A Member of DOCS Education asks:
The Sedation Dentistry Guidebook offers a form titled "Sedation Appointment Checklist”. The checklist outlines some instructions specifically for smokers, specifically how long to refrain from smoking after a sedation appointment. To clarify, are we to use this form to communicate to patients how long they are not to smoke before their sedation appointment? I remember from the DOCS course that smokers were encouraged to smoke before and throughout the sedation appointment as needed. Do we offer this option to all patients that smoke, or only to those who smoke beyond a specific threshold of cigarettes per day? Off of that, what is the protocol for allowing a patient to smoke during the sedation appointment? Should we keep the pulse ox attatched to the patient and accompany them outside? Any clarification would be appreciated.
Dr. Jerome Wellbrock, Live Patient Experience Director at DOCS Education, responds:
The Guidebook is just that, a Guidebook. Adapt the guidelines to what works in your office. I do not give the guidelines to my smoking patients but do suggest that they refrain from smoking as much as possible the morning of the appointment. As they are smokers, many will smoke before the appointment. I know most of my smoking patients, especially if they are anxious, are going to have their last smoke right outside of my office front door. There’s nothing I can do about that. As for smoking during a sedation appointment, that does not happen in my office. There may be others who manage to accommodate this, I do not and I do not recommend that others do either. Once a patient is being monitored and sedated in the office they do not come off the monitor except for rare occasion to use the restroom. I certainly would not want a patient standing or sitting in a companion chair in front of my office being monitored while smoking.
The DOCS Education member replies:
Thank you Dr. Wellbrock, I appreciate your response. I do have a follow-up question: Are you advising smokers to not smoke for 24 hours following the sedation appointment as recommended by the guidebook? If so, how dangerous is it to the patient if they ignore the instructions and light up within the 24 hours following sedation? Thanks again.
Dr. Wellbrock returns:
There are a few issues that could arise with a patient smoking post-op, mostly dealing with surgical sites and avoiding "dry socket" or other healing complications. There is also a chance of accidental injury from matches, lighters or burning cigarettes. We always want a companion to stay with the patient for 24 hours post-op to ensure the patient is not exposed to any harmful event. This could include driving, falling, operating power equipment or setting themselves on fire.
