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Anesthesia Surgery Center

      Master, College of Conscious Sedation American Dental Society of Anesthesiology           

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The Omaha Dental

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IV Sedation  provides an important level of safety to elder patients. Advanced Sedation Dentistry is of particular benefit to older patients. And not just geriatric dental patients.  Starting around age sixty the body does not handle stress as well. After all God designed us to live to about age 30 originally and fortunately S-He built in redundancy for the future. Like over engineering our liver and giving us two kidneys. But now we are outliving our organs.  Dentistry causes not only mental stress but physiological stress on the body.  The stress experienced in dental surgery does not end with the surgery it is extended into post operative and preoperative time.

Older patients are more susceptible to cardiac stress due to reduced lung function, due to heart muscle fatigue, along with our brain, pancreas, kidneys, and reduced stress reducing hormones- the gluco corticosteroids, our diaphragm resisting proper movement, and other endocrine glands. And of course there is the mental stress on the brain.

IV Sedation reduces cardiac stress, it increases the amount of oxygen the patient needs to avoid an emergency event, we use a small amount of steroid to cover for what the body cannot produce in a timely manner, of course our patients are in a relaxed comfortable state that would be difficult otherwise with some of the infirmities that make patients unable to lay on their back, or their increased gag reflex, we are able to provide IV antibiotics to reduce pill taking and for faster action, we can provide pain me in the IV for post operative comfort. Most importantly for geriatric patients is that we have an IV line already in place in case of any emergency we do not have to try to find 

Special Care for Older Patients.

Older Patients have special problems: their immune system is compromised, organs are compromised, often heart disease, diabetes for example.  As we age our organ function decreases rather dramatically starting around age fifty then it is like falling off a cliff at 80. God, being the great engineer he is built in safety factors for our organs and even our teeth. Our two little kidneys especially reduce their ability to cleanse our bofdykidneysOur medical history and exam takes special care for older patients. Our use of MAC-monitored anesthesia care- constantly evaluates the patient's condition.  IV medications practice make geriatric patients safer along with supplemental Oxygen.  We take extra care in protecting the airway from water droplets and particles that can be inhaled into lungs or go down the patients throat.  Older patients reflexes are reduced so must be protected with screens, nasal hoods, and rubber dams.

Here are the difficulties older patients get into with their teeth; that means their caregivers if and when assisted living begins have a very difficult time helping the elder patients take care of their teeth.

Oral hygiene in such situations take a back chair is secondary to other health conditions the patient might have; besides brushing some one else's teeth; cleaning their dentures.

Trouble shooting the problems of senior dental patients; start with the problems:

#1. Root caries; that is to say decay/cavities on the root surface at the gum line. When caught early they are usually easy to repair but as time goes on the decay becomes a wrap around recurrent decay under the gum line between the teeth. The germs causing the problem love the soft root surface and these creatures act like Beavers of the Northern Plains; eating thru the soft bark of  trees planted by humans.

#2 Gum disease; @79% of the population has some level of gum disease. The problem for we senior citizens is that gum disease problems are cumulative. For some older patients there are areas in their mouth that have advancing gum disease problems. The issue problem that stared in your gums 30 years ago which  your dentist told  you was not any thing to worry about has now become something to worry about:). Once gum disease gets a foot hold in your mouth; imagine that ...a foot in your mouth; the damage cannot be reversed. Gum disease after it has gone beyond simple gingivitis is no longer reversible; the good news is it can be managed by factitious attention to home care and becoming a loyal and frequent patient of your favorite hygienist; you know the rest.. no smoking; healthy diet; taking care of cavities and bad bite.

#3 Stress on the human body increases as we age. That is partly because our body clock winds down. Kidneys and adrenal glands work at half or less of what they did when a patient was 18 years old. There can be cardiac problems; there can be post traumatic issues and surgeries that compromise patient health. For this reason Dr. Starkey recommends a stress reduction protocol for patients over sixty years old. The stress reduction protocol is a way to reduce the negative effects of trauma from dental surgery on the heart and the pituitary adrenal kidney complex.

#4 Dry mouth- Dry mouth if I  did not mention is an important cause of root caries. A dry mouth means your body is not producing enough saliva to protect your gums and teeth. Saliva has white blood cells and immunoglobins to eliminate bacteria.