In Case 9 I have included a touch of honesty ! Today I examined an adult male in his mid 40s. He attends irregularly as he is a moderate gagger. His perio condition indicated the need for a number of periapical radiographs. He managed the first but then began to gag. In the past he had had RA for treatment. Unusually he requires a maximum dose to have a worthwhile effect. He agreed to using RA for the rads. Despite sedating him to a max 70% Nitrous : 30% oxygen, he had some difficulty in permitting the radiogrphic examination.
However we eventually succeeded with he minimum of gagging. In all probabliity, he was mouth breathing, at least for some of the time and so did to gain the full benefit.
So was he fully sedated? - No.
Did the RA negate his gag reflex? - Partially.
Did I manage to take the required x-ray images? - Yes
Was this a success?- Partially.
Will he return for further treatment? - I expect so.
There you have it. Is RA always the answer. No.
This afternoon I interviewed a prospective patient in need of some major dental treatment. It took her 20 minutes to cross the road to enter the practice. I have no doubt that the depth of her anxiety means she is more suited to IV sedation and intend to offer her this form of sedation.
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