IV Sedation dentistry advice

[TallGuyJohninBKK]

4 hours ago, yang123 said:

 excellent diagnostic consultation earlier this month at Bangkok Dental Hospital and the problem understood, but waiting for confirmation and an estimate.   .  

 

I had a large rear tooth pulled at Bangkok Dental Hospital a couple years back, and at the time, asked about some other kind of anesthesia besides the local shot in the gum, and was told NO, no other options.

 

And, just to note, BDH isn't a hospital in the traditional medical sense of the word, but really AFAICT just a large dental clinic/practice that happens to call itself a hospital.

 

[yang123]

8 hours ago, KneeDeep said:

Please take note that I am referring to GA for extensive dental work/oral surgery. I have no knowledge of sedation in a dentist's chair for someone who is simply afraid of going to the dentist.

Nor, apparently,  do you have any knowledge of sedation administered for physical rather than psychological reasons.....

[thaibeachlovers]

On ‎2‎/‎21‎/‎2018 at 2:00 PM, KneeDeep said:

 

IV Sedation is a General Anaesthetic, so everyone is talking about GA. Otherwise the thread topic would be about local anaesthesia.

 

I'm not sure what you meant regarding the "life is worth" comment.

 

For GA, you aren't likely to be sitting in a dentist's chair. Likely an operating room with at least four people involved.

 

 

 

I worked in operating rooms and IV sedation is not a GA. If giving a GA why would they give sedation? All sedation does is take the anxiety out of the procedure and stop the patient moving around. I've actually had operations under sedation and GA so I know the difference personally. Sedation is usually given IV which may have caused confusion.

 

In Thailand, medical is quite cheap, so they may just give GA and not bother with sedation.

[thaibeachlovers]

19 hours ago, KneeDeep said:

 

Not relevant to this thread then. This is a Thailand specific question.

 

http://www.silomdental.com/oral_surgery_sedation_dentistry.html

 

 

Are you saying they use different sedation in LOS compared to overseas? It's all the same.

Your own link says

Sleep dentistry offers pain-free and anxiety-free dental procedures as patients are in a deeply relaxed state, though fully responsive.

and a GA induces a fully unconscious state during which the patient is completely non responsive.

 

Whoever wrote that website was wrong to include GA as a sedation. It's not.

Edited February 23, 2018 by thaibeachlovers

[KneeDeep]

54 minutes ago, thaibeachlovers said:

Are you saying they use different sedation in LOS compared to overseas? It's all the same.

Your own link says

Sleep dentistry offers pain-free and anxiety-free dental procedures as patients are in a deeply relaxed state, though fully responsive.

and a GA induces a fully unconscious state during which the patient is completely non responsive.

 

Whoever wrote that website was wrong to include GA as a sedation. It's not.

 

Quibbling over semantics?

 

Local means applied to the specific location. General means....I think that you understand.

The options in Thailand are Local or GA.

I have referred to GA throughout.

[Sapporillo]

20 hours ago, yang123 said:

Hmm...

The section in the Silom Dental site linked above that deals with sedation dentistry indicates that neither IV sedation nor nitrous oxide sedation is available.  (Also appears that the text has been lifted from a  US web-site - see reference to State Board of Dentistry).

 

So, to repeat the question: where in Thailand is sedation dentistry available?  Any recent experiences? 

Since you mention nitrous oxide, the Bangkok Smile Dental Clinic offers sedation with nitrous (or "laughing gas"). They have a website with pricing for just about everything they offer, and they run more than one clinic. Personally, I've been to their clinic in BKK Sukhumvit twice, but only for minor stuff (a couple of cavities, scaling), and when I got a quote for a crown (nitrous included), it seemed a little expensive, compared to prices in Western Europe (still cheaper, of course, but not that much).

I was happy with the treatments I got there, but you might wanna check and see if you can find more references, especially about implants and stuff like that. Their staff is very professional and of course friendly, and while it isn't a top notch institution by its looks, everything inside seemed modern, clean and well maintained. 

 

On a personal note, years ago, I've had all of my wisdom teeth extracted under IV sedation, and 3 of them were buried quite deep, and I don't remember one bit of it, yet I was back home at noon. Laughing gas is usually the way to go for me, but when it comes to the serious stuff, nothing beats IV sedation...

 

(www.bangkoksmiledental.com)

[TallGuyJohninBKK]

1 hour ago, Sapporillo said:

(www.bangkoksmiledental.com)

 

In looking at their website, I'm not seeing any reference to any kind of sedation available there???

[Sapporillo]

1 hour ago, TallGuyJohninBKK said:

 

In looking at their website, I'm not seeing any reference to any kind of sedation available there???

Me neither, you're right. I hadn't checked their website in a while, and I think it's been redesigned. I'm pretty sure the offer for the nitrous was on their old site, so I don't know if they still have it, or if it's just not on their site anymore. I found an e-mail from September 2015, so at least you have an idea what the price is/was. If you're still interested, drop them an e-mail, they usually answer within 24 hours:

Dear  xx,

Thank you for your email, we will inform to the clinic that you prefer to
apply the gas sedation as well,
Usually, all the dental procedures are carried out under local anesthesia,
however, if you feel that you won't be comfortable under it, you can also
choose over widely sedation methods available these days and get your work
done. This is called the sedation. The cost of the gas sedation is THB 2,500
or approx. USD76 per hour.

Again, thank you for you information and should you have any question please
feel free to email us.   
We are looking forward to hearing from you.   

Regards,
Beth

[thaibeachlovers]

21 hours ago, Sapporillo said:

Since you mention nitrous oxide, the Bangkok Smile Dental Clinic offers sedation with nitrous (or "laughing gas"). They have a website with pricing for just about everything they offer, and they run more than one clinic. Personally, I've been to their clinic in BKK Sukhumvit twice, but only for minor stuff (a couple of cavities, scaling), and when I got a quote for a crown (nitrous included), it seemed a little expensive, compared to prices in Western Europe (still cheaper, of course, but not that much).

I was happy with the treatments I got there, but you might wanna check and see if you can find more references, especially about implants and stuff like that. Their staff is very professional and of course friendly, and while it isn't a top notch institution by its looks, everything inside seemed modern, clean and well maintained. 

 

On a personal note, years ago, I've had all of my wisdom teeth extracted under IV sedation, and 3 of them were buried quite deep, and I don't remember one bit of it, yet I was back home at noon. Laughing gas is usually the way to go for me, but when it comes to the serious stuff, nothing beats IV sedation...

 

(www.bangkoksmiledental.com)

IV sedation sometimes gives amnesia as well. In my case it didn't, but everyone reacts differently. I was in a dream state but I could hear the staff talking and move when requested.

 

I had a wisdom tooth removed with hammer and chisel, and got mild concussion when I was younger.

I think back then if I'd asked about sedation the dentist would have laughed at me.

[thaibeachlovers]

18 hours ago, Sapporillo said:

Me neither, you're right. I hadn't checked their website in a while, and I think it's been redesigned. I'm pretty sure the offer for the nitrous was on their old site, so I don't know if they still have it, or if it's just not on their site anymore. I found an e-mail from September 2015, so at least you have an idea what the price is/was. If you're still interested, drop them an e-mail, they usually answer within 24 hours:

Dear  xx,

Thank you for your email, we will inform to the clinic that you prefer to
apply the gas sedation as well,
Usually, all the dental procedures are carried out under local anesthesia,
however, if you feel that you won't be comfortable under it, you can also
choose over widely sedation methods available these days and get your work
done. This is called the sedation. The cost of the gas sedation is THB 2,500
or approx. USD76 per hour.

Again, thank you for you information and should you have any question please
feel free to email us.   
We are looking forward to hearing from you.   

Regards,
Beth

That seems a very high price for nitrous oxide. Unless it's some special "magical" sort the patient just breathes it through a special mask. They use it all the time for women in labour, or at least did when I was in the business. We used it for patients having very painful dressings changed. Don't know why they call it laughing gas as it doesn't make people laugh, but it does give a very pleasant feeling. Good stuff to use as as soon as stop breathing it it's gone. No recovery period.

[Sapporillo]

3 hours ago, thaibeachlovers said:

That seems a very high price for nitrous oxide. Unless it's some special "magical" sort the patient just breathes it through a special mask. They use it all the time for women in labour, or at least did when I was in the business. We used it for patients having very painful dressings changed. Don't know why they call it laughing gas as it doesn't make people laugh, but it does give a very pleasant feeling. Good stuff to use as as soon as stop breathing it it's gone. No recovery period.

Yes, extremely expensive, I’ve paid much less than that in Geneva, and it’s also very rare there (in fact I only know one). It was widely used in dentistry before the creation of whatever they were using after (lidocaine?), and AFAIK it’s still quite popular in the USA, and I can see why. It actually makes a visit to the dentist almost a pleasant experience, especially if used together with an injection in the gums. 

 

It can also make you laugh if you start thinking about something funnny...happened to me once, the dentist had to interrupt the treatment for a minute because i couldn’t stop laughing ? 

[TallGuyJohninBKK]

Glad you guys have mentioned that yes, the price quoted above for a laughing gas session does seem quite high! (to to speak...)

 

I'll just add that someone here recently posted info about a dental clinic in India that specializes in medical tourism for implants. And as I was reading their website, they were talking a lot about their use of nitrous oxide as part of their treatments to put their patients at ease.

 

[thaibeachlovers]

On ‎2‎/‎25‎/‎2018 at 12:15 AM, TallGuyJohninBKK said:

Glad you guys have mentioned that yes, the price quoted above for a laughing gas session does seem quite high! (to to speak...)

 

I'll just add that someone here recently posted info about a dental clinic in India that specializes in medical tourism for implants. And as I was reading their website, they were talking a lot about their use of nitrous oxide as part of their treatments to put their patients at ease.

 

Nitrous certainly puts one at ease as I can testify. Great stuff.

Would need an injection as well though, as I doubt it's enough on its own.

[sanuk711]

Hi

dont want to hi-jack the thread, but instead of starting a new one... Pattaya best place to get 1 crown, needs to be done in a week as its for visitors--- quality work is important as they will head back home after. The latest thread on Pattaya dentists is over a year old.

 

many thanks guys

[thaibeachlovers]

8 hours ago, sanuk711 said:

Hi

dont want to hi-jack the thread, but instead of starting a new one... Pattaya best place to get 1 crown, needs to be done in a week as its for visitors--- quality work is important as they will head back home after. The latest thread on Pattaya dentists is over a year old.

 

many thanks guys

Given it's 4 days since anyone posted on this thread, you would do better to start a new one.

[Sapporillo]

On 3/2/2018 at 3:02 AM, sanuk711 said:

Hi

dont want to hi-jack the thread, but instead of starting a new one... Pattaya best place to get 1 crown, needs to be done in a week as its for visitors--- quality work is important as they will head back home after. The latest thread on Pattaya dentists is over a year old.

 

many thanks guys

You can't get a crown in one (1) week, at least not with the dentists I have had my two crowns done. After the root canal treatment, the tooth (or what's left of it) and it's surroundings have to heal before they can put the crown in, and if I remember correctly, the waiting time is no less than one week. So even if he would get the root canal treatment the day he arrives in Thailand, he would still have to wait for the crown until the day he's leaving Thailand, and it would probably be better to wait another day. This is something that I definitely wouldn't wanna rush, but maybe you wanna send an e-mail to one of the big clinics, they can tell you exactly how much time he needs.

[sanuk711]

Thanks for that advice sapporillo...I will check it out

 

[Golden Triangle]

On 2/22/2018 at 4:19 PM, KneeDeep said:

Please take note that I am referring to GA for extensive dental work/oral surgery. I have no knowledge of sedation in a dentist's chair for someone who is simply afraid of going to the dentist.

I can assure that had you suffered as much I did as a young boy in a dentists chair you would be requiring the same sort of  services being discussed here, it was a thoroughly nasty, painful and frightening experience, so please do not mock people who may have a perfectly rational fear due to a previous encounter.  The last time I visited the dentist my BP was 236 / 138 and I ended up in the ER. 

[KneeDeep]

On 06/03/2018 at 7:19 AM, Golden Triangle said:

I can assure that had you suffered as much I did as a young boy in a dentists chair you would be requiring the same sort of  services being discussed here, it was a thoroughly nasty, painful and frightening experience, so please do not mock people who may have a perfectly rational fear due to a previous encounter.  The last time I visited the dentist my BP was 236 / 138 and I ended up in the ER. 

 

You don't know that I did not.

As to whether yours is a rational fear, I can't say.

Either way, my coping mechanisms have improved considerably since then and will have a dental implant inserted this month with just a local anaesthetic.

[thaibeachlovers]

On ‎3‎/‎6‎/‎2018 at 2:19 PM, Golden Triangle said:

I can assure that had you suffered as much I did as a young boy in a dentists chair you would be requiring the same sort of  services being discussed here, it was a thoroughly nasty, painful and frightening experience, so please do not mock people who may have a perfectly rational fear due to a previous encounter.  The last time I visited the dentist my BP was 236 / 138 and I ended up in the ER. 

Not wishing to cause increase in BP, but just taking Valium before might be enough. It works for me.

[shdmn]

On 2/22/2018 at 5:01 PM, yang123 said:

Nor, apparently,  do you have any knowledge of sedation administered for physical rather than psychological reasons.....

 

Yes, there are different types of sedation.  Oral sedation or nitrous oxide gas is just to relax you to ease your anxiety.  It doesn't do anything for pain so you still need local anesthetic although, with some people, less anxiety can increases their pain threshold.  A lower heart rate can also help increase the effectiveness of the local anesthetic.

 

IV Sedation make you semi-conscious and usually includes Fentanyl to kill the pain.  That is used in combination with local anesthetic which compliments the Fentanyl for more complete pain killing.  I think being semi-conscious also increases your pain tolerance in the brain since it is mostly switched off.  It is for people (like me) who can't get fully numb with local anesthetic and/or just don't want to be awake for any of it for whatever reason.  I have had it a few times now.  You are completely unconscious from your point of view and don't remember a thing.  You still apparently respond to some commands like open your mouth move your head etc. but you won't remember any of that.  You can still breathe on your own so you don't need a ventilator.  So it's ideal for dentistry.  

 

There is also general anesthetic dentistry which is the same as any other operation in a hospital.  You are totally knocked out and cannot breathe on your own so you need a ventilator or whatever that is they use in operations.  It's probably not ideal for dentistry because the ventilator probably gets in the way of them being able to operate on your mouth.  Not sure how they get around that.  I think that sort of thing is more for major oral surgery.

 

Anyways, for anyone who dreads going to the dentist for whatever reason, I highly recommend IV sedation.  You don't remember a thing so it makes the whole experience very pleasant, for lack of a better word.  It adds between $300-$500 US to any treatment but for me it is worth every penny.  I cannot get numb enough for even minimal drilling so I don't have any choice.  I have to do it for all dental work except cleaning.  I usually try get more than one thing done at a time to make it more cost effective but sometimes I have to bit the bullet, so to speak, if it's more of an immediate thing I need like a broken tooth or I lose a filling or whatever.

 

There is a place in Bangkok called Bangkok International Dental Hospital that does it.  I have not tried that place yet but I plan to.  They have an outpatient area with nurses so I think you can stay there in a bed for a few hours afterwards until the sedation completely wears off and leave on your own.  So you don't need someone to come get you and babysit you for a few hours which can be a hassle sometimes depending on your current situation.

 

 

Edited December 11, 2020 by shdmn

[yang123]

^^^  Good post - entirely agree!

 

I recently established that Bangkok Hospital (BH) in Chiang Mai offers IV sedation using midazolam and have an appointment there next month for a three-sitting course of treatment (implant preparation and fitting).  The service so far has been first class:  assessment by two dentists and discussion with an anaesthetist who will squirt the magic potion into my arm and monitor me during the surgery.  I'll report here afterwards on the outcome.

Cost:  One hour sedation THB 15,000; every 30 minutes thereafter 4,000. 

 

The BH website suggests that this treatment is also available in Bangkok.

[Bruno123]

I was going to complain about the bumping of a thread abandoned for nearly three years; but as the original poster replied to the answer, it appears entirely appropriate.

So I can add that I went under general @ Phyathai Sri Racha a while ago as I needed quite a bit of work.

 

Though it has to be said that their Implantologist does good work; so there is actually no need for General, as the discomfort is minimal. It's probably more for the anxiety, which is understandable if you have had bad experiences in the past.

10,000 - 15,000 baht sounds about right(I have no idea why someone on a Thailand related board regarding services in a Thailand hospital to Thailand expats would quote in US$).. Though of course the cost of Implants is a lot less than in Bangkok. So the price of an Implant including General would likely be the same as Bangkok without General.

 

For a single Implant, I would not bother with General; perhaps only for full mouth or some extensive oral surgery.

 

 

[Bruno123]

8 hours ago, shdmn said:

 

Yes, there are different types of sedation.  Oral sedation or nitrous oxide gas is just to relax you to ease your anxiety.  It doesn't do anything for pain so you still need local anesthetic although, with some people, less anxiety can increases their pain threshold.  A lower heart rate can also help increase the effectiveness of the local anesthetic.

 

IV Sedation make you semi-conscious and usually includes Fentanyl to kill the pain.  That is used in combination with local anesthetic which compliments the Fentanyl for more complete pain killing.  I think being semi-conscious also increases your pain tolerance in the brain since it is mostly switched off.  It is for people (like me) who can't get fully numb with local anesthetic and/or just don't want to be awake for any of it for whatever reason.  I have had it a few times now.  You are completely unconscious from your point of view and don't remember a thing.  You still apparently respond to some commands like open your mouth move your head etc. but you won't remember any of that.  You can still breathe on your own so you don't need a ventilator.  So it's ideal for dentistry.  

 

There is also general anesthetic dentistry which is the same as any other operation in a hospital.  You are totally knocked out and cannot breathe on your own so you need a ventilator or whatever that is they use in operations.  It's probably not ideal for dentistry because the ventilator probably gets in the way of them being able to operate on your mouth.  Not sure how they get around that.  I think that sort of thing is more for major oral surgery.

 

Anyways, for anyone who dreads going to the dentist for whatever reason, I highly recommend IV sedation.  You don't remember a thing so it makes the whole experience very pleasant, for lack of a better word.  It adds between $300-$500 US to any treatment but for me it is worth every penny.  I cannot get numb enough for even minimal drilling so I don't have any choice.  I have to do it for all dental work except cleaning.  I usually try get more than one thing done at a time to make it more cost effective but sometimes I have to bit the bullet, so to speak, if it's more of an immediate thing I need like a broken tooth or I lose a filling or whatever.

 

There is a place in Bangkok called Bangkok International Dental Hospital that does it.  I have not tried that place yet but I plan to.  They have an outpatient area with nurses so I think you can stay there in a bed for a few hours afterwards until the sedation completely wears off and leave on your own.  So you don't need someone to come get you and babysit you for a few hours which can be a hassle sometimes depending on your current situation.

 

 

 

I visited that place as part of my research, though decided against it. Firstly it was relatively expensive and secondly I did not like the idea of a roving Implantologist would who visit twice a week.

 

The results of my research lead me to Sri Racha. Permanent Implantologist; there for more than ten years now. Full hospital facilities, rather than just a dental centre. A good decision thus far. The fact that it cost less and they don't nickle and dime you to death is a bonus.

Be nice and receive the same service.

 

[shdmn]

So I finally went to BIDH for consultation on IV sedation.  They were very professional and the dentists seemed quite competent, so no complaints there.

 

I was all set to do it when I realized that the price they quoted me was only for the sedation part.  It's way more expensive than in the west.  Over 40k baht just for the sedation. The form said "IV sedation for foreigner".  So I think I was getting overcharged just for being a foreigner as well. 

 

The dealbreaker was the fact they wanted me to get a bunch of tests at Bumrungrad to determine that I was medically fit for IV sedation.  It may have been due to my age but I am not sure about that and they didn't really say that directly.  I didn't need any tests in the west when I had it done last year.  That would have cost at least another 3000b but that was only their estimate. It may have ended up being lot more with it being Bumrungrad and all.

 

The price they quoted me just for the crown work I wanted done was quite reasonable though. Less than the quote I got in Canada.  So I would say that place is probably a good option just for that without any IV sedation.  They also offered the option of laughing gas. That may be all some people need if it's just for anxiety.  My problem is that I have trouble getting fully frozen, the laughing gas doesn't help with that.

Edited October 4, 2022 by shdmn