Print & Go GuidanceBy Sharon Boyd, MA, RDH
When sedation is involved, extra attention is usually needed during the first 24 hours, so it’s essential for caregivers to be adequately informed of the resources necessary to make this process as smooth as possible. Here are some important tips to provide anyone accompanying your senior sedation patients to/from their scheduled procedure(s):
1. Stay with them for the first 24 hours
During the first 24 hours after receiving sedation medication, senior sedation patients should not drive or be left unattended. It should be the caregiver's responsibility to set up a comfortable space where they can easily rest with their head elevated and avoid strenuous activity (such as walking up or down stairs.) Since the medication can leave patients drowsy for several hours, remind caregivers to assist them when walking to and from the car after their appointment, into the house, or when they need to move rooms.
2. Fill all prescriptions and make sure they’re taken as directed, including over-the-counter drugs
At-home medications and prescriptions help keep patients comfortable, improve recovery, and reduce the risk of post-operative infections. Caregivers should ensure all antibiotics are taken in full, as directed, regardless of how the patient feels after the procedure. In most cases, over-the-counter pain relievers such as Tylenol and Advil are more than adequate for pain management when they're alternated as directed. However, prescription narcotics may also be needed depending on the complexity of the procedure; if so, these medications should be taken with food and only as directed. Inform caregivers that failing to take narcotic drugs with food could result in an upset stomach or nausea.
3. Manage swelling with a cold compress
Swelling is one of the most common causes of post-operative discomfort. To help manage inflammation, caregivers should apply a cold compress for 10-20 minutes at a time, alternating sites as needed. Reusable frozen gel packs are usually provided. Since the area may still be numb, caregivers should not leave the compress on longer than recommended.
After three days, warm compresses can also be used. Swelling typically peaks around day three.
4. Avoid caffeine, nicotine, and alcohol
Due to interactions with sedative medications and complications associated with dental surgeries, seniors should not consume any caffeinated beverages (including coffee or soda) or use products that contain nicotine, including but not limited to vaping pens and smokeless tobacco. These products can interfere with healing and significantly delay the recovery process.
5. Adjust their oral hygiene routine for the first few days
Depending on the type of procedure completed, oral hygiene and home care may significantly differ from what the patient is typically used to.
Ask caregivers to ensure the patient avoids rinsing their mouth for at least 24 hours, as vigorous swishing can disrupt blood clots or cause increased pressure and bleeding in their mouth. If a warm saltwater or prescription mouth rinse is prescribed, lightly swish the liquid around the surgical site and allow it to fall out of the mouth without spitting. The patient can continue brushing and flossing daily to avoid irritating any surgical sites with their toothbrush for at least the first few days.
6. Help them manage bleeding appropriately
It’s common for patients to experience minor bleeding immediately after dental surgery. Suggest caregivers apply sterile gauze to the area with firm pressure by having them bite down on it, and leave the gauze in place until it’s saturated, then replace it with a clean piece of gauze. If bleeding persists for several hours, caregivers can consider soaking the gauze in tea or have them bite down on a tea bag, as it will help with blood clotting. If bleeding worsens or persists, caregivers should call the patient's dental office.
Additionally, avoiding exercise or strenuous activity for at least three days is important, as this can increase blood pressure and the risk of bleeding in post-procedure dental patients.
7. Keep them fed and hydrated
Patients should only eat soft-textured foods cut up into smaller pieces for the first several days. It’s important that caregivers help them to avoid eating any sticky or crunchy textures, as these may disrupt surgical sites or pull off temporary restorations. Appropriate options include things like mashed potatoes, yogurt, and cottage cheese.
It’s imperative that any narcotics or prescription pain relievers be taken with food. If they are taken on an empty stomach, patients will likely experience nausea and vomiting symptoms. Caregivers should be advised to keep plenty of liquids on hand, such as sugar-free sports drinks, meal replacement or protein shakes, and water. Also, they should ensure patients avoid using straws for the first several days, as they may increase pressure in the mouth and contribute to complications such as dry sockets after dental extractions.
8. Know when to call their dental provider
If the patient exhibits a fever, cannot eat within 48 hours, or experiences prolonged bleeding after 3-4 hours of applying pressure to the site, caregivers are advised to call the patient's dental office immediately. Additionally, let the patient's provider know if any potential medical reactions—such as a rash, blurred vision, or increased heart rate—are noted. If symptoms are severe or life-threatening, caregivers must call 911 and take the patient to the nearest hospital emergency room.
Caregivers need to be adequately educated on how to best plan for the recovery of senior dental sedation patients in advance of the procedure. In addition, proper communication between the patient and their caregiver is essential to a successful and healthy recovery. Before taking a senior dental sedation patient home, caregivers should be familiar with the latest protocols and guidelines followed by the dental practice where the sedation procedure was performed. It is also important that your dental team is trained to recognize potential caregiver questions and concerns and be available to provide prompt responses.
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Author: Sharon Boyd, MA, RDH, has over 20 years of experience in the dental industry and is the founder of DentaSpeak, LLC. In addition to being a registered hygienist, she serves as a full-time patient education professional with a special interest in strategic dental communications. She often works as a liaison between practitioners and patients, bridging the gap between care needs and patient concerns. Sharon is an Ironman band mom and enjoys volunteering at her family's church.