This innovative technique is the solution for people in Malaga who become anxious about visiting the dentist. It consists of administering a relaxant so the patient is calm and relaxed, but is in an optimum state of consciousness at all times. This means the patients are able to cooperate fully with their odontologist, because they are not asleep. We talked to Francisco Maldonado Chinchurreta, the clinical coordinator of Grupo Dental Clinics, a pioneer in the use of this system as an adjunct to other odontological treatments.
How did the idea of using this type of anaesthesia come about?
Well, firstly I should say that conscious sedation is not really a form of anaesthesia. It is a form of sedation which provides a sense of wellbeing, but we also have to administer the local anaesthetic which we normally use in dental treatment. Some patients are reluctant to go to the dentist because they are afraid it will be painful, or simply because they feel anxious about anybody touching their mouth with surgical equipment. This type of sedation is perfect in cases like those, for two reasons: firstly, we are using an analgesic with which the patient will enter into a state of complete relaxation, and their initial anxiety will disappear completely. And secondly, it means that patients can respond to our instructions perfectly well throughout the dental procedure, so it can be carried out effectively.
How is the sedation carried out? Does it take long for the analgesic effect to wear off?
No, and that is a great advantage. The effects disappear completely with 15 to 30 minutes after the procedure (depending on the time the patient is sedated), so that we can administer it for simple procedures and afterwards the patient can carry on with their planned activities for the day as usual. Obviously, before beginning the treatment, we tell the patients what it consists of and we answer any questions they may have. Once the patient is in the dental surgery we monitor them completely to control the analgesia. We apply the intravenous sedation, and then give them the normal odontological local anaesthetic. From that moment, the patient is not even aware of the anaesthetic process prior to their treatment.
What does the patient feel during the treatment?
They are in a state of total relaxation. Nobody loses consciousness for a single moment with this sedation. It is not a general anaesthetic. The patient is aware of everything that is going on around them; they just feel drowsier than normal and in many cases they think that the duration of their dental treatment is much shorter than it really is. Even so, none of their vital functions are altered, so they can follow our instructions without feeling any anxiety whatsoever. What we want to do is to eliminate people’s phobia about the dentist’s chair. That fear is the reason a large part of the world population fails to look after their teeth properly.
What type of patients tend to use conscious sedation, and for what type of treatments?
As I said before, they are principally nervous people, they are afraid or they have simply had bad experiences in the past and want everything to be over very quickly. However, we do also have patients who need prolonged treatments, and they may prefer them all to be done at the same time even if it takes several hours. In the case of multiple implants, one of our best-known treatments, and one in which we specialise, conscious sedation can be a great help for those types of patient. Our experience with hundreds and hundreds of patients in this field tells us that people want to reconstruct their teeth in a single session if possible, and that can be a major procedure. Another ideal profile is a patient who needs more aggressive surgery to treat the problem they are suffering from. Conscious sedation also helps us with people who, for different reasons, such as mental disability for example, find it difficult to cooperate when they have to keep their mouth open for a long time.
Speaking of more complex cases, can children be given this type of sedation?
With children, the procedure is completely different. Depending on their weight and medical history, we prepare a medical cocktail with their favourite drink, and they need to drink it all up. Children are a special group, though, so we prefer not to generalise and to study each case individually.
Are there any side effects or contraindications to conscious sedation?
No, this sedation does not cause any important haemodynamic changes in the body, nor does it interfere with normal medication. If a patient has any type of chronic illness, they should still take their medication, even on the day of their treatment. Even so, in the end, it is the criteria of our professionals and the patient’s clinical history which determine whether conscious sedation is contraindicated or should not be used.