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Avoid your next sedation brain-buster with this one tool

Welcome to the Incisor Hub; we're glad to have you here. Whether you've been a DOCS Education member for many years, are a new member, or have yet to become a member (for shame!), you all have the pleasure of reading the informative blog posts written by our charming, smart, and dare I say it—ravishing editors. We make the Incisor available to all who are interested in reading, because at DOCS Education we believe information should be accessible to those that are thirsty for it. However, we’re not dummies—we reserve the best perks for our members. And one of the hands-down most important benefits we offer with a DOCS Education Membership is access to the Elite DOCS Forum. Monitored by esteemed dental professionals Drs. Jerome Wellbrock, Lesie Fang and Anthony Feck, the Elite DOCS Forum offers dentists the opportunity to read up on pertinent case studies and connect with other members. Have a question about pharmacology, patient management, IV sedation or protocols and regulations? No problem. Our faculty will respond to your questions within 24-48 hours—giving you the answers you need in a timeframe that truly benefits your practice.

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Choose Knowledge: DOCS Digest | Fall 2013

Part of what makes human beings so great is our capacity to choose: what kind of breakfast will you eat today? Where will you go on your next vacation? Will you definitely wear pants when you go into work tomorrow?

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When there's smoke, is there always fire?

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?

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Gaga Pops some Art on her Chompers: The story behind Lady Gaga’s creepy, creepy teeth

Who needs a Poker Face when you can be spine-chilling?

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Let the light in:

If you tear up a bit while reading this post, we won’t judge you. Feel your feelings.

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Multiple medications and health issues push towards outside sedation assistance

A DOCS Education member brings this question to the forum:
I would appreciate some input regarding this patient, a 56 year old female, 5 feet and 1.5 inches tall, 248 lbs. She is a non-smoker. I have an upcoming treatment appointment with her and I plan on using a Triazolam titration protocol with her starting with .25 mg of Triazolam one hour prior to her appointment. She reports the following medical conditions:
Hypertension
Diabetes
Asthma
Hay Fever
Hypothyroidism
Fibromyalgia

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Sweet Hierarchy

When it comes to candy, some deliver more tricks than others. This Halloween, consider giving your teeth a treat by indulging in the candies experts claim are less likely to cause tooth decay.

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What does a history of opiate abuse mean for sedation?

A DOCS Education Member asks:

I have a 32 year-old male patient with no health concerns other than a past history of opiate abuse. I first saw this patient three years ago for a sedation consultation; he never followed through with further treatment. At that time the patient was taking 24mg of Suboxone® a day. Patient is now down to 1mg of Suboxone® per day and is seeking treatment for his many dental problems. Is this a safe patient to treat with OCS medications, or are there changes I should make to the protocol? Patient may need several root canals and I normally do the extra strength Acetaminophen/Ibuprofen combo for the first day. I do not typically have to call in any pain meds for day two or beyond, but if this patient requires them, what would you suggest I do? My thought is to have the MD managing his Suboxone® make this judgment.

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Customized brushing: 3D printing gives the time-pressed something to chew on

As a dentist, you know three minutes is the recommended amount of brushing time. But what if you could brush just as effectively in…six seconds?

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Does a failed IV sedation attempt negate an OCS try?

A DOCS Education member asks:

I have a patient that I plan on doing a RCT under sedation. Health hx normal. Allergic to Morphine and NSAID. Meds taking: estrogen, metroprolol tartrate. BP: 146/74, Pulse: 66, SPO2: 99. She said Valium didn't do much for her before, and one dentist had tried to do IV sedation on her and she was awake the whole time and "felt everything he did".
My initial plan is do single Dose Protocol #3 with diazepam 5 mg night before, triazolam 0.25 mg and hydroxyzine 25 mg one hr before procedure.
Is it worth the try or would another protocol be better served for this patient?

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We recently had a patient whose medical history revealed serum disease as part of a sensitivity to narcotic agents. Is this a concern if we choose to use conscious sedation medications with her?
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I have a 24-year-old moderately anxious female patient with sarcoidosis in remission and diagnosed with Graves' disease at age 14. Are there any thoughts, suggestions or warnings?


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I know that pregnancy is a contraindication for oral conscious sedation (OCS). But I have a patient that is trying to get pregnant and wants OCS. How accurate is a hospital administered pregnancy blood test (false positives)?


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A DOCS Education member asks: Have you had any personal experiences with sedating an autistic patient? Have you heard of any concerns with this issue?


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My patient is a female, age 31, married, taking birth control pills, and has multiple sclerosis. Are there any special precautions I should take for this patient for oral sedation?


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