A DOCS Education Member seeks the faculty’s advice: I have a long-standing patient that now has severe positional vertigo. She will not let me lower the back of the chair from the 90 degree seated position. She has no dental fear, and has always tolerated her dental work without local anesthetics. She reports that she sleeps at home in a seated position. Are there any sedation medications that have been successful to use with patients like this? My body can no longer tolerate treating her in an upright position.

Dr. Anthony Feck, DOCS Education faculty, responds:

Sedation medications may help with vertigo, but there are no guarantees. In all of the cases I have treated, as the patient became more sedated, we were able to lean them back further. Depending on the degree of vertigo, deeper levels of sedation may be required that are beyond the limits of oral conscious sedation. If you do not provide IV sedation, then you can always perform a test sedation appointment, and if you find that titration to a deeper level of sedation with an IV is necessary, you can refer the patient. The DOCS Education member responds: Even if these patients can tolerate the procedure with sedation, do they have an episode of vertigo later?

Dr. Jerome Wellbrock, DOCS Education faculty, adds:

I have treated many patients who suffer from vertigo over the years and there seems to be a high frequency of these patients lately. The one constant is there seems to be no predictability of success.

Disclaimer

The information contained in this, or any case study post in Incisor should never be considered a proper replacement for necessary training and/or education regarding adult oral conscious sedation. Regulations regarding sedation vary by state. This is an educational and informational piece. DOCS Education accepts no liability whatsoever for any damages resulting from any direct or indirect recipient's use of or failure to use any of the information contained herein. DOCS Education would be happy to answer any questions or concerns mailed to us at 106 Lenora Street, Seattle, WA 98121. Please print a copy of this posting and include it with your question or request.

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The information contained in this, or any case study post in Incisor, should never be considered a proper replacement for necessary training and/or education regarding adult oral conscious sedation. Regulations regarding sedation vary by state. This is an educational and informational piece. DOCS Education accepts no liability whatsoever for any damages resulting from any direct or indirect recipient's use of or failure to use any of the information contained herein. DOCS Education would be happy to answer any questions or concerns mailed to us at 3250 Airport Way S, Suite 701 | Seattle, WA 98134. Please print a copy of this posting and include it with your question or request.
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