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190 Cranbourne Rd, Frankston VIC 3199

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Sedation Dentistry

Who We Are And What We Do
Sedation Dentistry at Peninsula Dental Frankston Vic

Millions of Australians avoid going to the dentist.

There is even a group of patients at Peninsula Dental who, before their first visit with us, were afraid, anxious and nervous to visit the dentist. For these types of patients we are happy to offer sedation dentistry to help them attend their appointments with the greatest ease.

We do what it takes to make sure the right sedation dentistry is used for our patients no matter how big or small the dental problem is.

We take the time to listen and understand our patients’ anxiety issues and help them build confidence and trust. This in itself is the most important part of overcoming dental phobias.

The rest is easy and can easily be achieved through the use of local anaesthetics, oral sedatives, nitrous oxide, twilight sedation or a combination of any of the above by our specially trained dental team at Peninsula Dental .

Pain Free

This makes our patients experience relatively pain free treatments each and every time they visit us.

Our sedation/sleep dentistry services are ideal for patients who….

  • Fear going to the dentist and are experiencing complex problems
  • Dislike the dentist due to bad past experiences
  • Have had a recent bad experience at the dentist
  • Have difficulty achieving the desired effects of local anaesthetic even with multiple injections and /or have gag reflex
  • Have sensitive teeth during routine cleans
  • Want the majority dental work done in a short time.
  • Hate injections/needles, noises, smells, and taste associated with dental care
  • Are afraid or embarrassed about their teeth

What form of sedation dentistry is right for you?

Whatever concern or phobia that is holding you back from sorting out your dental problems; please do give us call to discuss your options. Better still come see us and we will not only lend a listening ear but an empathetic hand as well.

Since no single method is best for every patient, a thorough consultation at Peninsula Dental with Dr Pavan Mittapalli or one of our other experienced dentists will help relieve your nervousness.

We at Peninsula Dental take sedation dentistry very seriously and consider our patients’ safety our top priority. We are here to make a true difference to the practice of dentistry and we will do what it takes to make our patients feel comfortable and at ease.

For the convenience of our patients, We now offer treatment under General Anaesthesia for nervous and anxious patients. For more information talk to our dentists at Peninsula Dental.

Nitrous Oxide Sedation Dentistry

Nitrous Oxide or laughing gas

As it is often called is actually a combination of nitrous oxide and oxygen delivered through safe Porter System to achieve a mild form of analgesia and sedation.

A nosepiece is normally used to deliver this sedative. Dr Pavan Mittapalli often uses this form of sedation for children over 6 years of age and adults who have mild anxiety issues and can tolerate a mask over their nose. As this form of anaesthesia depends on the patient’s ability to breathe comfortably through the nose, any form of respiratory disorder can make this a difficult option for sedation dentistry.

Best for...

Patients who dislike needles as it provides a bit of altered consciousness and reduces mild anti anxiety.

It can be used safely for most patients except for ones with terminal disease, respiratory obstruction, severe cold or hay fever.

How Is Nitrous Oxide Administered?

The equipment used for delivering “happy gas” is quite simple. It consists of a supply of compressed gases and an apparatus which delivers the gases to the client. By turning some knobs and flipping on/off switches, the administrator can produce the desired mix of N2O-O2 in the desired quantities.

Flowmeters and pressure gauges allow the administrator to keep an eye on the flow of gases. The desired N2O-O2 mix is fed through a tube to which a nasal hood or cannula is attached. This hood is put over your nose.

All you have to do now is breathe normally through your nose – bingo! In modern machines there is a sort of double mask where the outside mask is connected to a vacuum machine to suck away the waste gas – you wouldn’t want your dentist to get a face full of N2O… The white inside mask, which is placed over your nose, comes in lots of yummy scents – such as vanilla, strawberry, and mint! The twin tubes running to the mask are for “gas in” and “gas out”.

The “gas out” line is attached to the vacuum machine, while the “gas in” line is attached to the RA (short for relative analgesia) machine. The inner mask is attached to the “line in”, you breathe out through a one-way valve in the inner mask, and the exhaust gas is collected inside the outer grey mask (pictured to your right) and sucked into the vacuum machine.

What Are the Advantages of Nitrous Oxide?

Nitrous oxide works very rapidly – it reaches the brain within 20 seconds, and relaxation and pain-killing properties develop after 2 or 3 minutes.

The depth of sedation can be altered from moment to moment, allowing the person who administers the gas to increase or decrease the depth of sedation. Other sedation techniques don’t allow for this.

For example, with IV sedation, it’s easy to deepen the level of sedation, but difficult to lessen it. Whereas with laughing gas, the effects are almost instant.

Other sedation techniques have a fixed duration of action (because the effects of pills or intravenous drugs last for a specific time span), whereas gas can be given for the exact time span it’s needed for.

It can also be switched off when not needed and then switched on again (though to avoid a roller-coaster effect, you shouldn’t do this too abruptly).

There's No ``Hangover`` Effect

The gas is eliminated from the body within 3 to 5 minutes after the gas supply is stopped. You can safely drive home and don’t need an escort.

With nitrous oxide, it’s easy to give incremental doses until the desired action is obtained (this is called “titration”). So the administrator has virtually absolute control over the action of the drug, preventing the possibility of accidental overdoses.

While giving incremental doses is possible with IV sedation, it’s not possible with oral sedation (as a result, oral sedation can be a bit of a hit-and-miss affair).

For Certain Procedures

Those involving gums rather than teeth (e. g. deep cleaning) – it may be possible to use nitrous instead of local anaesthesia. N2O acts as a painkiller on soft tissues such as gums.

However, its pain-relieving effects vary a lot from person to person and can’t be relied upon. No injection is required. In cases of very severe needle phobia, getting laughing gas first can help you feel relaxed enough to allow the needle required for IV sedation to be inserted in your arm or hand. The very deep state of sedation achievable through IV sedation will then allow you to accept local anaesthetic.

Inhalation sedation is very safe. It has very few side effects and the drugs used have no ill effects on the heart, lungs, liver, kidneys, or brain. Inhalation sedation has been found to be very effective in eliminating or at least minimizing severe gagging.

Frequently Asked Questions

Are There Any Disadvantages?

Some people are not comfortable with the effects of laughing gas (either because they’re afraid they might lose control or because it makes them feel nauseous – this is quite rare, though, and usually due to oversedation).

If you’re prone to nausea, it’s a good idea to have a meal (not a huge one) about 4 hours before your appointment. If that’s not possible (e. g. an early morning appointment), make sure your stomach isn’t completely empty – but don’t stuff yourself straight beforehand either.

According to Gordon, who’s a bit of an expert in the field, the normal working concentration of gases is about 70% oxygen to 30% nitrous oxide: “It’s rare to go beyond that because that’s what brings on the nausea, more than 45% N2O and you’re going to have the patient puke on you :grin:”. Some people will not achieve adequate sedation with permissible levels of oxygen.

If you can’t breathe through your nose (either because you’re a pure mouth breather, or because your nose is blocked), or you feel too claustrophobic when something is put over your nose, it can’t be used. Depending on where you live, a dentist who offers nitrous oxide may be hard to come by.

Apart from that, most of the disadvantages of inhalation sedation don’t affect you, but the dental team: there’s training required, the equipment is quite bulky and takes up a lot of space, and there is a possibility that dental staff who are chronically exposed to nitrous oxide might develop health problems.

The cost of the equipment and gases is high, so you’ll have to contribute to the cost – but it’s quite a bit cheaper than IV sedation.

What About Bad Experiences With Laughing Gas?

On rare occasions, people have reported a bad experience with nitrous oxide. Usually this is due to oversedation – getting too much N2O in the mix.

This is easily reversible by reducing the amount of N2O. For example, a few people have reported auditory and “physical” hallucinations, dizziness, or vertigo. Don’t panic if you should experience this.

While these symptoms are usually due to the N2O concentration being too high for you, the machines used nowadays have built-in safety features preventing an accidental overdose. Nonetheless, these sensations can be unpleasant – let your dentist know asap about any unpleasant sensations or symptoms so that they can adjust the percentage of N2O.

Laughing, becoming giddy, crying, or uncoordinated movements are other signs that the NO2 concentration is too high, but these will easily be spotted by your dentist. Alternatively, just rip the mask off your nose!

Don’t confuse “dizziness” with the normal feeling of lightheadedness which many people who’ve never had N2O before experience after maybe 60 or 90 seconds. The feeling of lightheadedness will pass as the concentration of N2O is increased. Some experts in this field (e. g. Stanley Malamed) argue that nitrous oxide should always be “titrated”. This means gradually increasing the percentage of nitrous oxide in the N2O – O2 mix until a comfortable level is reached.

The reason why titration should ideally be used every single time is because of potential adverse effects in the event of oversedation (including flashbacks of traumatic past events, as well as physical ill-effects). However, other experts (e.g. Fred Quarnstrom) say that it’s ok to use a mix based on prior experience (a concentration which a particular patient has experienced as pleasant during previous appointments).

Quite a lot of dentists do this because it’s quicker. The problem with this approach is that tolerance can vary from visit to visit, depending on both psychological and physiological factors. What is experienced as pleasant varies from person to person and from day to day.

And once a person has been oversedated, they may come to dislike nitrous oxide so much that they don’t want to try it again.

Are There Any Contraindications?

There aren’t any major contraindications to relative analgesia, except for M.S., emphysema and some exotic chest problems.

It hasn’t been proven to be safe during the first trimester of pregnancy, so you can’t use it then. Because you have to breathe it in through your nose, it’s not suitable for people who have a cold or some other condition which prevents them from breathing through their nose.

You can’t be allergic to N2O. It’s also safe to use if you suffer from epilepsy, liver disease, heart disease, diabetes, or cerebrovascular disease. It is also used quite successfully in many people with respiratory disease – but it depends on the exact nature of the disease, so check with your dentist!

How do I know if it’s for me?

Why not ask if you can have a 5 minute ‘sample’ so that you know what to expect on the day of your procedure.

Anti Anxiety Medication/Penthrox

Anti Anxiety Medication Penthrox is often referred to as the “green stick” and is also used also by ambulance officers to provide immediate anti anxiety and analgesic effect in case of emergencies and accidents.

It is used in the dental setting for similar benefits.

The drug used here is called 0.5% Methoxyfluorane and is delivered as inhalation through the specially designed green device. It is quite safe to use, even in pregnancy and young adults alike, as it is a single use, one-off medication and is quickly eliminated from the body within a few minutes after use.

Best for… Patients with mild anxiety benefit from use of Penthrox as it is easy to use, non-threatening and patients are in control with the device in their hand and can moderate how much they need to use.

It lasts for about 10 to 45 minutes and patients can drive home straight after. Minimal cost compared to the above-mentioned options.