Dental procedures under sedation are becoming more common, especially in pediatric dentistry. Of course, patients have some questions about the safety of the sedation procedure. Our chief anesthesiologist Mykola Demianiuk answers these questions:
Sedation procedure in our clinic is performed according to the modern science and meets international standards. The risk of infection during manipulation is leveled by the fact that we adhere to strict infection control. Each breathing circuit is sterile and used in combination with a respiratory filter that protects the tracheo-bronchial tree from infection and condensation; O2 concentration in the air is maintained in the range of 21-40%. The clinic has modern sterilization room, all consumables also undergo standard disinfection, which allows us to guarantee sterility and provide high-quality service.
Our team has an individual approach to each patient, depending on their health status and planned procedures. The anesthesiologist has all the necessary equipment for respiratory protection (laryngeal masks, endotracheal tubes), as well as nasal cannulas, facial masks, modern types of ventilation modes (PCV, VCV, Pressure Support, SIMV) with gas monotoring (capnography), determination of sevoflurane concentration, control of the MAC, which makes it impossible to overdose inhaled anesthetics. We perform full monitoring of the patient, which includes BIS monitoring (determination of depth of sedation), electrocardio monitoring, measurement of blood pressure, pulse oximetry and blood saturation, and body temperature.
And now I’d like to tell you about the novelty product we have - the Mindray WATO EX-35 anaesthetic machine. It is a breathing apparatus which supports all modes of modern ventilation (Assist-Control Ventilation, Spontaneous Ventilation, Pressure Support Ventilation), has a full-fledged gas analyzer, and also allows evaluation of each respiratory cycle with the help of graphical loops and can work on a self-sufficiency basis for up to 3 hours . This anesthesia station allows to provide high level of patient safety and accuracy of work of the anesthesiologist.
How to prepare to medication sleep?
First of all, this is a conversation with the anesthesiologist who assesses the overall health of the child, draws attention to the allergic and hereditary history, discusses in detail the process and types of anesthesiology procedures. We provide a patient with a newsletter outlining key recommendations, time intervals for food and drink consumption, a list of necessary laboratory and instrumental tests. Depending on the treatment program and the patient's overall health, we choose the best option to provide the high-quality and safe anesthesia and do it professionally.
Talking about the emergencies, we have all the necessary equipment in our clinic and your anesthesiologist has all the necessary skills to respond properly to an acute situation. During sedation we do ECG monitoring, pulse oximetry and blood saturation measurement, capnography, blood pressure measurement - so we continuously evaluate the patient's condition and can respond quickly to any changes. We also have BIS monitoring, which allows us to determine the depth of sedation, that is, the patient will have only a superficial sleep, that makes it impossible for complications in terms of drug overdose. Modern equipment allows to control the body temperature of the patient and to provide heating if necessary. Therefore, it’s impossible for our patient to have such conditions as, for example, shivering in the postoperative period. We pay special attention to pain management, so our little patients do not know what the pain is. We are a dental team who knows how to manage pain quickly and proficiently in accordance with evidence-based medicine.
Traditional Parenting Question: "Is Medication Sleep Safe?"
Patient safety is our top priority! Therefore, each patient is advised by an anesthesiologist for some time before medication sleep, who gives recommendations on the preparation and the list of the necessary laboratory and instrumental tests. On the day of sedation the anesthesiologist examines the patient, checks the condition of the oropharynx, excludes any lymphadenopathy, performs auscultation of the heart and lungs, which minimizes the risk of complications.
Are there any age restrictions for sedation?
The drugs we use, sevoflurane or propofol, refer to so-called hypnotics - they “plunge the baby into sleep”. These are the safest sedatives drugs in the world nowadays. They do not accumulate in the body, do not cause addiction, are not contraindicated in patients suffering from diseases such as epilepsy, cerebral palsy, heart defects, liver and kidney damage. However, there are some specific features that our anesthesiology team can consider and treat each patient individually. According to the instructions, sevoflurane and propofol can be used in children from birth and from 1 month, respectively. In our clinic we treat babies aged from 9-10 months and older, so we successfully use these two drugs to provide optimal sedation depth for effective and safe dental treatment.
For today, a professional team of doctors has been formed at the Dubnova Clinic. Recently, two other anesthesiologists have joined who have a wide range of knowledge and practical skills. They are Dmytriy Olexandrovych Prysiazhniuk and Mykhailo Petrovych Varyvoda - pediatric anesthesiologists from “OHMATDIT”, who keep up with the current tendencies of anesthesiology and intensive care. Mykhailo Petrovych is the Assistant Professor in the department of Anesthesiology and Intensive Care, Bogomolets National Medical University. The anesthesiologists take an active part in congresses and international conferences, and are an active members of the European Society of Anaesthesiology. There is also an assistant-anesthetist who help anesthesiologist during the sedation procedure. He is the right hand of the anesthesiologist, the person who helps the doctor to control the patient's condition.
We understand that you trust us with your loved ones, so we treat each patient professionally and individually, and put safety first – this is the motto of our clinic!