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Master, College of Conscious Sedation American Dental Society of Anesthesiology
Advanced Systemic Health Care through the Mouth
All your dental treatment needs met in one location
Michael A. Starkey, DDS MS and The Team
Star Sedation Dentistry
Specializing in Total Dentistry
With Advanced Infusion Therapy To Rejuvenate the Mind & Body
Here are some reasons that prove you are NOT being irrational to have dental phobia
Dental treatment can:
- Instill fear
- Inflict pain
- Cause nerve damage
- Cause cardiac problems from stress
- Cause bleeding cause patients to swallow blood.
- Spread bacteria from the mouth to other parts of the body.
- Cause PTSD from previous painful episodes
- Painful shots and injecting painful anesthetics
- Inject potent vaso constrictors that can cause cardiac flutter and stess
- Expose patients to dental materials, cause aerosol of bacteria, tooth particles, dental materials that patient will inhale or swallow.
- Prescribe medications that can result in anaphylactic (severe allergic) reaction; medications that cause complications with the patients current medications.
- Result in worse infections or spread infection from the mouth to other parts of body.
- Cause numbness that results in eye droop loss of feeling; chronic paresthesia pain. Numbness in lip or tongue.
- Nausea
- Change your appearance for good or bad.
- Change the way your teeth function for better or worse
- Claustrophobia- the dental team so close to your face. The rubber dam.
- Jaw problems from having your mouth kept open.
- The psychic cost of dentistry.
Often dental patients experience significant swelling after dental surgery. The result is an un pleasant sight and patients don't want to be seen in public. In addition the swelling results in additional pain for the patient.
With IV Sedation Dr. Starkey uses a medication intravenously to reduce or sometimes actually prevent swelling. Thus the patient feels better and looks better.
Not all our patient needs or want IV sedation but might want other ways such as oral sedation only or Nitrous Oxide or some combination; some patients prefer Hypnosis which I understand works well for some patients. We do NOT offer hypnosis in our practice.
Dr. Starkey provides IV sedation for healthy patients; according to the American Society of Anesthesiology that is ASA I and II.
Patients that have health issues greater than that are referred to Oral Surgery Specialists or Hospital based dentists. That is more expensive and less convenient but patient safety is the number one priority.
Moderate IV Sedation or IV Conscious Sedation has the benefits of general anesthesia but without the risks, without the high costs, without the long recovery time; without being intubated; one obtains the amnesia so has little to no memory of the visit, more importantly the visit seems so short just as in general anesthesia, and the patient breaths on their own the entire time making the procedure much safer than general anesthesia.
There are risks with any anesthesia procedure; most often local anesthetic will be needed; you have to have a ride; we refer you to the informed consent part of our web site so that you understand the risks as well as benefits of IV sedation.
The Benefits of Sweet Dreams Sedation Dentistry
Here are some more risks of going to dentist and white knuckling the drill
- Cardiac Arrest (heart attack) due to stress.
- Hypoglycemia: anxiety, fear, coldness, tachycardia, hypotension
- Syncope -Fainting- loss of color, tachycardia, nausea, hypotension, sweating
- Hyperventilation, rapid shallow breathing, feeling cold, numbness
- Epinephrine reaction: fear, anxiety, tenseness, headache, weakenss, dizzy, perspiration, respiratory difficulty
- Anaphylactic-allergic reaction. It can be mild or severe and life threatening
- Hypertensive crisis-High blood pressure spike
- Local anesthetic over dose: talkative excited patient, anxiety, hypertensive, light headed, dizzy. low heart rate, low respiratory rate, seizures, loss of consciousness
The type of sedation can be customized for each patient, advanced modern sedation reduces stress on the patient, and multiple instruments constantly monitor the patient's state of comfort and health, sedation actually makes safer procedures for patients. Work that could not be done unless in hospital can be done in an outpatient setting at many times less expense to the patient. Most important the patient can experience enjoyable relaxing, mild euphoria instead of the stress of shots and pain.
Type your paragraph here.
No need to shussh our practice is like a library.
A man should not try to eliminate his complexes but get into accord with them; they are legitimately what directs his conduct in the world
Sigmund Freud (Brainy Quotes)
What do you see wrong in this picture?
It is not the drill. It is that the patient doesn't have rubber dam or face and airway protection:)
Some more benefits of the Sweet Dreams Dental Team
- Of course Parenteral Sedation (IV) is great for dental phobia patients. Having dental work done is NOT normal for a human being; it can be difficult and painful and time consuming. I think dentists got use to seeing fearless patients when they were in dental school and have come to conclude that all patients can take it.
- When patient's have low grade anxiety it causes time to slow down for them; with resulting increase in pain and fear and stress and anxiety and inability to make rational decisions. Procedures seem to take too long and are in slow motion. The fears induced by dental anxieties become a self fulfilling prophecy it causes the body to release cortisol; an abrasive steroid that can irritate and damage the body.
- MAC- Which is short for monitored anesthesia care. State of the art monitoring instruments that constantly track patient's sedation status and a dedicated IV sedation monitoring assistant to observe patient and instrument readings so patient is kept safe and comfortable.
- Moderate (parenteral) Sedation has all the benefits of general anesthesia without the risk and the cost and the inconvenience.
- We use a computerized automatic pump for smooth anesthesia induction. This eliminates human error in controlling the rate of med.
- IV induction sedation is superior to oral sedation because the doctor can titrate the amount of sedative medication; the medication our practice uses is short term and results in a more rapid recovery than oral meds; with oral sedation once the meds are on board there is no reversing them out if there is an overdose; the IV system allows us to include other helpful medications (see below); IV anesthesia is closely monitored with appropriate instruments and dedicated IV Monitoring assistant.
- IV sedation reduces the catacholamines that are automatically released into your system even when you are outwardly calm and in control. These Reactive proteins place stress on the cardiac system as well as kidneys and other vital organs.
- With parenteral sedation the patient is able to relax comfortably in a "twilight sleep" through the visit
- The patient can have an extended visit with IV sedation and get more work done; that means less visits and can save patients time and money in that regard.
- An extended visit of say 3 hours feels only like a few moments.
- Patients rarely recall the visit and those stressful things such as the noise of the drill and don’t experience pain from the injections in the mouth.
- Patients over the age of 60 are especially helped with IV sedation because the cardiac system and stress reduction system of the adreno-kidney-pituitary system works at about half of what it pumped out when the patient was 18 years old.
- Patients that are older say in late sixties on benefit by having an IV line that is placed before surgery so that in the event of any medical emergency the doctor can immediately place any needed IV meds.
- Patients with severe gag reflex
- or claustrophobia
- or Meniere's disease
- or who have difficult getting numb
- Busy patients that do not want to make a lot of dental appointments but would rather get more done in one visit.
- Regulating the patients blood pressure and heart rate and breathing rate and oxygen level is paramount. This cannot be done without IV sedation.
- The safety of our patients is always of paramount concern. Our patients are carefully monitored with precordial stethoscope, pulse oximetry, automatic blood pressure readings and expired CO2 graph.
- Dr Starkey uses no narcotics and no diazepam in his sedation system. There are no controlled substances in the office. Instead Dr. Starkey uses Propofol; this is the most widely used drug for anesthesia in the world and propofol is the safest anesthetic in use today.
- We have on hand and have been trained in the case of emergency care.
- The State of Nebraska does periodic inspection and permitting of our practice to make sure it conforms to the requirements of a safe and effective out patient sedation practice. (Ne license 004)
- Post operative recovery with Propofol is relatively quick and does not give the hang over that patients experience from narcotics and diazepams.
- Our IV sedation technique takes advantage of using a drying agent in the system so that the doctor has a clear dry field in which to work. That means he can see better and it means saliva and bacteria in the saliva are less likely to contaminate the surgery zone.
- Dr. Starkey also uses steroid medication in the IV to reduce post surgery swelling and make post operative recovery less painful and for the patient to not f
Not all our patient needs or want IV sedation but might benefit from other methods such as oral sedation only or Nitrous Oxide & O2 (laughing gas), in some instances oxygen alone may be of benefit to the cardiovascular system and the nasal hood will protect nasal airway from inhaling debris or water mist from drill, or perhaps there is some combination other combination; some patients prefer Hypnosis which I understand works well for some patients. We do NOT offer hypnosis in our practice.
However breathing exercises alone can help make a dental visit more tolerable for some patients.
Here is an interesting Youtube video on how to improve your mental state with a particular breathing exercise:
https://www.youtube.com/watch?v=PZP51FtBP0M
Dr. Starkey provides IV sedation for healthy patients; according to the American Society of Anesthesiology that is ASA I and II.
Patients that have health issues greater than that are referred to Oral Surgery Specialists or Hospital based dentists. That is more expensive and less convenient but patient safety is the number one priority.
Moderate IV Sedation or IV Conscious Sedation has the benefits of general anesthesia but without the risks, without the high costs, without the long recovery time; without being intubated; one obtains the amnesia so has little to no memory of the visit, more importantly the visit seems so short just as in general anesthesia, and the patient breaths on their own the entire time making the procedure much safer than general anesthesia.
There are risks with any anesthesia procedure; most often local anesthetic will be needed; you have to have a ride; we refer you to the informed consent part of our web site so that you understand the risks as well as benefits of IV sedation.
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The benefits using the Starkey Dream Dentistry Sedation Team:
- Safety is number One. Dr. Starkey has treated patients with IV sedation since 1985 and has provided IV sedation safely to over 3,000 patients.
- Affordability. The Dental Dream Team provides excellent sedation for the lowest price in the Omaha area. It is several hundred dollars less than a Nurse Anesthetist and thousands less than IV sedation in outpatient hospital by anesthesiologist.
- High degree of success using today's modern anesthesia medications such as propofol. The Dream Team utilizes a computerized infusion pump which optimizes patient's enjoyment of the visit and makes patients anesthesia not only relaxing but smooth and even sedation with rapid recovery.
- The Total Sleep Dentistry Office is set up to provide anesthesia/ sedation routinely. It is the focus of the practice. It is streamlined to provide safe effective anesthesia as a matter of routine. It is similar in that way to outpatient surgery center.
- Quiet. Our office is quiet right down to the dental drill. Instead of the old noisy screechy compressed air high speed drills that have such a high pitch that rings the dental teams ears and stresses the patients the Dream Team uses the new state of art electric drills that are now able to cut as well as the old drills. In addition we treat only one patient at a time for patient safety and to maintain a calm atmosphere and get more done for the patient.
- The patient's airway is protected & debris & contaminated water droplets prevented from being inhaled through both a nasal hood and a screen over the face as well as rubber dam
- Bite blocks are annoying but they protect patients Jaw Joint. & with sedation the patient is not bothered by this important device.
- Dr. Starkey routinely provides medication (Zofran) that prevents nausea during and after the procedure. When patients swallow blood and takes pain meds later nausea usually results. By providing anti nausea drug in IV this problem is greatly reduced.
- Dr. Starkey can provide antibiotics in the IV if they are warranted.
- Swelling is a problem post operatively with implants, dental extractions, and other invasive treatments. We provide a steroid in the IV that limits and sometimes prevents swelling post operatively.
- Dr. can inject pain medication in IV line so patient can have pain control during and after the appointment. He uses a non narcotic drug so there is not the addictive properties of narcotics.
- Dr. Starkey uses the sedation medication that is the most used world wide. That is because it is safer than standard narcotic versed mix and prevents nausea, and the medication only works when it is being supplied in IV line. The affects of this medication (propofol) immediately start to dissipate as soon as the medication is turned off.
- The medication he uses allows for rapid recovery for the patient. So patient does not feel tired and drugged out all day.
- Dr. Starkey provides IV lines and supplemental oxygen for his older patients. This keeps patient hydrated, reduces stress on the heart, and allows for quick application of emergency drugs if they should be needed.
- IV Sedation in our practice actually makes dental procedures safer for the patient.
- Providing patient with supplemental oxygen takes stress off the cardiovascular system and protects the airway so the patient does not breath in particles from the drill or inhale aeresol particles that contain irritating debris.
- The office is intentionally kept cool for suppressing microbial creatures but we keep the patient comfortable with a nice warm hospital blanket from our blanket warmer.
- The sedation we use is customized for your needs. You can even have general anesthesia in our office by a trained nurse anesthetist under certain conditions.
Is it time for you to be brave at your next dental treatment?
Not if you don't have to; you can be fearless about something else. Make dentistry easy on your self and your wallet with Advanced Sedation Dentistry