What is the correct dose when receiving sedation?
22nd July 2011

I hope you can give me some advice and your opinion? I have been struggling with dental phobia - but I had to go to the dentist 3 weeks ago due to a root infection with facial swelling. I agreed to undergo the extraction under IV sedation which was done last Friday. I don't feel it went well! I don't believe I was sedated - he seemed to struggle to get the drug in. He asked me if I had trouble giving blood as he couldn't find a vein - (I have had a vein go into spasm before when I gave blood) It felt like it took him around 5 minutes to do the IV injection and afterwards I noticed I had two puncture holes on my arm. I was fully aware throughout the whole procedure - I can describe everything that happened including the sensation of my gum being cut either side of the tooth - the sensation of my tooth cracking! The nurse checking my BP! When I left the dentist I only felt slightly dizzy. Could it be that I am not affected by the drug or I believe I only had a small dose, nowhere near enough to sedate me. Previously he has done a local anaesthetic that has made my throat numb and my mouth was unaffected - this has happened twice although I don't feel like he believes me. I am reluctant to ask him about the IV Sedation as I don't feel he will be honest with me but it will affect how I have any future work done. I know it has worked for others from speaking to some of my colleagues!

A. Hello , Im sorry your experience was not as good as you hoped . the two puncture marks may have been due to the difficulty getting IV Access . If the drug was just a single one called midazolam , then it has to be given slowly and matched to how the patient is responding . There are some patients who are not sedated deeply enough with Midazolam only , or to get deep enough sedation would need a dangerous dose of the drug . Every person responds differently to sedative drugs , some being sedated with a very small dose , others as with yourself finding you still are too aware for your comfort . Dont be afaid of describing your experience because as you rightly say your future treatment choices may be affected by this , every dentist who gives sedation comes across this occasionally .. I have a very experienced dental anaesthetist for my patients , who gives a cocktail of two or three drugs Almost all people remember nothing about the procedure , even though still safely consciously sedated . However I have had the occasional person who even at that level has not been comfortable , and Ive referred to hospital for a full general anaesthetic . .

Dental Phobia

Dr Jennifer Pinder

Bupa Dental Centre 77 Cornhill, London, EC3V 3QQ

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