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Conscious Sedation

Conscious Sedation

Several methods of conscious sedation are available. The method of conscious sedation that are chosen for or by a patient depends upon the nature of the surgical procedure and the patient’s level of apprehension. Consideration will also be given significantly to the patients medical status and overall health.

Conscious Sedation Options

The following table illustrates the choices of anesthesia, a description of the anesthetic technique, and the usual indications for that technique.

Method	Description of Technique	Usual Indications
Local Anesthetic	The patient remains totally conscious throughout the procedure. A local anesthetic (e.g. lidocaine) is administered in the area where the surgery is to be performed. Local anesthetic is used in conjunction with the other methods of anesthesia in all oral surgery procedures.	Simple oral surgery procedures such as minor soft tissue procedures and simple tooth extractions.
Nitrous Oxide Sedation with Local Anesthetic	A mixture of nitrous oxide (laughing gas) and oxygen is administered through a nasal breathing apparatus. The patient remains conscious in a relaxed condition. Nitrous oxide has a sedative and analgesic (pain- controlling) effect.	Simple oral surgery procedures to more involved procedures such as removal of wisdom teeth and placement of dental implants.
Office Based General Anesthesia with Local Anesthetic*	Medications are administered through an intravenous line (I.V.). The patient falls asleep and is completely unaware of the procedure being performed. Supplemental oxygen is delivered through a nasal breathing apparatus and the patient’s vital signs are closely monitored.	Conscious Sedation is available for all types of oral surgery. A patient may choose general anesthesia for simple procedures depending on their level of anxiety. Most people having their wisdom teeth removed or having a dental implant placed will choose general anesthesia. Conscious Sedation may be necessary if local anesthesia fails to anesthetize the surgical site which often occurs in the presence of infection.
Hospital or Surgery Center Based General Anesthesia	A patient is admitted to a hospital or surgery center where anesthesia is administered by an anesthesiologist.	Indicated for patients undergoing extensive procedures such as face and jaw reconstruction and TMJ surgery. Also indicated for patients with medical conditions such as heart disease or lung disease who require general anesthesia.

To administer conscious sedation in the office, an oral surgeon must have completed at least three months of hospital based anesthesia training. Qualified applicants will then undergo an in office evaluation by a state dental board appointed examiner. The examiner also inspects all monitoring devices and emergency equipment and tests the doctor and the surgical staff on anesthesia related emergencies. If the examiner reports successful completion of the evaluation process, the state dental board will issue the doctor a certificate to perform general anesthesia or intravenous conscious sedation. The license is renewable every five years if the doctor maintains the required amount of continuing education units related to anesthesia.

Again, when it comes to anesthesia, our first priority is the patient’s comfort and safety. If you have any concerns regarding the type of anesthesia that will be administered during your oral surgery procedure, please do not hesitate to discuss your concerns with your doctor at the time of your consultation.

Intravenous Sedation (“Twilight Sedation”)

Our office offers our patients the option of Intravenous Sedation or Dental Intravenous Anesthesia or to some it is referred to as “Twilight Sedation” for their dental implant. Intravenous Sedation or “twilight sleep” helps you to be comfortable and calm when undergoing dental procedures. Your treatment can be completed under intravenous sedation. Intravenous sedation or “IV sedation” (twilight sedation) is designed to better enable you to undergo your dental procedures while you are very relaxed; it will enable you to tolerate as well as not remember those procedures that may be very uncomfortable for you. IV sedation will essentially help alleviate the anxiety associated with your treatment. You may not always be asleep but you will be comfortable, calm and relaxed, drifting in and out of sleep – a “twilight sleep”.

If you choose the option of intravenous sedation your IV sedation/anesthesia is administered and monitored by the doctor therefore eliminating the costly expense of having your treatment carried out in an operating room or same day surgical facility.

How is the IV Sedation Administered?

A thin needle will be introduced into a vein in your arm or hand. The needle will be removed and a small catheter will remain in the vein during the procedure attached to an intravenous tube through which medication will be given to help you relax and feel comfortable. At times a patient’s vein may not be maintainable, in these situations the medications will be administered and the needle retrieved – both scenarios will achieve the same desired level of conscious sedation. Once again some patients may be asleep while others will slip in and out of sleep. Some patients with medical conditions and/or on specific drug regimens may only be lightly sedated and may not sleep at all; and some may not be stable enough medically to have these procedures performed in the outpatient office setting.

The goal of IV sedation is to use as little medication as possible to get the treatment completed. It is very safe, much safer than oral sedation. With IV sedation a constant “drip” is maintained via the intravenous tube. At any time an antidote can be administered to reverse the effects of the medications if necessary. Along with IV sedation there are also other different “levels” of sedation available to you in our office. There is nitrous oxide analgesia.

Nitrous Oxide (Laughing Gas)

Nitrous Oxide is a sweet smelling, non irritating, colorless gas which you can breathe. Nitrous Oxide has been the primary means of sedation in dentistry for many years. Nitrous oxide is safe; the patient receives 50-70% oxygen with no less than 30% nitrous oxide. Patients are able to breathe on their own and remain in control of all bodily functions. The patient may experience mild amnesia and may fall asleep not remembering all of what happened during their appointment.

There are many advantages to using Nitrous Oxide

The depth of sedation can be altered at any time to increase or decrease sedation.
There is no after effect such as a “hangover”.
Inhalation sedation is safe with no side effects on your heart and lungs, etc.
Inhalation sedation is very effective in minimizing gagging.
It works rapidly as it reaches the brain within 20 seconds. In as few as 2-3 minutes its relaxation and pain killing properties develop.

Reasons to Not use Nitrous Oxide

Though there are no major contraindications to using nitrous oxide (except pregnancy), you may not want to use it if you have emphysema, exotic chest problems, M.S., a cold or other difficulties with breathing. You may want to ask your dentist for a “5 minute trial” to see how you feel with this type of sedation method before proceeding.

What Our Patients Say

I was extremely nervous to get my wisdom teeth removed, but my experience here could not have been better. Scheduling appointments over the phone was quick and easy, I was always greeted by name for my appointments, and the follow up care was great! Dr Dingman did a wonderful job explaining everything and was always open to questions. Every person that assisted me at any point along the process was absolutely amazing! While I don’t hope I need any other procedures soon, I know that if I ever do, I am in the best hands here!

- Bailey S

Absolutely the best oral surgery experience anyone could ask for.

- Janet G

Very friendly staff. I had Dr. Bezak and he was very personable and kind. He did a fantastic job with the surgery. I would recommend OSA to anyone.

- Keara V

Confident, that is how I feel about this procedure. Prepping for an implant, and I am sure that will be a breeze. I hope to not need OSA again, but if I do, I will be confident that I will be taken care of.

- Michael H

Dr. Kintz is amazing! My daughter first saw him 10yrs ago for 2 extractions at the age of 6yr. old. Last week she had all 4 impacted wisdom teeth removed. He has the best bed side manner and is so friendly. He put us both at ease and did a wonderful job. She was in quite a bit of pain the next day due to the depth of her top wisdom teeth, and who called me back after leaving a message with the emergency staff…… none other than Dr. Kintz himself. He goes above and beyond and you feel it from the first meeting. He is exceptional!!!!

- Stephanie S

My father was the patient and was referred over to Dr.Kintz. I just wanted to let everyone at your office know what a great environment you have and how friendly everyone was. I also work in healthcare and unfortunately people hear more about the bad than the good. Huge thank you to everyone and especially Dr.Kintz for squeezing my father in to have the actual extractions done today.

- Ema C

Dr. Kintz is the best! Very gentle, very patient, and super kind. I have had extractions and implants. I wouldn’t go to any other doctor.

- Noelle H

Thank you to all of the staff at Oral Surgery Associates, you are all very informative, by answering any and all questions. You are understanding to the patient and their concerns and that life happens. I thank you all very much for everything. I will highly recommend you to anyone!

- Stephanie F

DR. KINTZ IS THE GREATEST. HE IS SO GENTLE AND HAS GREAT BESIDE MANNER.

- Tiffani J

My appointment was for a dental extraction, which was my initial preference versus undergoing root canal and crown procedures. But unbeknownst to me, the extraction was a high risk proposition due to my currently rather complex health condition. Yet, without objection or elaboration, two general dentists I had earlier consulted had independently asserted that the extraction was understandable and presently doable, but definitely should be performed by an oral surgeon. In later preparation for the extraction, however, Dr.Kintz immediately recognized certain risks associated with the extraction at this particular time, and after promptly conversing with the second dentist I had consulted, strongly advocated having a dental specialist (endodontist) perform an immediate root canal procedure as the best present action to be taken. He explained that doing the extraction now could possibly result in significant consequences that ought to be avoided if at all possible. I greatly appreciated Dr. Kintz’s unhesitating professional and ethical assessment of this situation and the advice rendered in reversing my initial intentions. His recommendations were unequivocally endorsed and successfully performed the same day by a highly regarded dental specialist to whom I was referred.

- Ron N

I would not think twice about having these guys help you out. They are great

- Wendy Y

I was very impressed with the new office, since I have had appointments at the previous location in the past. The new building is so clean & modern! I love the décor and all the modern updates….it’s very high tech. I have also been extremely happy with the care I have received from Dr. Dingman and his staff. The procedures relating to my extraction and implant were a bit anxiety inducing but I quickly found that there was no need to be anxious. Dr. Dingman made me feel very comfortable and I had little to no pain & no complications. My follow up appointments have been thorough, but at the same time, quick & easy. I appreciate all the staff at Oral Surgery Associates for all their help & care during my implant process & I love, love, LOVE the new office!

- Carrie W

Procedures

Grand Rapids

Grandville

What Sets Us Apart?

Oral Surgery Associates is committed to providing top-tier care utilizing the latest techniques and technology. Our team, trained in advanced procedures like I.V. sedation, offers a full scope of oral and maxillofacial surgeries, ensuring comfort and high-quality results in their state-of-the-art facilities.