The Front Page

Monday, February 17, 2003

Dentist: Sedation putting patients a little more at ease
Controversial: The practice is 'effectively outlawed' in the state of Iowa
by TERRY MORGAN

PLATTEVILLE, WIS. - For those adults who would rather hide under their blankets than walk into a small room with an adjustable chair, sedation dentistry has come to the rescue.

The field of sedation dentistry is also known as sleep dentistry and oral conscious sedation. Under sedation dentistry, patients are given an oral sedative called Triazolam, which puts them into a very drowsy, sleepy state, but they are not unconscious as with a general anesthesia.

The biggest selling point of sedation dentistry is the lack of pain during dental work.

"The patient is often amnesiac and doesn't even remember the procedure," said Dr. Paul Podruch, who practices sedation dentistry at Mineral Point Family Dentistry, in Mineral Point, and Oak Park Dental, in Platteville.

Triazolam, also referred to as "the tiny blue pill," is in the Valium family of drugs and is extremely safe, he said.

The U.S. Food and Drug Administration has not approved Triazolam for children. But youngsters in need of sedation should see a children's dentist for alternative sedatives. There is no upper age limit for safe administration of Triazolam, Podruch said, but he prefers to consult with a patient's physician if that person is on a number of medications or has certain health problems.

Prior to a procedure that requires sedation, a patient is given a dental exam, during which his or her pulse and blood pressure are checked. During a follow-up visit, dental work under sedation can be done.

Although a patient normally will be able to walk out of the office after sedation, it is required that someone else drive them home.

Podruch reports an estimated 145 million people in the United States are afraid to go to the dentist, and he says the procedure is ideal for the patients who fear needles or "hear a drill in an adjacent room and cover their ears."

Besides the absence of a painful dental procedure, another advantage to sleep dentistry is efficiency. More work can be done per visit on sedated patients who are not squirming around. And accomplishing a lot of work in one day is convenient for those with limited schedules.

People who have avoided the dental chair for many years have given sedation dentistry a try.

"It's very satisfying because you reach people who are desperate," said Dr. David Hall, who formerly practiced dentistry and sedation dentistry in Cedar Rapids, Iowa.

Sedation dentists are not yet abundant in the Midwest. Besides Podruch, other sedation dentists are located in major metropolitan areas like Madison, Milwaukee and Chicago.

Oral sedation is not widely available in Iowa dental offices. Hall said the Iowa Board of Dental Examiners has "effectively outlawed sedation by oral medication" by placing prohibitive restrictions upon the practice. He knows of Cedar Rapids-area patients who travel to Wisconsin for sedation treatments.

"It's sad," said Hall, who left the field of dentistry altogether because of "disagreements" with the dental board. "In other states like Wisconsin and Missouri, it (sedation dentistry) is OK, but in Iowa it is considered dangerous."

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