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A new dentist, practicing sedation dentistry, has joined Dr. Anthony Bailey’s practice in Bedford.
Dr. Rudolf Wolf, who hails from San Diego, Calif., joined Dr. Bailey on June 1. Dr. Wolf went to dental school at Virginia Commonwealth University in Richmond. He liked Virginia, and got to know Dr. Bailey when he met him working at a free dental clinic in Lynchburg.
Sedation dentistry uses sedatives for two purposes. One purpose is for people who are afraid of dentists. According to Dr. Wolf, 30 percent of the population are terrified of going to a dentist and 75 percent have some degree of fear. He said that 57 percent of Americans don’t go to dentists regularly and many of these people skip the needed work because of their fear. Sedation dentistry aims at encouraging these people to come in.
The second purpose of sedation therapy is to allow people to get extensive dental work done in one visit. Dr. Wolf said that many will have difficulty getting off work for multiple sessions in the dentist’s chair. Sedation makes it possible to do everything at once.
This second purpose usually relates to the first. People who don’t go to the dentist on a regular basis end up letting problems accumulate, as well as allowing small problems to turn into big ones. Wolf said that most of the people he sees, who need five or six hours worth of dental work, are people who have been afraid to go to the dentist.
Sedation dentistry is a specialty that requires study, prescribed by the Dental Association for Conscious Sedation, in addition to the regular dental school program. Virginia also requires dentists practicing sedation dentistry to have advanced cardiac life support training and have the necessary equipment, such as an automatic external defibrillator, and medications next to the patient during the work. This, by the way, makes him a handy fellow to have around in any medical office as he could help, even if something happened to a person he wasn’t treating at the time.
This allows Dr. Wolf to sedate patients, and in the case of a five or six hour procedure, keep them sedated. He doesn’t give patients something that knocks them out, they are conscious the entire time. They are, however, comfortable and relaxed. He said the medications do have an amnesic affect so that patients have little or no memory of the time they spent in the dentist’s chair.
Dr. Wolf said that, in addition to people who are afraid of dentists or need to get a lot of work done at one time, it’s good for people who have trouble getting numb. It also helps people who tend to gag because it suppresses that gag reflex.
People who want sedation must come in for a preliminary visit first. Dr. Wolf conducts a baseline vitals check. This is so he knows what the patient’s normal heart rate, blood pressure and oxygen saturation levels are. All of these are monitored during the course of the dental work.
He also reviews what medications the patient is taking. Some drugs can amplify the effect of the sedation medications, others can inhibit the sedation. Some may render a patient a poor candidate for sedation dentistry and Dr. Wolf will consult with that person’s physician.
The night before going to Dr. Wolf, his patient takes a relaxation medication. This is typically followed by another dose the next day. Additional medication depends on the procedure that Dr. Wolf is doing and the length of time it will take.
“I don’t start any work until the patient is completely comfortable and relaxed,” he said. “The nice part of it is that people are not totally knocked out, they are conscious.”
Dr. Wolf said that another benefit of sedation dentistry is that people who have undergone procedures that tend to result in a good deal of pain after the numbness wears off experience little pain the next day. Over-the-counter pain killers are sufficient to handle it, although Dr. Wolf is available to call in a prescription pain killer if his patient needs it.
Dr. Wolf said that he got interested in the sedation specialty because of the problems that delaying dental work causes. Problems that could have been taken care of easily, become very serious. He said that, nationally, 164 million work hours and 51 million school days were lost due to dental problems last year.
Along with liking the area, Dr. Wolf said he was attracted to Dr. Bailey’s office because he is interested in innovative dentistry. The office uses digital x-rays which, Dr. Wolf said, uses less radiation. It also allows him to display the x-rays on two screens, one of which the patient can see.
“It’s nice because I get to explain things to the patient easier,” he said.
The x-rays can also be e-mailed to the patient’s insurance company, which makes it simpler to get insurance to pay for the procedure.
A particularly innovative device that Dr. Wolf likes is a CAD/CAM machine which will build a crown while the patient waits. Conventionally, the dentist will take impressions using a gooey material when a patient needs a crown. These are sent off to a business that makes the crown. A temporary crown is put in the patient’s mouth during the days while he’s waiting. Temporary crowns, as they are temporary, sometimes fall off and have to be put back in during this time.
With this machine, the patient gets his crown right away. Dr. Wolf said it’s very precise, with an accuracy of 30 microns. He said that’s a third of the width of a human hair.
“Most of the crowns I do are CAD/CAM crowns,” he said.
In addition to his weekday work, Dr. Wolf is on call, on weekends, for emergencies through Bedford Memorial Hospital.