While we aim for every appointment here at Bullis Pond to be stress free, we do offer both IV sedation and Oral Conscious sedation, for patients who prefer it. IV Sedation, which is sometimes combined with Oral Conscious Sedation, is ideal for a patient who is particularly nervous and having a larger dental treatment case done. It also can help in situations where a patient has trouble getting numb or dealing with pain management. If a patient is anxious but has trouble swallowing pills, IV Sedation can be used on its own, without oral conscious sedation.

There are also some situations where, even if a patient would prefer IV Sedation or Oral Conscious Sedation, we are not able to utilize this in an appointment. Typically, this is due to certain medications the patient is currently taking or medical conditions the patient has that do not allow the patient to be a candidate for Sedation Dentistry. In these circumstances we always do all that we can to still create a pleasant and calm experience for the patient.

When a patient is using Oral Conscious Sedation as a tool to create a Stress-Free dental appointment here at Bullis Pond, their experience starts the night before. We will have you into the practice 1 - 2 weeks before your appointment to go over necessary consent forms, payment information and to dispense your medication. The night before your appointment is typically when you will take your first dose. You will also take a dose 1-3 hours before your appointment, and we will likely give you a final dose at the start of your appointment.

Due to the nature of the prescribed medication, you will need a driver to and from your dental appointment. In addition, the drugs will stay in your system for 6-8 hours after your appointment, so you will need to take the day off of work and avoid operating heavy machinery. By the day after your appointment, you should be good to return to work and normal activities.

Oftentimes when Dr. Metropolus is providing Stress-Free IV Sedation, he will prescribe Oral Conscious sedation along with the IV Sedation. This will start the night before, the same as Oral Conscious Sedation. The difference occurs once you arrive for your appointment. At that point, we make sure you are comfortable and then the IV line is placed. At this point, most patients are relaxed and calm. Most patients report that they have little to know memory of the appointment after it is over.

Patients will require a driver to and from the appointment and they will also need to come 1 -2 weeks prior to the appointment to sign consents, discuss payment and pickup medication. Most patients are also ready to return to normal activities the day after the appointment. We do recommend that while you are taking the medication that you have another person home with you and that you plan on laying low. Don’t make any decisions during this time, relax and try to stay hydrated.

We determine this on a case-by-case basis with each patient at a screening appointment approximately two weeks before the appointment. There we ensure that we have a comprehensive understanding of our patient’s health and identify any concerns that could come up.

Factors that come into play as we make this decision include: Can the patient take oral medication? Does the patient have any health conditions that would put them at a higher risk? For example, congestive heart failure.

Is the patient taking any medications that would conflict with a medication we would use? Does the patient have a driver for the day of the appointment? How much does the patient want to remember from the appointment? Typically they will remember more from Oral Conscious Sedation than they will with IV Sedation. How long will the appointment take?

In all cases, we take the safety of our patients very seriously. We are conservative in the amount and doses of medications used, and we ensure that we are doing what is always best for the patient.

IV SEDATION

In the IV there is a mix of three things: a sedative, to make you relaxed and sleepy, a pain reliever, to keep you comfortable and sugar water to keep your blood sugar maintained throughout the appointment. Typically, the sedative used is Versed (Midazolam) and the pain reliever is Fentanyl. The combination of these two drugs creates a fast-acting and relatively short-lived period of time where you feel painless and drowsy, which is perfect for Stress-Free Dentistry. Please note that because Fentanyl is an opioid, we will avoid using it if a patient has a history of drug abuse.

ORAL CONSCIOUS SEDATION

We will prescribe a couple different oral medications for our Oral Conscious Sedation Patients. Remember, sometimes we combine these with the use of IV Sedation in office, depending on what is best for you. The night before your appointment we typically dispense diazepam (Valium) and then the morning of the appointment, triazolam (Halcion) will be given. These two drugs are very closely related and can help to reduce anxiety and create sleepiness for your during your appointment.

In all cases, we are prescribing and dispending the lowest dose that we can that will still allow us to create a Stress-Free Dental appointment for you.