Informed Consent | Oral Pre-Medication

Oral pre-medication is a means of sedation that lowers the anxiety level of patients. It is not a general anesthetic and does not put the patient to sleep, however it often makes the patient so relaxed that they do sleep, sometimes even during the dental treatment.

This sedation contains a narcotic and is given as a liquid that the patient must drink approximately 1 hour before the dental treatment. After they have drunk the medicine they are allowed to be with their parents/care provider until the time of their treatment. They must be supervised at all times and should not be left alone. During this time they gradually become more sleepy and relaxed. After the treatment, most patients sleep for 3-4 hours and awake refreshed.

This medication does not take the place of local anesthetic. Local anesthesia must still be given however; it can usually be given without the patient feeling any discomfort. It must be recognized that patients will experience the usual numb feeling for 2-3 hours after the appointment. Please pay close attention to be sure that the patient does not bite or play with their lip, cheek, or tongue during this time and cause a sore.

Oral sedation does not always work. Usually it is not effective on patients under the age of 4 years and sometimes even older patients are so afraid that they cannot relax. Such cases need to be scheduled for a general anesthetic. It is important that the patient drinks ALL of the medicine.

Benefits and alternatives

Patients who are inexperienced, afraid, or require a lot of dental work that will take more time, can usually be treated with an oral pre-medication more comfortably than using local anesthetic alone. The alternative would be to use a local anesthetic only, multiple short appointments, and the use of restraints, which often results in a long lasting dental fear.

Common risks

  1. Reaction to sedation medications: In rare instances patients have an allergic reaction to the sedation medications, which may require emergency medical attention. In such an occasion, Dr. Pierson and his staff are trained and equipped to provide emergency care until the patient is transferred to the hospital. Always inform us if the patient has had any known reactions to any previous medications/
  2. Nausea and/or vomiting: Some patients feel nauseous after an oral pre-medication and may vomit. Usually this is not a major problem and stops without treatment, however if it is severe, treatment may be necessary to prevent dehydration.
  3. Loss of airway: In rare cases it has been reported that a patient was so sleepy that their tongue blocked their airway without waking them, and they suffocated. While the patient is in the dental office breathing is closely monitored and if there is any suspicion that the patient is over-sedated they are kept for observation. However, it is important that the parent or care provider observe the patient after the appointment to be sure that they are breathing normally and make sure that the patient is not in a position where their chin is flexed down against their chest which might block their airway.

Consequences of not performing treatment

This treatment will enable the dental treatment to be done more comfortably and lessen the chances of the patient developing a dental fear or phobia.

Every reasonable effort will be made to ensure that the patient will be treated properly, although it is not possible to guarantee perfect results. By signing the consent form, you acknowledge that you have received adequate information about the proposed treatment, that you understand this information and that all of your questions have been answered fully.

PRE-OPERATIVE INSTRUCTIONS

  1. DIET: Usually patients do better with the pre-medication medications if they have some food in their stomach. It is not dangerous to take it on an empty stomach, but so doing seems to produce slightly more nausea. Patients who take it on a full stomach also have more nausea, so a light snack before coming to take the medicine is the most effective.
  2. ILLNESS: Please notify us if the patient develops a cold, fever, runny nose, asthma or other illness. It is usually uncomfortable for the patient to have dental work done when suffering from an infection or illness. If the patient has a change in their health the day before or the day of treatment, please call us. If necessary, we can reschedule the appointment and save you an unnecessary trip.
  3. DAY OF SURGERY: Due to our small waiting room and the fact that the patient may need your undivided attention on the way home it is not recommended that you bring other small children unless there is another adult to assist. Plan on at least 3 hours from the time you arrive until you can leave. The patient should use the bathroom just before the treatment to minimize the chance of wetting themselves while relaxed.