IV Sedation and Overweight

[Scully1214]

I am seeing a Dentist for the first time 10 years. I'm terrified. I want to be put under. twilight sleep I had IV sedation for my wisdom teeth but that was 20 years ago. Will I be denied my request due to my weight? I'm so scared.

 

[Dg6300]

I was obese when I got wisdom teeth out two years ago, and it wasn’t an issue.

 

[comfortdentist]

Weight may be an issue. It is a risk factor that we look at in deciding if the patient is a reasonable risk. If obese and your neck is wider than your head another risk
If you can't lean back and put your chin up- another risk
If I can't see beyond your uvula- another risk
Sleep apnea- another risk

I had a patient last year that I have sedated her a few times over many years but now she is an old 66, overweight, large neck, large tongue, limited mobility of her neck, and forward posturing of her neck so I declined to sedate her. She allowed me to take pictures of from the front and side as I consider her an example of someone who shouldn't be sedated in an office. I showed them to a OMS and an anesthesiologist who both quickly agreed that I made the right call.
We want you to stay alive at the end of it all.

 

[Gordon]

We could maybe be more helpful if you told us what weight/height you were, any other medical issues and you're around 40 years old?

 

[Scully1214]

I’m 5’1 255lbs. I don’t smoke, drink. No high blood pressure , no sleep apena

 

[Scully1214]

Could I do oral sedation?

 

[drhirst]

Hi Scully 1214,
From the information you have supplied I can say you would not be suitable for sedation in a practice setting, at least not here in the UK. For safety purposes you would need to be seen by a a specialist who could deal with any complications.
Oral sedation would also be a problem if it was anything more than a small dose to relieve pretreatment nerves.
Ask you new dentist if he or she can refer you to an specialist center where they can help you safely.
Hope this helps

Lincoln

 

[Gordon]

Hi Scully, thanks for updating. As Lincoln says, you would not be suitable for IV or oral sedation in practice in the UK, inhalation sedation would be possible though, would that be a compromise you could accept?

 

[Scully1214]

I don’t want to be aware what is happening. I’ve had gas in the past. I didn’t like it. I live in US. I looked at the ADA guidelines. I could get a medical clearance from my doctor

 

[comfortdentist]

I calculated your BMI at 48 so there aren't any firm weight restrictions but it has to do with risk assessment. This risk is perceived both from the individual practitioner and their concern as to how it would look if there was a problem. Today there is little tolerance by either the media or the dental regulatory people for sedation complications. Even if you gave complete consent to the high risk it wouldn't help your case.