Now dental clinics strive to ensure that the treatment will be not only effective and safe, but also comfortable for the patient.

Modern methods of anesthesia can provide complete analgesia, but sometimes they cannot cope with the fear of treatment or tooth extraction. Dental treatment with sedation is a comfortable solution to such issues.

If indicated, dental treatment under anesthesia is now available.

In Kyiv, it is performed in certain clinics, since it is necessary to fulfill a number of rules and conditions: the availability of special equipment, licenses, permits for the use of special drugs approved by the laws of Ukraine, an anaesthesiologist who knows the methods of sedation and other qualified doctors.

The popularity of the procedure is limited by legal issues, a high cost of treatment and the purchase of expensive equipment.

Dental treatment while sleeping. Indications

Children and adults are offered to treat teeth while sleeping if:

• - there is intense fear of dental treatment,
• - there is a major intervention or an increased risk of trauma, for example, when extracting wisdom teeth or other atypically positioned teeth, as well as various types of bone grafting,
• - low pain threshold,
• - allergic to local anaesthetics,
• - there are severe concomitant diseases, for example, mental disorders,
• - marked gagging reflex,
• - a child has numerous dental caries lesions.

Dangers of sedation and contraindications

In dentistry, a specific type of sedation or medication sleep is used, during which there is no deep depression of consciousness and the upper respiratory tract remains completely passable, and the reflexes and proper spontaneous breathing are preserved. The competence of specialists, the level of equipment, certified medicinal products and quality preparation for the procedure help protect the patient from harm.

Dental treatment under anesthesia is contraindicated in adults if there is a pregnancy, any acute inflammatory and infectious processes in the body, such as bronchitis, pneumonia, pyelonephritis, or while intoxicated. In these cases, anesthesia is delayed until complete recovery.

Types of sedation

Sedation is distinguished by the level of depression of consciousness: from minimal to deep.

1. 1. Minimal sedation — the patient can respond to simple commands, consciousness is preserved, coordination of movements may be slightly impaired, but at the same time there is complete relaxation and calmness, respiration and blood circulation are stable, despite the emotionally tense atmosphere.
2. 2. Moderate sedation — a focused response can only be obtained by reinforcing verbal commands with tactile stimulation, there are signs of superficial medication sleep, but contact with the patient remains.
3. 3. Deep sedation — a response occurs only to repetitive pain stimuli; it can be recommended only in a hospital setting.

In addition to heart rate and blood pressure, the BIS monitoring of depression of consciousness and continuous measurement of oxygen and carbon dioxide concentrations in exhaled air are used to assess the depth of anesthesia. These indicators are recommended and approved by the American Dental Association (ADA).

If dental treatment under general anesthesia is indicated, then the following methods of medication sedation are most often used:

• - It is possible both a constant supply of anaesthetic with an infusomat, and a periodic supply until the target concentration is reached. Sometimes one drug is enough, but a combination of drugs may be needed.
• - Inhalation using nasotracheal intubation. Its advantages include quick effect, high controllability, moderate anesthesia, quick recovery of consciousness. A safe certified medicinal product Sevorane (sevoflurane) is used. It is not addictive and is rapidly excreted from the body.

The price of such sedation in dentistry depends on the method of anesthesia, the drug, the total time of anesthesia, the scale of intervention. It is worth considering that the time of medical procedures under general anesthesia in dentistry is reduced, since the doctor can work with concentration and not be distracted by the patient's emotions and reflex movements.

High technologies bring each patient closer to the dream of having a healthy and beautiful smile, no matter what the patient was afraid of before.