A DOCS Education member writes:
My patient is 31 years old and taking birth control pills. She has been diagnosed with multiple sclerosis but was approved for treatment by her medical doctor. She requires surgical extraction for teeth numbers 2 and 16. Are there any special precautions I should take for this patient for oral sedation?
Dr. Anthony Feck, Dean of DOCS Education Faculty responds:
Multiple sclerosis is a progressive continuum of deterioration. In this case it appears the patient is in an early stage of the disease. In the latter stages, the respiratory muscles can be affected, which is a significant concern when it comes to the CNS depression that accompanies sedation.
If the patient’s doctor has approved her dental treatment under sedation then I would proceed as normal using the appropriate DOCS Education sedation protocol: dosing low and slow. Birth control pills can inhibit the metabolism of sedation medication, but the interaction is generally mild.
This blog post 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.