Is going to the dentist really stressful for you? Fear and anxiety, muscle and psycho-emotional tension interfere not only with the patient, but also with the doctor. Premedication will help cope with this.
Premedication, or simply put, taking sedative medications, is carried out before pain relief and enhances the anesthetic effect. It is simply irreplaceable for those who are terrified of dental treatment. Especially for the youngest patients.
Why is premedication needed?
The purpose of premedication is to prevent possible reactions and complications during or after dental procedures, including achieving:
- suppression of fear;
- patient relaxation;
- elimination of the gag reflex;
- suppression of increased salivation;
- reduction of pain sensitivity;
- prevention of allergic reactions.
Restrictions
The doctor pays special attention to explaining to the patient the rules and restrictions that he must adhere to before premedication and after its completion:
- The day before the procedure, you should not take any sedatives or alcoholic beverages. Their combination with the medications used can give an undesirable effect.
- After its completion, it is not recommended to drive a vehicle or perform work that requires attention and concentration. This limitation is explained by the fact that in many patients, after premedication, mental activity and response decrease.
- Throughout the day, you should also not deal with financial, legal and other important issues that require concentration and high responsibility.
- You cannot play sports or go outside without an accompanying person.
- If the procedure was performed on a child, he should not be left without adult supervision.
- It is prohibited to take additional vital medications without the permission of a specialist.
Important: these restrictions are due to the fact that all drugs suppress brain activity. The recovery of a person and the return to normal of all his physiological reactions occurs within 24 hours.
Types of nonspecific premedication
Sedative
Has a sedative effect. Reduces mental and emotional stress, eliminates fear and anxiety, and also enhances the effect of pain relief.
Half an hour to an hour before treatment, the patient is recommended to take tranquilizers or homeopathic sedatives of plant origin:
- The first include afobazole, diazepam, phenazepam, valocordin.
- The second includes tinctures of valerian, motherwort and peony, novopassit tenoten, corvalol.
Under their influence, a person relaxes, while remaining fully conscious. The effect lasts for several hours. If you have a panicky fear of dentists, it is better to take medications not only before visiting the doctor, but also on the eve of the scheduled visit.
Valerian and peony
Analgesic
Completely suppresses or significantly reduces the pain threshold, enhances the result of local anesthesia. The analgesic effect is achieved by taking painkillers - narcotic or non-narcotic. Half an hour to an hour before dental intervention, the following are prescribed: ibuprofen, ketrodol, xefocam-rapid, nubain, tempalgin, tramadol, tramal, fortal.
On average, the effect of analgesics lasts four hours.
Antiallergic
To prevent allergic reactions to local anesthetics and pseudo-allergic manifestations in response to a stressful situation for the body, patients are prescribed antihistamines.
Most often it is diphenhydramine, suprastin, claritin, tavegil. Other drugs are also used - Zyrtec, Kestin, Parlazan, Telfast.
Diphenhydramine, claritin, tavegil and suprastin also have a sedative and anti-inflammatory effect.
Cholinergic
Excessive salivation and the gag reflex are suppressed with a number of medications:
- atropine;
- haloperidol;
- glycopyrronium;
- droperidol.
Clozapine, metacin, Robinul and triftazine are used for the same purposes. Medicines are taken the day before dental procedures and/or half an hour before them.
Combined
In other words – combined. This type is most often used to eliminate several problems at once. Which types of premedication will be combined depends on the results of the anamnesis.
Alternative to general anesthesia
Sedation is considered a safer alternative to general anesthesia. This procedure involves inhaling a special mixture of nitrous oxide and oxygen through a mask. It makes the child feel relaxed and slightly drowsy, lifts his spirits and calms him down. At the same time, the small patient remains conscious and can interact with the dentist.
Sedation is not anesthesia, but has a slight analgesic effect. It is usually combined with an anesthetic injection. The mixture of gases is supplied through a special device that controls the duration and dosage and allows you to smoothly enter and exit the state of sedation. The effect of the procedure wears off within about 10 minutes after stopping the supply of nitrous oxide.
Premedication in pediatric dentistry
A different set of medications is recommended for children than for adults. Premedication regimens depend mainly on the age of the child.
Children from 0 to 3 years old are not given premedication.
- Children 3-6 years of age are prescribed phenobarbital and bromide-based sedatives the night before a visit to the dentist. Half an hour before the procedures, the same drugs and 10 drops of valerian tincture are taken again.
- 6-10 year old children are prescribed barbamyl, bromides and pipolfen before bedtime. 30 minutes before dental surgery, the medications are taken again along with vitamin B1.
- Adolescents under 15 years of age take diphenhydramine, phenobarbital, barbamyl and pipolfen before going to the dentist. Before a dental procedure, promedol, atropine, and aminazine are added to these medications.
Drugs that depress mental processes and the functions of the respiratory, circulatory and excretory systems are contraindicated for children.
Reviews
A properly selected medicinal product for premedication will not cause side effects. When selecting a drug, the doctor must assess the patient’s general health condition and take into account his individual characteristics.
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Contraindications
- Liver diseases, for example, cirrhosis, Botkin;
- kidney diseases;
- myasthenia gravis – a disease that causes pathologically rapid fatigue of striated muscles;
- pregnancy and lactation;
- age up to three years.
There may be other individual contraindications, so you should act only under the guidance of a doctor.
Prices
The total cost of premedication directly depends on the type of medications prescribed to the patient. The cheapest are tinctures made from herbal preparations. So, for “Motherwort” and “Valerian” you will have to pay only about 50 rubles, an increase of 10-20 rubles. Valoserdin and Corvalol are more expensive. The most expensive of these drugs is Valocardin - about 100 rubles.
Painkillers cost a little more. For example, Ibuprofen costs about 80 rubles. (the cheapest of them), and the cost of “Tramadol” reaches 220 rubles, “Xeform - Rapid” - from 170 rubles.
If powerful tranvilizers are required for premedication, the cost of the procedure increases. So, “Morpholine” costs about 340 rubles, “Sedoxazin” - from 400 rubles, “Elenium” - from 300 rubles, “Mebikar” - from 260 rubles.
Most of these products cannot be purchased freely at pharmacies. Their sale is permitted only by prescription.
Complications
If the procedure was carried out according to indications and in compliance with the dosage of medications, there should be no complications. However, some drugs have side effects and can cause a number of negative symptoms:
- hallucinations;
- dry mouth;
- rash;
- increased drowsiness.
Side effects go away on their own when the drug wears off. On average - four hours after administration.
Immediately after completing dental procedures, the doctor must make sure that the patient is in adequate condition, reacts normally to external stimuli, and feels well. If this is not the case, the dentist contacts the patient’s relatives and waits for their arrival.
General overview
Premedication is a medicinal preparatory measure aimed at adapting the body to therapeutic procedures and administering painkillers.
It is used in dental treatment not only in adults, but also in children. To prepare the body, specialists use various medications or a combination of them. What is the purpose of this procedure if anesthesia is still required after it?
The fact is that during dental intervention local anesthesia is more often used, which cannot suppress some components of pain. Their action is aimed at eliminating the pain syndrome itself.
It is impossible to get rid of the autonomic and emotional components of pain using analgesic blockades.
The psychological and emotional stability of the patient is an important component of effective pain management. Not only the choice of product, but also its dosage depends on this.
Many patients behave inappropriately during or before treatment, that is, they react emotionally to existing circumstances. This is expressed by a feeling of anxiety and worry, as well as neurotic fear, insomnia and refusal to eat.
However, the problem is not only psychological instability. This condition can lead to physical disorders and malfunctions in important organs of the body.
For example, the adrenal glands produce steroid hormones (glucocorticosteroids) many times more intensely. The consequence of this condition is an increase in blood pressure and body temperature, the pattern of blood movement through the vessels is disrupted.
All of these factors determine the use of premedication in dentistry. Its task is to provide conditions that will allow the administration of a well-chosen painkiller, prevent negative consequences and bring the patient to a state of psychological comfort.
FAQ
Does premedication hurt?
Not necessary. Premedications can be taken orally, so there will be no pain. Injections, however, give better results.
Does it influence behavior?
Sometimes patients become more talkative and unreasonably cheerful. But such manifestations are extremely rare. If adverse reactions occur in the form of hallucinations and drowsiness, it is prohibited to drive. Until these symptoms go away, it is not recommended to engage in activities that require increased concentration. In other cases, after premedication, you can return to a normal lifestyle and do your usual activities.
Indications
With the help of premedication, dentists and patients solve the following problems:
- reduce and eliminate psycho-emotional instability;
- prevent the occurrence of a vagal reaction of the body (bradycardia, slow heartbeat);
- provide neurovegetative protection;
- stabilize the patient’s condition and reduce his reactions to external and internal environmental factors that cause agitation;
- prevent various allergic manifestations;
- slow down metabolic processes;
- enhance the effectiveness of anesthetics and prolong their effect.
In addition to the main problems that premedication can eliminate, there are a number of indications for its use:
- Complex and lengthy surgical interventions (for example, osteoplastic surgery), requiring the mandatory use of general anesthesia.
- Implantation of artificial roots into the gums in the form of implants.
- The patient is in a tense, agitated and anxious state.
- Autonomic disorders and physical instability. This could be bradycardia, elevated body temperature, etc.
- The presence of diseases of the respiratory apparatus and cardiovascular system, which increase the patient’s feeling of anxiety and develop complications.
- The patient becomes faint or loses consciousness during a consultation with a doctor.
Causes of development of bottle caries in children and treatment used in dentistry.
Find out more here what to do if the tooth root hurts when pressed.
At this address https://zubovv.ru/lechenie/zubyi/kak-delaetsya-provodnikovaya-anesteziya-v-stomatologii.html we will talk about the types of conduction anesthesia in dentistry.
