Pain? Dental Emergency?!
Master, College of Conscious Sedation American Dental Society of Anesthesiology
Anesthesia for a pleasant escape
Systemic dentistry for a better life
Michael A. Starkey, DDS MS and The Team
When detailed clear vision is required for complex dentistry along with loupes we use throw away head lamps. The advantage over reusable ones is lower risk of contamination. And we use a medication that temporarily reduces the saliva a patient produces. This allows for a clear field and a dry field so fillings and crowns being placed are not contaminated by saliva.
The Medications and the System we use for sedation in our practice
Your safety is our First Priority; we have a dedicated sedation monitoring assistant with 20 years of experience; we use the safest sedation medication with quickest recovery; Dr. Starkey has performed IV sedation since 1985 and has done over 3,000 sedations safely. Doctor is a member of the American Dental Society of Anesthesiology. He is a Master in the College of Conscious Sedation, American Dental Society of Anesthesiology. He is the only general dentist in Nebraska that has attained that level of mastery. We use a computerized pump for smooth induction and even level of sedation. Dr, has been trained in advanced cardiac life support.
ALL of our medications are single use in disposable viles. Therefore there is no risk of any patient contamination
You may know this as the MIchael Jackson drug; I have heard one anesthesiologist say: "If it is good enough for Michael Jackson it is good enough for our patients.:
There are less complications with propofol use than with a mix of narcotics and diazepams.
Further propofol can be titrated more evenly and used with automatic pump for smooth induction.
Dr. Starkey is the only
general dentist in the state of Nebraska and one of the few qualified the nation to use this exceptionally wonderful medication.
I am blessed that I have the opportunity to use it for my patients as the safest and best form of dental anesthesia.
In our practice we use what Dr. Stanley Malamed, DDS, MD Anesthesiologist
refers to as a "Stress Reduction Protocol."
Of course a pertinent pre anesthesia health history and evaluation is taken prior to any anesthesia or treatment procedure.
This works well for patients over the age of 50 because it reduces the physical stress on the cardiovascular system. Also for more elderly patients the IV system maintains a critical line in case of emergency.
The stress reduction protocol involves a patient taking a sedative orally the night before; most often this is Halcion (trade marked); in the morning an hour before visit an oral sedative is taken and then at the office we may have the patient take one or more depending on the anxiety level. It is important to note that it is not necessary nor a good idea for EVERY patient to follow this regimen. It depends on patient.
The next step is to have our patient back to the surgery operatory and obtain vitals review treatment plan and health history.
we next start our patient on relaxing gas and oxygen prior to starting the IV line. This helps relax the patient further. In addition having the nose piece on patient prevents patient from inhaling any tooth dust or particles during treatment procedure.
By having the IV line we can now place any additional medications that might help with patient recovery, healing and pain as well as swelling prevention; the meds in this category:
Zofran (TM) ( Ondansetron generic) for preventing nausea. It along with all the meds listed are more effective when given intravenously.
Glycopyrolate reduces saliva patient has better airway as well as allow the doctor to do procedures without saliva contaminating the surgical area as easily.
Dexamethasone to prevent swelling or at least reduce the severity
Nalbuphine HCl for pain control (non narcotic)
sometimes an antibiotic IV such as Cefazolin
We have several other medications available as needed to help keep patient safe and comfortable
We use no narcotics and no controlled substances in our practice.