General anesthesia in dentistry: what are the risks

October 22, 2012

 General anesthesia in dentistry
 Today, general anesthesia is rarely used to treat teeth. One reason for this is that the intravenous sedation with midazolam use is effective for almost all patients and is very safe. The use of general anesthesia are much more risky.

Typically, general anesthesia for the treatment of adult patients should only be used in extreme cases when there are no other ways to cope with pain and anxiety Anxiety - how to distinguish normal from disease?  Anxiety - how to distinguish normal from disease?
 . If the decision on the use of general anesthesia, it must take place in conditions of maximum safety. This means that this type of anesthesia used only in hospitals or special clinics, where there is all the necessary equipment. This policy led to the fact that general anesthesia was used less frequently; it is increasingly replacing intravenous conscious sedation.

The so-called deep sedation in some countries, also belongs to the category of general anesthesia. For example, propofol - one of the drugs for deep sedation. Most dentists have never used a pain relief as when deep sedation acceptable, they are generally preferred general anesthesia.

 General anesthesia in dentistry: what are the risks

Disadvantages of general anesthesia in dentistry

Besides the risk of serious complications (which, although very small, is still much higher than with intravenous conscious sedation), general anesthesia has the following disadvantages:

  • General anesthesia suppresses the cardiovascular and respiratory systems. For certain groups of patients, it is contraindicated or at least is allowed only in case of emergency (dental surgery such cases, as a rule, does not apply);
  • General anesthesia is not recommended for use in performing routine dental procedures such as, for example, sealing. The potential risk is too great to justify the use of general anesthesia;
  • Due to the significant risk to the use of general anesthesia, patients often need to undergo a medical examination, which includes laboratory tests, chest X-ray, electrocardiogram;
  • For the operation with a general anesthetic is required by personnel with the necessary training, special equipment and a place that satisfies the applicable standards. In addition, it raises considerable difficulties for conducting surgery dentist - snorkel and temporarily paralyzed muscles of the patient are greatly interfere with his work and cause fatigue more quickly than usual.
  • The patient can not eat or drink six hours before the procedure (otherwise possible vomiting, and it is very dangerous when using general anesthesia);
  • The use of general anesthesia is expensive, increasing the already considerable cost of dental services;
  • General anesthesia does not help to cope with the anxiety that plagues many patients before dental procedures. Fears directly related to anesthesia, may even enhance this anxiety.

 General anesthesia in dentistry: what are the risks

When used

In some cases, the use of general anesthesia is acceptable and even recommended.

Intravenous conscious sedation works in about 97% of people experiencing extreme anxiety in connection with the operation. However, there is always a small percentage of people for whom such sedation is ineffective - because they are not able to adequately cooperate with the medical staff, even under the influence of sedatives and / or because of the high tolerance to the drug used. In this case, the best choice may be a general anesthetic.

When a potentially traumatic procedures also frequently used general anesthesia. In some clinics, patients who are especially afraid of any part of the treatment procedures, such as tooth extraction, it is proposed to carry out this step under general anesthesia, and, for example, has put a seal with sedation. However, it should be borne in mind that in this case you can not do the procedure is expensive.

 General anesthesia in dentistry: what are the risks

As used general anesthesia

In most cases, the drug for general anesthesia is administered through a vein in the arm. If you use inhaled anesthetics to the face of the patient to wear a mask. In the first case, the patient typically stores the injection itself, and several seconds later, in the second case, generally only remember the moment when the tray to the face mask.

If the operation is expected pain during surgery, the patient is administered a long-acting local anesthetic. When the patient wakes up, he is in a few hours will not feel the pain, and then you can begin taking painkillers. It is much better to prevent the emergence of pain than to take action against them when they have already appeared.

One of the most common fears of patients with respect to general anesthesia is associated with the fear of not wake up. First, you must understand that general anesthesia be appointed only if the doctor understands - without the operation for the patient will be too unpleasant. Provided that you work with a qualified anesthetist, the risk of death from anesthesia extremely small. According to a study from 1982, from complications of general anesthesia, the patient died 1 of 338,536. And that was 30 years ago - now medicine as a whole has become even safer.

 General anesthesia in dentistry: what are the risks

Intravenous and inhalation anesthesia

Separate the two main categories of anesthesia - intravenous and inhalation. In most cases the gas used to maintain anesthesia after administration of intravenous anesthetic.

Previously, the use of inhalation anesthesia was pretty uncomfortable for the patient because of the unpleasant odor. Today, it uses drug sevoflurane, who does not have a strong odor (smell it a little bit reminiscent of wet fur), and acts very quickly.

Anesthesiologists sure to use intravenous anesthesia for general anesthesia in adult patients (in combination with an inhaled anesthetic, or not), many also prefer to use it for the kids. If the patient is afraid of injections, it may enter into a state of anesthesia using inhaled medications, but then commonly used intravenous anesthetics.

Article Tags:
  • dental treatment

Malocclusion: beauty for all ages

October 17, 2011

 bite correction
 Malocclusion may be just a cosmetic defect, but can cause unpleasant and much more complications in the form of violations of chewing food (this will necessarily affect the state of the gastrointestinal tract), speaking and even breathing. Therefore, you need to correct an overbite.

 Malocclusion: beauty for all ages

Types of malocclusion

Bite - is between teeth. With the right bite the upper dentition wider lower, at the closing of the upper incisors teeth overlapping the lower one-third the height of their crowns. Malocclusion - a phenomenon very often. But there are minor violations, that may not even be seen by man, and there are those who literally "interfere with life." Identify the type of malocclusion closing of indigenous and anterior teeth on both sides of the jaw. Malocclusion is always to some extent reflected in the development and operation of the masticatory muscles.

Abnormal bite can be manifested in the form of deformation of dentition and improper clamping in the sagittal, transverse and vertical directions.

By sagittal malocclusions are disorders interdigitation in the anteroposterior direction with respect to the vertical plane. This advance may be granted front teeth (prognathic bite) or lower (progenichesky attack).

Transversal malocclusion observed with unilateral or bilateral narrowing or expanding the dentition or lateral displacement of the mandible. These anomalies include cross-bite, which is the outward sign of facial asymmetry.

Vertical malocclusion due to a violation of the vertical level of the dentition, which is in contact with the other side, ie the teeth are of different heights. The bite there may be deep (front teeth largely overlapping crowns of teeth-antagonists, low lateral teeth crowns) or open (with interdigitation between them a gap, often in the area of ​​the front teeth, crowns of the molars high).

Correction of malocclusion Malocclusion: fix is ​​never too late  Malocclusion: fix is ​​never too late
   It should be comprehensive, with orthodontic treatments, special exercises, and if necessary - surgery.

By orthodontic treatments include treatment with orthodontic appliances, removable and non-removable.

 Malocclusion: beauty for all ages

Malocclusion using non-removable orthodontic appliances

The modern version of the non-removable orthodontic apparatus - brackets (braces), they can be used to fully restore the proper closing of dentition. Bracket - orthodontic device is manufactured with high precision, which is fixed with glue on the teeth, thereby setting the desired direction of movement of the teeth. The force (thrust) to move the tooth braces receive from wire fixed between molars jaw with a predetermined tensile force. Wire periodically change, thereby adjusting the force of impact on the teeth.

The standard set of braces is usually a 20 (10 for the upper and lower teeth for 10) and the support rings for molars.

Braces can be made from many different materials - metal, plastic, ceramics, artificially grown sapphire. They can be transparent, colored (including colored) and fluorescent. There are also so-called lingual braces - the latest achievement in this field, which are installed on the inner side of the jaw and are invisible to others.

With braces Braces: Proper installation - a pledge of a beautiful smile  Braces: Proper installation - a pledge of a beautiful smile
   You can correct an overbite, make the teeth smooth, straighten the direction of the tooth root, push tooth, turn it on the axis. Install braces at any age, but it is best to do it in 7-9 years when erupted four upper permanent incisor and the first permanent molars. And of course, braces are installed only on the healthy teeth.

 Malocclusion: beauty for all ages

Occlusion correction using removable orthodontic appliances

The most modern non-removable orthodontic devices are special clear plastic aligners that are prepared in the dental laboratory casts of the patient's teeth. Computer programs allow you to pre-calculate the movement of the teeth and produce a series of thorough, replacing each other and move the teeth for a long time in a pre-programmed position. Kappa change regularly, which allows us to slowly but surely move the teeth into the desired direction. The very first such technique applied Invisalign Company (USA).

It is best to treat malocclusion in childhood. In this case, the special removable plate and functional products that deliver a minimum of inconvenience to the children, thus restoring the bite.

Today, restore bite at any age, although in adults it will take more time and effort than children.

Galina Romanenko

Article Tags:
  • bite