Pain and the fear of pain have long been associated with dentistry. Modern
dentistry has the means to control pain, either with safe reliable local
anesthetics, intravenous sedation, or for some cases, general anesthesia.
Yet, for many people, the fear of dentistry remains a serious deterrent
to seeking and receiving needed dental treatment. In the US annually,
155 million people have acute pain at least once a year, yet 35 million
people in the US avoid dental care because of fear. 1
To a large degree, success in dentistry requires the recognition and effective
treatment of fear and anxiety in patients. Local anesthesia does not necessarily
reduce fear, and in fact, since it is administered by a "needle"
may be the source of fear itself. A broad range of anxiety control methods
are available to dentistry today. With the exception of hypnosis and acupuncture,
all methods employ the use of drugs that produce effects from mild forms
of sedation to general anesthesia. This course is concerned with only one
of these drugs, nitrous oxide.
Other sedative or tranquilizing drugs can be, and occasionally are, combined
with N2O sedation to enhance the effect. However, it should be
noted that the combination, while giving greater effect, also may produce
increased risk of complications. This course has not been constructed to
include information for the provision of oral or intravenous sedation, therefore,
this course will be concerned primarily with the use of nitrous oxide-oxygen.
You will find some of the information will be repeated in different chapters.
These points are obviously felt to be important issues that we want you
to be well aware of, often in different contexts. Hopefully, you will not
find the redundancy disconcerting.
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