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Dee Nishimine, D.D.S., Inc.
Sophia Y. Tseng, D.M.D.
Periodontics & Dental Implants
Call: (559)229-6557

Sedation (or) Sleep Dentistry

Sedation Dentistry

Drs. Dee Nishimine, Dennis Nishimine, and Sophia Y. Tseng have been providing "sedation dentistry" for many years! Drs. Nishimine, Tseng, and our team use IV Sedation, or Moderate/Conscious Sedation, to help you with fear, anxiety, and possible medical issues and will be able to treat you with a very relaxing dental experience.  This may allow you to have your dental care resulting in a beautiful smile.  "Beautiful Smiles Through Periodontics and Dental Implants." 

Your smile and your comfort are our greatest concerns, and we may be able to help you with this. 

Your understanding and your "comfort" are most important in treating you for your periodontal or implant needs.  Many people have anxiety and fear of dentistry.  We can make your experience comfortable and accomplish more in a shorter period of time. 

"sit back, relax, and be comfortable!"

(Testimonial)   "Wonderful. No problem, I was really nervous about the IV.  You hear horror stories, but Dr. Nishimine did awesome!  I could not locate the area where the IV was placed.  Absolutely no bruising!  Was nervous until he gave me the drugs.  It was a calming effect.  Starts from the top of the head and once it got to my waist that's all I remember and look forward to the next procedure.  Thanks so much." (SR 9/10)

Drs. Nishimine & Tseng.  Contact us today!

 Moderate or Conscious  Sedation: is defined as a drug-induced depression of consciousness during which patients respond purposefully to verbal commands, either alone or accomapanied by light tactile stimulation.  No interventions are required to maintain a patent airway, and spontaneous ventilation is adequate. Cardiovascular functions is usually maintained.

Sedation Dentistry: moderate or conscious sedation is provided by Drs. Nishimine & Tseng to help manage Anxiety  and Pain during your dental appointment.  Our concern is your safety and comfort.

Unlike General Anesthesia where a patient is completely unconscious, asleep, and unable to respond,  patients under Conscious Sedation, are able to respond to commands and breath on their own.    If General Anesthesia is needed we work with Dental Anesthesiologist who may provide this for you if needed.

There are many ways that sedation drugs can be administered. There are 3 primary ways that Sedation is administered in our office: 

Sedation Dentistry

1. IV Sedation also known as Moderate or Conscious Sedation is usually used by Periodontist, Oral Surgeons and dentists with specialized training and special certification. With this type of sedation, medications are administered directly into the blood stream. The greatest advantage of IV Sedation is that if someone is not sedated enough, that Dr. Nishimine & Tseng can administer more medication and the effects are almost instantaneous. IV Sedation is not used commonly in most dental offices because of the specialized advanced training required and the requirements for certification by the State Board of Dentistry. The drugs used for IV Sedation are more effective then the same drugs taken orally. There is a more profound amnesia associated with this technique. You will  remember very little about the procedure and time will seem to go by fast!

 2. Enteral Conscious Sedation "Orally Administered Sedation", sometimes called  "Sedation Dentistry" is administered by taking a pill. All body functions remain normal and the person is able to breathe on their own. The patient will often fall asleep. Some degree of amnesia is common. The disadvantage with this method of sedation, is that the level of sedation for each person is not predictable.  We have far greater control and effect with the IV Sedation.  YOU MUST have a driver to and from the office for 1 and 2.

3. Inhalation Conscious Sedation, Nitrous Oxide/Oxygen Sedation also known as "laughing gas". This is the most frequently used sedation method used  in dentistry. All bodily functions remain normal and the person is able to breathe on their own. The patient will often fall asleep and experience some degree of amnesia about what happened during their dental appointment. Nitrous Oxide is very safe and at the end we will flush you out with 100% Oxygen and You DO NOT need a driver for this. 

Sedation Dentistry

IV Sedation

IV (intravenous) Moderate or Conscious Sedation:  We will place medication directly into your blood stream and we can titrate (control) the desired amount very easily and effectively for you.  The IV will be monitored very carefully by the Doctor and staff.  You should have a very profound amnesic effect and should remember very little about the dental procedure.  The time "should fly by"!

Advantages to IV Sedation:

  • Very fast acting
  • Great margin of safety
  • Very positive amnesic effect
  • May be positive for medically compromised patient
  • Awake and ambulatory when you are dismissed

Disadvantages to IV Sedation:

  •  Must have a driver to and from office
  • Not able to work or drive for the rest of day or possibly longer
  • Moderate cost involved.

You will still  be given local anesthetics to control the pain or discomfort associated with your needed dental procedure.

 

Sedation Dentistry

Oral Sedation

Oral Medication used for Oral Conscious Sedation in dentistry are from a group of drugs known as Benzodiazapines. Not only do these medications have a sedative effect they also have some degree of  amnesic effect for most people. Patients remember little or nothing about their dental appointment.

Advantages to Dental Oral Sedation:

  • Easy to administer: Swallow a small pill 
  • It is safe and easy to monitor
  • Works well for most people, it is effective but does not work for all patients.
  • Moderate Cost

Disadvantages of Dental Oral Sedation:

  • The level of Sedation is not easily changed it may not be as effective as we would like it.  We can not titrate it or adjust as needed. 
  • Someone must drive you to and from your dental appointment
  • There is no analgesic (pain relief effect) We will still use local anesthetic agents.

What medications are used for Dental Oral Sedation?

  • The most common medications used are Halcion (triazolam), Ativan (lorazepam). These provides a deep level of relaxation and amnesia effect. 
  • Currently we have a preference for Halcion.

 

Sedation Dentistry

Inhalation Conscious Sedation

Nitrous Oxide and Oxygen ("laughing gas") has been used as the most frequent and primary means of Sedation used in Dentistry for many years. 35% of all US dentists offer Nitrous Oxide Sedation to their patients. 

Advantages or Dental Inhalation Sedation:

  • Works well for mild to moderate anxiety
  • Rapid Onset
  • Flexible duration can be used for any appointment length
  • Absolute Control. It is easy to quickly control the level of sedation which may be altered moment to moment. 
  • People recover quickly
  • Very few side effects
  • There is an analgesic effect
  • You can drive yourself to and from your dental appointment
  • You can return to normal activities immediately
  • Low cost

Disadvantages of Dental Inhalation Sedation:

  • Moderate anxiety may require a deeper level of sedation
  • Not indicated for people who have respiratory problems (Asthma and Emphysema)
  • Claustrophobic patients do not like anything covering their nose
What medications are used for Dental Inhalation Sedation?
  • Nitrous Oxide (N2O)
  • Oxygen (O2) 

The safety features of the machine insure a patient receives no less than 30% Oxygen mixed with Nitrous Oxide. Usually the patient receives 50 to 70% Oxygen.

We will use what is best for you with your comfort and safety in mind.  If General Anesthesia is needed this can be arranged for you. 

If you have any questions about your comfort and sedation needs.   Contact us today!

 

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