IV sedation for pediatric patients(Oral surgeon-Hinesville, GA and Statesboro, GA)

www.SouthernGeorgiaOMS
Statesboro and Hinesville oral surgeon

IV sedation for pediatric patients in the oral surgery Setting

Providing the service of IV sedation in the oral surgery setting is a tediuos and anxious process.  It is even more unsettling when pediatric patients are the recipents of this modality of treatment.  I employ the following measures to ensure a safe and comfortable IV sedation experience for my patients.

1)  At the initial consultation build a rapport with the child.  This envokes and establishes a level of trust between you and the patient.  Communication is ultimately the key to success and it starts with formulating commonality with the patient.  I have patients that come to my office and say "your the only doctor that has spoken to me like a human being".  I emphasize in my office communication, compassion and politeness.
2)  Minimize the risk of aspiration by informing the patient not to eat or drink 8 hours prior to the procedure.
Inform the patient that this is a significant action to perform prior to surgery.
3)  To reduce the patients level of anxiety, I have them take a tablet of halcion 1 hour prior to the procedure.  This relaxes the patient and really promotes a better experience.
4)  Having the parent in the room prior to and during the placement of the IV.  This presents a factor of reassurance and less alienation for the patient.  Once again, I gently talk the patient through the process and I have never not been successful placing an IV involving a pediatric patient.

What modality or approach do you use in your office?

Four important tips after a tooth extraction

Southern Georgia Oral Surgery
Hinesville and Statesboro locations
WWW.SouthernGeorgiaOMS.com
Roger L. Myers DMD

Tooth extraction post-op management

1)  Prolonged bleeding
     Once a tooth has been extracted it is important to control post operative bleeding.  I always compare an extraction to a laceration on the skin.  Direct pressure will tamponade the bleeding and therefore create a clot.  Biting on guaze simulates this comparison and is effetive in most cases.  However, there are some instances where bleeding is prolonged.  In this case I always encourage patients to bite on a wet tea bag and the tannins(component of tea leaves) in most cases will stop the hemorrhaging.  This scenario has even been effective for patients on anticoagulants( i.e. coumadin, aspirin).

2)  Pain Control
      NSAIDS such as motrin are very efficacious in cotrolling pain and inflammation post extraction.  Of course time, level of difficulty and trauma incurred during and after the extraction influence how your body is going to respond.  It is also recommended to take antibiotics and stronger analgesics when warranted.  Thereby reducing the incident of pain and subsequent infection.

3)  Swelling
     The most profound swelling for any surgical procedure occurs 72 hours post-op.  The critical time to reduce the level and progression of swelling is 24 hours after the procedure.  Ice should be applied for the first 24 hours and then warm heat for a least three more days post-op.  This should in effect reduce the level of swelling evident after a toothe extraction.  I find that there is a considerably high correlation between the amount of swelling and level of pain one experiences.

4)  Dry Socket
      Dry socket is a circumstance that occurs after an extraction has been performed and a blood clot has not formed.  This results in bone exposure and leads to susequent radiating pain to the jaw.  There appears to be no effective remedy with the exception of strong analgesics.  Otherwise a visit to your dentist is warrantedto adress the issue of pain.  Dry socket paste(Eugenol) based paste is applied to the extraction site and acts as a medicament that coats the area and helps alleviate pain.

Top 7 reasons for removing wisdom teeth

Southern Georgia Oral Surgery - Hinesville Georgia
WWW.SouthernGeorgiaOMS.com

1)  Limited opening
     Commonly known as trismus.  This symptom usually appears when an infection is present with concomitant swelling(abcess or cellulitis).  This condition often occurs when a third molar is partially
erupted and has a food trap resulting in inflammation/erythema.
2)  Ear pain
     Some misinterpret this as an ear infection, but the nerves that give sensation to the tooth is the actual culptrit.  This is called referred pain and the origin of the nerve is in the area of the ear canal.
Many of my patients have been evaluated by their ENT because they think that an ear infection is present.  But to their surprise, there is no ear infection and the pain is comming from an infected wisdom tooth.
3)  Headaches
     The trigeminal nerve has many branches which provides sensation to one half of the face.  This nerve is bilateral and is stimulated only on the affected side.  Typically the headaches resolve once the wisdom teeth are removed.
4)  Loss of adjacent teeth
     If wisdom teeth are impacted(partial or complete bony) there is a possibilty of losing adjacent teeth.  Meaning that wisdom can exert pressure on an adjacent tooth which may result in decay and subsequent loss of a tooth.
5)  Crowding of Teeth
     Wisdom teeth apply pressure to adjacent teeth and eventually in most cases the lower front anterior teeth become crowded.  As a result, the crowding may require the removal of wisdom teeth and eventual orthodontic(braces) treatment.
6)  TMJ(Temporomandibular Joint Disorder)
     Wisodom teeth in the upper jaw can create a problem called TMJ.  In most cases our jaw structure is too small to accomodate all the teeth we have in the upper jaw.  In this case, the wisdom teeth are usually impinged between the adjacent tooth and the coronoid process of the lower jaw.  This arrangement creates limited opening, deviation of the jaw upon opening, locking and clicking, and specific pain to the ear.
7)  Cyst development
      When wisdom teeth do not erupt through the bone and tissue a cyst can develop.  Cysts associated with wisdom teeth are usually benign(dentigerous cyst), but some can become malignant(ameloblastoma).  Numbness, swelling and pain are variant indicators of a cyst.  However, symptoms some times do not appear at all clinically and require a radiograph for diagnosis.  If this occurs, the site will require treatment and continued follow-up over a number of years.

Roger Myers DMD oral surgeon@ Southern Georgia Oral Surgery

     

Southern Georgia Oral Surgery
Full scope oral and maxillofacial surgery office with two locations:  Hinesville and Statesboro, Georgia.
Dr. Roger Myers is the owner and operator of these locations and practices full scope oral surgery.  Procedures include the placement dental implants, removal of wisdom teeth and sedation for children/adults.  Our website is www.SouthernGeorgiaOMS.com which provides answers to all your questions convening the field of oral surgery.
Our mission is to educate the public in reference to oral surgical issues and provide guidance on how to address these issues should they arise.

  Roger

Dental Implants and you

Dental implants are viable alternatives to replacing dentition, when we find is difficult to chew or have esthetic appearance issues.  At southern Georgia Oral Surgery, we provide these services and many of our patients are excited about their results.  The healing process takes approximately 4 months and then the restoration process can begin.  The implant is osseointegrated(fuses) to the bone and pretty much stays with the recipient for life.  A general dentist is responsible for the restoration stage, which entails the placement of a crown.  They are great alternatives to a removable prosthesis.
For more info visit my website at www.SouthernGeorgiaOMS.com
Dr. Roger Myers@ Southern Georgia Oral Surgery