INFORMED CONSENT FOR SEDATION
ORAL/INTRAVENOUS SEDATION

In our office we offer the use of oral and intravenous drugs to sedate/calm the apprehensive patient; produce greater comfort and in most cases, help the patient forget about the dental procedure that is being performed.

ON THE DAY OF TREATMENT:

  1. DO NOT HAVE ANYTHING TO EAT OR DRINK 8 HOURS PRIOR TO YOUR APPOINTMENT.  You may have a small amount of water, only to take any medications you normally would.
  1. Wear loose, comfortable clothing.  Short sleeves are best; we usually use a vein in the arm to give medication.  Do not wearbracelets or watches.  DO NOT WEAR CONTACT LENSES.
  1. Please be on time for your appointment.  If you are late, your appointment may have to be rescheduled.
  1. You will need someone to drive you home and accompany you for the remainder of the day.YOU MAY NOT DRIVE OR OPERATE MACHINERY FOR 24 HOURS. 
  1. Inform us of any drugs: alcohol, aspirin, birth control pills, coffee, tea, cigarettes, recreational drugs and over the counter drugs you may have taken.
  1. For at least 24 hours after the procedure, do not take sedatives of any kind (this includes alcohol).
  1. Be aware you may feel some sedative effects up to 24 hours after treatment; especially, thirty minutes following your first meal. 
  1. Use the bathroom prior to your appointment.
  2. You must have a known, responsible driver to bring you to your appointment and take you home. They must stay with you for at least 2 hours post-operative. 

I acknowledge that I have carefully reviewed the information on the Oral/Intravenous Sedation and any questions have been answered.  The doctor has discussed in detail the possible alternatives for treatment, which include local anesthesia or general anesthesia which is done in the hospital.  I understand the possible complications for using Intravenous Sedation, which could range from a bruise at the injection site to a severe life threatening response.  The benefits to an apprehensive patient like me have been explained.  I relate that I have accurately completed the medical history questionnaire supplied to me.  I have no idiosyncrasy or allergy to barbiturates, benzodiazepines, analgesics or anticholinergic drugs.  I affirm that I have someone to drive me home and care for me after treatment; I am also aware that because of the medications administered during treatment, I should not drive or operate any machinery for 24 hours after treatment or until alert and off of all pain medications.