Tens of thousands of general dentists throughout the United States have been specially trained to implement conscious sedation, be it with nitrous oxide, oral sedatives, or intravenously. As a result, millions of patients – especially those with dental fears and anxiety – have had a safe, comfortable experience while improving their oral health.
If you’ve been curious about adding IV sedation to your dental practice but have difficulty finding accurate information about how to go about meeting board regulations or simply have some confusion about what providing intravenous sedation would entail, this article is for you. We’ve taken five of the most common myths and broken down some of the misgivings and misconceptions about IV sedation:
1. “Adding IV Sedation to a Dental Practice is an Expensive Proposition.”
Because of the extensive hours of both didactic and clinical sedation training required to receive IV certification, the programs are not cheap. However, the return on your investment can be as profound as the difference it will make in your patients' lives.
IV sedation takes effect more quickly than other forms and as a result, a patient is more relaxed and experiences less pain, allowing the procedure to go quickly. It can also decrease the number of visits which is time efficient for them and your practice. IV sedation can elevate your productivity as well as your profile as a healthcare provider in the community.
Using IV conscious sedation enables general dentists to administer the exact level of sedation needed, perform longer procedures, accomplish more dentistry efficiently, and provide treatment to the large number of people who have avoided dental care for years because they fear the pain and potential trauma of significant dental work.
Some training providers offer payment plans allowing you to spread the cost out over several months, so the program is affordable for working dentists. Concerns about an increase in malpractice insurance premiums for IV sedation providers are generally unwarranted, but you’ll want to contact your carrier for the specifics of your practice and situation.
2. “It’s Too Hard to Get Certified or Permitted to Provide IV Sedation.
Dental regulations in general, and sedation requirements in particular, can be a lot to navigate – and some states are more difficult than others. That’s why a good training program should provide full support from start to permit, including a full-time regulatory counsel. Click here for more answers about IV sedation regulations.
An experienced education team should prepare your permit application upon your successful completion of the program and assist in preparing your office for inspections for a smoother transition.
While a few state dental boards still require a dental residency, most U.S. state dental boards have a pathway to IV sedation permits for general dentists already in active practice. The ADA Guidelines recommend a program of 60 hours of didactic study and 20 live patients in a clinical setting.*
3. “IV Sedation Carries Too Much Risk.”
As with any sedation modality, it’s all about training and compliance. In order to receive a sedation certification or permit by the state dental board to administer sedatives parenterally (IV) in a dental setting, there are many hours of didactic and clinical hours required.
Additionally, dentists are required to prepare for potential emergencies and receive American Heart Association Advanced Cardiac Life Support certification (ACLS) to mitigate the risk. ACLS trains you to manage a patient’s airway, prepares you to handle the most common medical emergencies that might arise in sedating patients, and most importantly, teaches you how to sedate patients safely.
Treating live patients with expert supervision as part of your training increases the knowledge and confidence level of the dentist before they ever introduce IV sedation into their practice.
A critical safety factor of IV administration is in patient assessment and case selection. There are some patients who aren’t good candidates and would benefit from deep or general anesthesia in a hospital setting, but they are the exception not the rule.
4. “All IV Sedation Should Be Administered in a Hospital.”
IV sedation dentistry in the dental office setting by a general dentist is typically moderate sedation, not deep sedation or general anesthesia. The patient is not unconscious and is still able to respond to commands.
The versatility of the medications administered allows dentists to adjust sedation levels according to the individual patient’s needs, as well as the permit level of the dentist. A well-trained dentist and team make it more convenient and cost-efficient for people to receive this level of sedation in the dental chair.
There are some patients who may be evaluated as higher risk during assessment, such as some children or patients with certain comorbidities, and a certified nurse anesthesiologist (CRNA) or MD may be enlisted to administer deeper sedation in the dental office. Good patient communication and a full medical history can determine circumstances that would merit deep sedation and/or the presence of a CRNA or MD as well as cases that should be performed in a hospital setting.
Further, there simply is not enough hospital and surgery center space available to perform all IV sedation dental procedures. If IV sedation were restricted to hospital settings, many patients would be forced to go without the dental care that they need.
5. “IV Sedation is Only Good for Oral Surgery.”
There was a time when oral surgery, and especially the removal of wisdom teeth, was the only reason to implement moderate or deep sedation for treatment in the office. However, with advances in sedation training and sedative medications, IV sedation has proven to be appropriate for a wide variety of patients.
People who have severe anxiety, special needs patients who lack control of their movements, or those who haven’t had success with mild sedatives, have all benefited from IV sedation. Although they maintain a level of awareness throughout the procedure, many patients don’t remember their time under IV sedation which further decreases their fear.
The decision to add IV sedation to your practice is a personal, practical, and financial one. We hope some of your concerns or misapprehensions have been addressed in this article. With approximately 93 million Americans experiencing some degree of dental fear, sedation dentistry can be life-changing.
If you’d like to gain a deeper understanding of the benefits of IV sedation and learn if it would align with your practice, Dr. Anthony Feck provides answers in this special $5 DOCS Education course. You can also schedule a short 30-minute call with DOCS Education’s Clinical Program Manager, Lindsay Olsen, by clicking here.
Don't wait - we have a very limited number of seats for each IV Sedation Certification clinical session and they fill up quickly.
*DOCS Education, in affiliation with Idaho State University and Meharry Medical College, offers such a program you can complete without taking significant time from your current active practice.