This form is intended to document the discussion we have had regarding your planned conscious sedation procedure.
The medications we use are typically either Triazolam (Halcion), Lorazepam (Ativan), Diazepam (Valium) or Midazolam (Versed). These medications can greatly minimize anxiety that may be associated with going to the dentist. In a relaxed state, you will still be able to communicate with the dentist while treatment is being performed. Even though it is safe, effective and wears off rapidly after the dental visit, you should be aware of some important precautions and considerations.
Benefits of conscious sedation include reduced awareness of unpleasant sights, sounds and sensations associated with the procedure along with reduced anxiety. Most patients fall asleep, but not always.
I understand that it is critically important that I fully discuss my complete medical history with the dentist before sedative medications are administered especially any medications I’m taking.
You should not use these medications if you are PREGNANT, breast feeding, or have significant liver or kidney disease.