Favorite form of sedation?

[brit]

Is it ordinarily dangerous to have Nitrous Oxide at GA levels? Or were the problems caused by incompetents or people with serious problems like heart conditions? Just wondering why they stopped using it so often on the NHS (other than grounds of cost).

It wasn't cost grounds at all...it was much simpler for dentists especially with kids. There was always a very real risk of death associated with it...your parents would have had to sign a consent form acknowledging this risk each time. GA of any kind is much safer in a hospital environment. Apparently the more scared the patient is, the higher the risk too.

I don't think dentists however they are, actually go into dentistry to kill their patients, in-surgery GA meant that one day they could kill someone conceivably (a bit stressful) and there were some who never offered it for this very reason including a practice I went to.....this meant they worked on making their local injections comfortable even in those days...they would refer people out who insisted they wanted it, as I did at age 12 but that referral out was actually one of my better experiences of it. By age 14 for further orthodontic extractions I chose just TLC and LA.

There are some other threads on this which include some of the stats but trust me as a mum you really don't want your 4 year old dying from a tooth extraction when it can be done painlessly with just local by the right dentist. http://www.dentalfearcentral.org/for...ead.php?t=1287

[Tradlad]

It wasn't cost grounds at all...it was much simpler for dentists especially with kids. There was always a very real risk of death associated with it...your parents would have had to sign a consent form acknowledging this risk each time. GA of any kind is much safer in a hospital environment. Apparently the more scared the patient is, the higher the risk too.

I don't think dentists however they are, actually go into dentistry to kill their patients, in-surgery GA meant that one day they could kill someone conceivably (a bit stressful) and there were some who never offered it for this very reason including a practice I went to.....this meant they worked on making their local injections comfortable even in those days...they would refer people out who insisted they wanted it, as I did at age 12 but that referral out was actually one of my better experiences of it. By age 14 for further orthodontic extractions I chose just TLC and LA.

There are some other threads on this which include some of the stats but trust me as a mum you really don't want your 4 year old dying from a tooth extraction when it can be done painlessly with just local by the right dentist. http://www.dentalfearcentral.org/for...ead.php?t=1287

And there's me carrying all this guilt all these years about the way I behaved the first time even though I was only 6. I had to be physically restrained with one of the staff on one side and another on the other holding me down in the chair throughout. Anybody would think that it was an execution the way it was done. The wierd thing is though I recall screaming the whole way through I could feel absolutely nothing - certainly no physical pain.

I really wasn't warned what would happen. I suppose everybody thought I was too young and stupid. There was no deception - everything happened too fast for anything involved like that - but I had this really painful abcess and everything was rush, rush, rush. I never realised that by causing me to panic in this way they were actually putting my life at serious risk. I note what you say about the heart rate - I shudder to think what mine was.

I note from the other thread you had too similarly bad experiences not once but twice. I wonder how many of these deaths of young kids have been precisely because of an incident like mine.

Strange then we should both want it when older - in your case asking for it assertively on the last occasion.

In my case I think it was (still is) partly a desire to overcome this phobia and negate this bad experience.

[MarkAntony]

Hi,

I think that Dentists had stopped using gas as a GA by the 1980's. Perhaps it was still available for children but I know that when I needed a couple of wisdom teeth extracted in 1982 (I think) I couldn't find a Dentist who would do it with gas or use any other form of GA or sedation.

I was in a great deal of pain because the gums around the wisdom teeth had become infected so after a course of anti-biotics I was persuaded to have the extractions done under a LA.

This went from being uncomfortable to very unpleasent when the Dentist had trouble removing the teeth, I can remember him remarking that I was well put together as he pulled at my bottom tooth.

As this went from being very unpleasent to painfull and I began to think he was going to break my jaw I wished that I could have been given something to put me to sleep while he removed the teeth.

When I compare this with my previous experience of having teeth out under gas I can certainly testify that this was far more stressful and unpleasent.

[brit]

I'm not sure until when nitrous oxide was used as a general anaesthetic agent... looking at old books (copyright expired) on Google books though makes me think that it was used at a 50% concentration, at least for Caesarians (not sure if it was used as the sole anaesthetic agent)... no wonder people used to throw up afterwards

It's probably a question for the "Your Dentistry Questions Answered" section!

Letsconnect...do you mean as the sole agent even in hospital-based GA? All my hospital GAs have been i/v based and extremely pleasant experiences in comparison but the first one was in the 1980s.

An English friend 'in you know where' (Not UK) was advised that there was still a gas option for hospital GA and that they preferred to use it for kids (they tend to use i/v in UK even for kids) but I'm guessing you would just now use it to get the patient under and then insert i/v...maybe...surely you can't keep someone under with just the nitrous oxide approach????

Going back to old-style surgery GA, I don't know if it did work like this but given that they were working in your mouth..it always seemed a bit hit and miss to me..no breathing tube or constant monitoring just knock you unconscious and whip them out quick before you came round again and spewed up or have I missed something here? Was it more sophisticated than this?

To Mark Anthony...gas option was probably a bit of a blessing where infected teeth were concerned..you were unconscious, you would feel no pain...with just local especially back then, infection could cause problems getting properly numb in some cases....but not always.....I did have one extraction with just local at the dentist who used to gas me all the time; and I remember crying after the injection but finding the extraction totally painless and it was a tooth which had made my eye close up so it needed urgent attention....I had taken antibiotics (from A&E two days before) so some of the infection would have cleared up hence local was ok even back then...why risk my life for one tooth??? They didn't .


Wasn't 'in surgery GA' finally outlawed after yet another child death case in Scotland somewhere....who outlawed it the Government or the NHS authorities? As far as I'm aware they were still using nitrous oxide..it wasn't i/v GA which was prevented. I personally had the old-style as late as mid 1970s and so did most of my friends...I doubt there was anyone in my class at school who escaped it at least once ...(especially with NHS braces).it was a real rite of passage .

[letsconnect]

I didn't know what you meant by the reference to nitrous oxide GA:

I think it would have been laughing gas (nitrous oxide GA)....I had it several times in 1960s and 1970s but you should have been completely unaware...it is a general anaesthetic..you are unconscious.

I thought that nitrous oxide wasn't the sole agent for inhalation GA, because it's too weak... but I don't know anything about GA techniques

I'm just worried that this thread might cause some confusion to readers as both nitrous oxide sedation and inhalation GA are sometimes referred to as "gas", even though they are totally different things.

[letsconnect]

when I needed a couple of wisdom teeth extracted in 1982 (I think) I couldn't find a Dentist who would do it with gas or use any other form of GA or sedation.

Luckily, IV sedation has become much more widely available since .

[mikey]

Yes its very lucky, I'm even luckier because my normal dentist office that I get my cleanings from does everything from I/V sedation to nitrous ect. without having to go anywhere else and meet a new dentist/oral surgeon which is great since im probably going to have to get my wizzies out in the next year or two.


This is the most confusing thread yet interesting

[MarkAntony]

Luckily, IV sedation has become much more widely available since .

I didn't feel very lucky at the time. Even now there are few Dentists in my area that provide sedation as an option and it is quite expensive, almost prohibitivly so.

[letsconnect]

I suppose what I was trying to say was that the situation has improved a lot, and there is now a safe alternative to GA. Considering the training required to administer IV sedation, obviously only a minority of dentists will offer it. I don't know the figures, but I'm under the impression that IV sedation is more widely available in the UK compared to other countries (perhaps because of the high insurance premiums dentists have to pay to be able to offer it, as well as the training).

[bluesuew]

Is this really a fair question? As not everyone has nitrous oxide, general anesthetic, natural remedies, a good stiff drink and know when to stop, so you can wobble home, and because of kids keeling over, under general anesthetics, not many dentists like to put people under, because of the so called risks.

I have had a general quite a few times, when I was a kid, I had multiple adult teeth growing from the roof of my mouth, I do remember it was fantastic, but the last time I had a general for extraction, it was to take 5 wisdom teeth out, at the dental hospital, at the age of 18, I ended up in a mess, in agony, and unable to eat proper food, for as long as 2 months, and was left very sesative to needles in my mouth, in fact I now freak out.

I know, I take the easiest route, sedation every time.