Tag Archives: Triazolam

Sedation Dentistry

Is Dental Sedation Safe?

I keep reading about how dental sedation can help someone with like me with severe dental anxiety. I was about to schedule an appointment, but then I read about a case where someone died because of sedation and the dentist was blamed. Is dental sedation really safe?

Emma

Dear Emma,

woman asleep in the dental chair from dental sedation

I think I know of the case you are talking about. In fact, if it is the case I’m thinking about (and it’s the only one I’ve heard of in years) a colleague of mine was actually called as an expert witness in this case. Before I go over the case for those who are unaware of what happened, I want to assure you that dental sedation is completely safe.

The Wrongful Death Case

The patient was a 270-pound female with extreme dental anxiety. I do not mention her weight as a means of being cruel. It is actually quite relevant to the case. She was given 1.0 mg of Triazolam. This medication is commonly used for dental oral conscious sedation. This is a pill, which the patient is instructed to take at a certain time before their appointment and will be taking affect by the time the patient arrives. When this patient arrived, she showed no signs of there being any issue. She entered without needing assistance and was able to communicate well.

However, once she was given the local anesthetic, something every dental patient is given during a procedure even if they don’t use sedation, things changed. She quickly became unresponsive. She was taken to a hospital where she later died.

The Iowa dental board asserted that the dentist gave the patient double the recommended dose of the sedation medication. The typical recommendation is 0.5 mg and she was given 1.0 mg. They accused the dentist of overdosing the patient. Here is why that is absolutely ridiculous and I’m dumbfounded as to why the board would even suggest it.

In order to establish the safety of a medication, the recommended does isn’t the standard for evaluation. This is because some drugs have a very narrow safety margin and even giving a tiny amount over the recommendation is dangerous, but for other drugs (like
triazolam) there is a HUGE safety margin.

I won’t get too technical, but if you want all the technical details please write again and I will give you all the data. The maximum safe dose of a drug is the LD-50, which is when 50% of the animals in the clinical trial died. Tested on mice, which are extremely small compared to even a normal sized human, the recommended does is no greater than 1,000 mg/kg. When you are talking about a woman who is 270 pounds, which is a little over 120 kg. That would mean she was safe to have up to 120,000 mg of the medication.

Obviously, the dentist didn’t give her anywhere near that. There was no overdose from the dentist. The coroner didn’t give an official cause of death, which is odd. The patient did have a history of drug use, so (and please understand I’m just wondering about this next statement, I have no documentation) I wonder if she’d taken something else along with the medicine her dentist gave her or if given her physical condition combined with the stress it was just too much for her.

Bottom line, dental sedation is very safe. In fact, patients with dental anxiety find that it completely changes their life for the better and they are finally able to get the dental care they need.

This blog is brought to you by Gilbert Dentist Dr. Matt Roper.
Click here to learn how he tries to keep dental care affordable.

Sedation Dentistry

Why Won’t Novocain Make Me Numb?

Hi,

I need a root canal on two front teeth on my lower jaw. Despite an infection and nerve damage, my dentist cannot get these teeth numb enough for a root canal. He did over 5 injections in my gums and even used a numbing paste, but it still wasn’t enough! He didn’t charge me, but I’m tired of living off pain killers. I need this root canal, but can’t unless I get numb. What can I do?

Miranda, from Mexico

 

Hi Miranda,

Your problem sounds like it’s related to dental anxiety. Research has shown that each time the tooth fails to get numb, anxiety increases substantially. Anxiety counteracts novocain; the higher your anxiety, the more difficult it is to numb your mouth.

Unfortunately, your dentist did not understand the correlation between increased anxiety and the need for more novocain. The dentist needs to write you a script for anti-anxiety medication. You will be instructed to take the medication before your appointment, about 30 minutes to an hour before. No matter the medication, you will need someone to take you to and from the appointment.

Another option is to find a sedation dentist that offers nitrous oxide. The difference between taking anti-anxiety medication prior to your appointment or getting nitrous oxide is that nitrous oxide will wear off shortly after the appointment. Gentle dentists offer sedation dentistry, as they understand how anxiety-inducing going to the dentist can be.

If your dentist does not offer sedation dentistry, try to find one, and hopefully under their guidance, you can be numb enough to finally get your root canal.

This blog post is brought to you by Gilbert sedation dentist, Dr. Matthew Roper, of Vista Dorada Dental. Dr. Roper offers both nitrous oxide sedation or a prescription for Triazolam for dental anxiety.

 

Sedation Dentistry

Can You Get Sick from Dental Sedation?

Hi,

I started seeing a gentle dentist for my dental anxiety. Sedation is supposed to calm your nerves, but I’m worried about getting it at my upcoming dentist’s appointment. I’ve heard it causes nausea, and the painkillers you get afterwards can cause drowsiness. Those two side-effects mixed together is a recipe for disaster. I’ve never had any adverse reactions to medications before, but I’m still worried. Is choking on your own vomit a risk after dental sedation? Or am I overthinking this?

Samira, Sterling, Colorado

 

Hi there Samira,

There are different levels of sedation and medication a dentist can provide.

The first is nitrous oxide, Also known as laughing gas. This is the sedation of choice for gentle dentists, because it works fast and wears off quickly afterwards, before you even leave the office. You may experience some nausea afterwards, but not necessarily vomiting. Most procedures using nitrous are relatively short, but the longer you are under sedation, however, the amount of nausea you may experience increases. To reduce this risk, don’t eat before your appointment.

The second is oral conscious sedation (OCS): This method uses nitrous oxide and an oral medication (like a sedative, anti-anxiety medication, or anti-histamine) prescribed by your dentist. The type of medication prescribed will depend on your dentist’s personal preference and which one best suits your needs; for instance, at Dr. Roper’s office, he prescribes Triazolam, a safe method of oral sedation.

It’s also recommended you have someone take you to your appointment and check in with you for a few hours after the appointment. Again, to combat nausea, your dentist will schedule you for a morning appointment, and instruct you to not eat the night before or morning of your appointment. Even with this stronger sedation, no cases of asphyxiation during sleep have occurred, so please do not worry.

In summation, nausea is a common side-effect of sedation, but vomiting is not. Talk to your doctor about your fears, and they should be able to give you advice on how to minimize your experience with side-effects.

This blog post is brought to you by Gilbert sedation dentist, Dr. Matthew Roper.