Have you avoided going to the dentist because you’re afraid of needles? Maybe you’ve had bad experiences before or suffer from a terrible gag reflex. Perhaps you’re too busy with traveling for your job, or can’t seem to get numb, or don’t like the noise of the drill or the smell of a dental office. Maybe you are simply too embarrassed to show your mouth because of years of neglect.
An estimated 30 million to 40 million Americans are fearful of seeing a dentist, according to the Colgate Oral and Dental Health Resource Center. While most procedures a person undergoes in the dentist’s chair are completely painless, the experience of visiting the office—or even just the thought of it—can cause so much stress that these millions of people avoid going to the dentist entirely. This, of course, can lead to neglect and ultimately very poor dental health. Fortunately, for such patients, there are dentists such as David E. Stall, D.M.D., who are experts in handling just these types of cases.
Sedation dentistry, which Dr. Stall has been offering for more than 10 years, can help with all that. Gone is the anxiety and worry, replaced by total comfort, peace of mind and true relaxation.
“Sedation is used for many reasons,” explains David E. Stall, D.M.D., a graduate of the University of Pennsylvania School of Dental Medicine, whose practice, David Stall Dental, has been serving the West Chester area since 1985. “We found there were a lot of patients avoiding having treatment done, through fear of pain and other reasons. They were walking around with horrible problems, waiting until they had no choice. But by then the solutions were extreme. For the patients who are severely phobic, it’s hard to even get them in the door.”
Yet, he says, “If I can get those people through the door and they can sit and talk to us, we’re very good at keeping people calm and happy. My staff are really kind, caring people, and that shows through to patients.”
Seeing the need, and with hardly any other dentists in the area providing sedation, Dr. Stall decided to learn more about the service. He became certified in this procedure in an effort to provide better treatment to phobic patients and those with nausea or strong gag reflexes. In 2004 he began the required 80-hour hospital-based course Pennsylvania requires for sedation-dentistry certification. He also received his Advanced Cardiac Life Support (ACLS) certificate, another requisite for performing this work. After receiving his temporary sedation accreditation, his office was officially certified by a series of oral surgeons who watched him perform. Once they completed their report saying that he was accomplished in the processes, the temporary certificate became permanent. The entire process also must be renewed every six years, and continuing education is required for the yearly maintenance of the certificate.
Sedation dentistry is, in essence, exactly what it sounds like—a means of performing dental procedures on patients who have been relaxed with a mild to moderate sedative. During this time, patients experience what is referred to as “twilight sleep,” during which they are moderately conscious and able to offer verbal responses to questions. At the same time, they are anesthetized to pain and will have little to no memory of the procedure.
While under sedation, patients are monitored closely to ensure that their breathing and heart rate remain normal. As one might expect, obtaining the proper training and certification to utilize such methods requires a great deal of study and training, which Dr. Stall and his staff have undergone. “Dentistry changes every year, so you have to stay up to date,” Dr. Stall explains, noting that he completes more than 40 hours of dental continuing education, plus 15 hours just on sedation, biannually. In fact, he has taken more than 2,100 hours of dental and medical continuing education since 1983.
Dr. Stall, who utilizes conscious sedation only for patients ages 18 and older, also uses oral medications and nitrous oxide, when indicated. For patients who wish to receive calming medication even before visiting his office, Dr. Stall can prescribe pills to semi-sedate patients in advance. Most often, however, he uses IV sedation medications, as he can apply a great deal more precision in dosage.
“By utilizing an IV, I can actually control how much of a drug is needed,” Dr. Stall explains. “I can give exactly the amount of drug a patient needs to be sedated.”
The array of procedures Dr. Stall can perform while a patient is under sedation is vast, and can include anything from extracting teeth to placing implants to completing a bridge to denture and gum therapy, all in a single session. In fact, some patients can be saved numerous extra visits to the office by undergoing multiple procedures in a period of several hours, with help from sedation.
Sedation dentistry is just one of Dr. Stall’s areas of expertise. Dr. Stall is also an experienced provider of complete family, cosmetic, laser and implant dentistry. “Improving smiles through the use of bonding, porcelain veneers and implants today is a lot easier than it was 15 years ago,” he says, noting there has been significant improvement in not only the technology but also the techniques for cosmetics, implant placement and healing time. “For example, with implants, if you have to lose a tooth … many times we can now put an implant in during the same visit the tooth comes out.”
One of the biggest benefits of implants is for people with no teeth who wear dentures, according to Dr. Stall. He explains that by adding a few small-diameter implants to a patient’s bottom arch a patient’s denture can be stabilized to eliminate most, if not all, of the movement and discomfort.
“If you fear the dentist, you’re not alone,” Dr. Stall assures. “That’s why we have these options. We understand your fears and can help you through this. Our dental assistants will even hold your hand if you want them to.”
David Stall Dental is located at 1646 West Chester Pike, Suite 1, in West Chester. To see if you are a candidate for sedation dentistry, call 484-427-4400. For more information, visit www.DavidStallDental.com.
Photograph by Jody Robinson
