T-Bone Speaks

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tagarwalnc

In this week’s podcast episode, I speak with Dr. Brian McGue about how oral sedation dentistry can grow your practice.

Brian is a general dentist in Chesterton, Indiana and specializes in providing all aspects of dentistry in a relaxed but informative environment. His practice is built on the constitution of ‘family,’ and this is realized by treating each patient like a valuable member of an extended family. His practice provides a full range of dental services from simple teeth cleaning to root canals, wisdom teeth extractions, and implants. He always strives to give his patients “something to smile about,” and he certainly lives up to his outstanding reputation.

What is your dental practice missing?

I’ve often debated why many practitioners tend to focus on the same procedures as everyone else. Is it easier to follow the crowd, or have we become too “set in our ways” to know any better?

What if I were to tell you that there is a procedure available that applies to 50% of the population that doesn’t go to the dentist? And that this same procedure is one that also applies to a significant percentage of the patient population that are fearful of the dentist?

Sounds too good to be true, doesn’t it?

Well, Oral Conscious Sedation does exactly that, and I’ve invited Dr. Brian McGue on the show to talk about how you can add this service to your practice and appeal to a much broader spectrum of potential patients.

How can you grow your practice?

This is a question that comes up time and time again, and the hard truth is, there isn’t a one magic bullet answer. What dentists need to realize is that there are three significant objections our patients face before they even step foot into your practice; time, money and fear.

We need to ask ourselves three questions:

1. How can we make the experience less time-consuming for our patients?

2. How do we make our services more affordable?

3. How can we remove the ‘fear factor’ from the experience to make the process less fearful for our patients?

Many people assume that sedation dentistry is only for fearful patients. However, sedation isn’t just for nervous patients, it’s for many patients beyond that.

I was pleased to welcome Dr. Brian McGue to the show to discuss how oral conscious sedation can help grow your practice.

How to learn the skills required for a successful sedation?

Brian is passionate about sedation, and it allows him to offer a variety of procedures from minor restorations to full mouth reconstructions. Many of his patients are referred to him by other dentists. However, he often finds himself encouraging those dentists to learn about sedation themselves as it’s a valuable service for any practice.

You can learn the necessary skills with continued learning. Brian refers to himself as a “big advocate” for continued education, and he even received the prestigious Fellowship Award from the Academy of General Dentistry by participating in 600 hours of continuing education.

What is oral sedation?

Oral sedation dentistry involves the administration of sedative drugs to help reduce the stress and anxiety of a patient. There are many ways a patient can be sedated such as oral conscious sedation, inhalation sedation, and IV sedation. 

Conscious oral sedation is particularly beneficial to the patient because it’s a less intrusive way of medicating a patient and it’s also very safe.

How safe is oral sedation?

There are three essential factors to ensure a safe oral sedation procedure. Firstly, you must always have a reversal agent on hand so that you can reverse the medication as fast as possible if necessary. Secondly, you must maintain an airway and thirdly, you need to monitor the patient’s heart rate.

Monitoring is a vital part of oral sedation. You need to monitor the patient's blood pressure, blood oxygen level, and heart rate. You’ll have machines to help you with this, such as capnography to track CO2 levels and a pulse oximeter to monitor the oxygen saturation of the patient’s blood.

Sleep dentistry Vs. conscious sedation

Many people confuse conscious sedation with sleep dentistry – but they aren’t the same thing? When patients arrive at my practice for sedation, I’m honest with them about their expectations and the reality of oral conscious sedation.

Around 80% of my patients are going to be in and out of a nap for the majority of their visit, and 90% will wake up without any memory of their visit. I can still talk to them during the procedure, and they’ll be responsive - but they won’t remember any of it.

Dosing and medication

There’s a lot of confusion around the amount of medication and dosing a patient needs for a single visit. Brian explained that Benzodiazepine is one of the best drugs used in dental and medical sedation because they don’t have a lot of respiratory depression, which is the major concern in sedation.

Another great option is Halcion, which was designed in the 70’s to help people suffering from insomnia have a better night’s sleep. It works for up to four hours, which is why it’s such a great drug for dentistry.

Dr. Brian’s maximum recommended dose for Halcion is 0.5mg. It’s also possible to use multiple medications on patients if required, such as Hydroxyzine, which is a useful antihistamine.

Nitrous Oxide is often used in inhalation sedation, which is perfect for dentistry because it’s safe and reverses faster than other drugs.

What to look out for with patients who need the sedation reversed?

Brian explained that once the pulse oximeter drops below 90%, it’s time to stop and ask the patient to take a deep breath. If it continues to decline, stop the procedure immediately and use the reversal agent.

Flumazenil is used to reverse the effects of the sedative and is essentially a competitive inhibitor of Benzodiazepine. Continue to monitor the patient and make sure they are getting plenty of oxygen.

What procedures are suitable for sedation?

When I asked Brian this question, he simply said, “every one of them.” Whether you are going the dentist for a simple procedure or something more complicated, sedation should be a viable option for everyone.

If you want to gain the necessary skills and knowledge to incorporate oral sedation into your practice, join Dr. Brian at his Oral Sedation Program here with 3D Dentists in Raleigh, North Carolina.

The course takes place from June 7th to June 9th and will give you the opportunity to learn more about the benefits and safety precautions associated with sedation dentistry in a fun and interactive environment.

To learn more about this program and book your place in the course, visit 3d-dentists.com/sedation.

Get in touch with Dr. Brian McGue by sending him an email at bmcgue702@aol.com. 

Watch my interview with Brian in the video below: