

It is quite natural to be nervous of dental treatment, we are very used to helping patients to cope, one step at a time.

Whilst fear of the treatment is eased with painless dentistry, the thought of sedation can also make people anxious.

Conscious Sedation is the Answer

When thinking of dental sedation, people are either scared of being asleep or being conscious, but Consacious Sedation is the solution to both fears. Other fears include needle phobia, Gag reflexes and invasive dental treatment. CS is the best way overcoming all these fears.

With CS you are neither awake nor are you put to sleep.

The sedatives and pain killers administered makes you VERY VERY relaxed and drowsy and makes you completely unaware of both the numbing dental injections, called local anaesthetic (LA) and the actual treatment. Most people fall into a natural sleep despite dental treatment continuing and NO ONE remembers anything about the treatment. The benefits of CS is you are still able to respond to the dentist’s instructions, e.g. “please open your mouth” or “please bite down now” and you are ALWAYS able to say if you are uncomfortable. Yet you are unaware of the LA and dental treatment. CS is safe to administer outside the hospital setting and therefore you can have CS at the Dental Practice and the Dentist with which you are familiar and comfortable. CS is also very often offered in A&E and other settings outside of theatre for minor or non-invasive procedures. CS is usually NOT administered by a Consultant Anaesthetist.

When you have CS your oxygen saturation and pulse rate is monitored throughout with a pulse oximeter. A combination of pain killers and sedatives are titrated according to need and within safe doses. There is always at least three professional people present to take care of your needs and we are there to make sure you are in a safe environment: A doctor (myself), the dentist and the dental nurse. When administering CS in Dental Practices I always carry emergency medication and equipment in my case, which I can proudly say I have never needed to use in a private dental practice. Because the focus of CS is ALWAYS on safety, there might be some conditions which are unsafe with CS outside a hospital setting. Everyone has a risk assessment before CS by means of a medical history. This involves screening for allergies, health problems and medication prescribed. Recreational drugs may also interfere with CS. It is therefore VITAL to be honest and open about your medical history to prevent unforeseen complications. This will also give you a more pleasant experience and better dental treatment and sedation outcome.

The alternatives to CS is either being awake for the LA and treatment or being given a General Anaesthetic (GA) in hospital. GA can ONLY be administered in a hospital theatre (Operating Room) and is usually administered for major surgical procedures or operations. GA involves being temporarily paralysed for the procedure and connected to a breathing machine. GA needs to be in a hospital to access more staff and drugs if things go wrong. GA carries many risks and the responsibility for GA usually falls on a Consultant Anaesthetist. Private hospital GA is usually VERY costly as hospital theatre and Consultant Anaesthetist fees are high. The risk for GA is usually overshadowed by the need for surgery and minimised by the expertise and experience of a Consultant Anaesthetist.

I see myself as a Medical Practitioner with a special interest in Sedation. Or in other words a Sedation Specialist, even though this is not a recognised Medical Speciality. I have gained my sedation experience working as a senior doctor in A&E for over 15 years and since 2008 working in several well known NHS Dental Sedation Referral Clinics in and around London. I expanded my sedation practice to the private sector in 2012 and have worked in many private dental clinics including Harley Street. I am on the Council for the ADA (Association for Dental Anaesthetists), a member of SAAD (Society for the Advancement of Anaesthesia in Dentistry) and a member of the SPS (Society for Paediatric Sedation). In 2016 I went to an international SPS conference in the US to share experiences in and learn more about children’s sedation.

I studied Medicine at the University of Stellenbosch in South Africa and graduated in 2000. My first two years as a medical doctor I worked in South Africa rotating through different hospital departments including Anaesthetics. I moved to the UK in 2003 and became interested in Emergency Medicine. As part of my daily duties I taught medical students, nurses and junior doctors. I have kept up to date with the Resus Council (UK) courses ALS, APLS and ATLS over the last 10 years. I started as a Honorary Lecturer in Sedation with University College London in 2014. Other interests have been working as a Ships Doctor on the Queen Mary II cruise ship and working for the Metropolitan Police as a Forensic Medical Examiner.

I am happy to answer any other questions or concerns you might have about sedation. Please call Winning Smiles if you would like to know more.