Combined Inhalation-Enteral Conscious Sedation for the Adult Dental Patient / Includes Airway Management and Emergencies

Date: Thursday, November 3 - Saturday, November 5, 2022
Time: 9 a.m. to 5 p.m.
Location: University of Maryland School of Dentistry
Tuition: Dentist:   $1,995.00
Team Member:      $550.00

24 CDE credit hours - lecture

The University of Maryland School of Dentistry designated this activity for 24 Continuing Dental Education hour.

Target Audience:  The Dental Professional
Presented by: Marvin Leventer, DDS and Richard L. Wynn, PhD
Conflict of Interest: Presenters have nothing to disclose.


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Speaker Biography

Dr. Leventer graduated from the University of Maryland School of Dentistry in 1990. He then completed a General Practice Residency and a Dental Anesthesiology Residency at Brookdale Hospital Medical Center in New York. He is a full-time assistant professor at the UMSOD and provides sedation and general anesthesia, with the post-graduate residents. He also practices general dentistry and provides dental services at the University of Maryland Hospital.



Richard L. Wynn, PhDRichard L. Wynn, PhD, is a professor of pharmacology in the Department of Neural and Pain Sciences at the University of Maryland School of Dentistry. He is a nationally recognized speaker, author, columnist, and consultant on dental drug therapeutics and drug information for the dental professional. He is the lead author of the most recognized chairside dental drug reference book, Drug Information Handbook for Dentistry, now in its 25th edition. Wynn keeps the dental profession informed about current issues relative to drugs in dentistry, including new therapeutic agents, new drug interactions, and newly reported adverse reactions in dental patients. He researches the literature daily for new reports of interest to the profession.

Course Description

This intensive 24-hour course is offered to the dentist and staff for training in the safe and effective use of combined inhalation (Nitrous Oxide)-enteral (oral) conscious sedation in the adult dental patient.

The goal is for participants to synthesize didactic knowledge with simulated hands-on skills to be competent and safely take care of patients that would otherwise be uncomfortable or avoid dental care because of significant anxiety. This course teaches safe and accepted techniques to allay anxiety. This course will cover deep sedation and general anesthesia as informational only, to understand the whole spectrum of anesthesia for dentistry. Pediatric sedation will be covered also as informational.  We believe to be safe and proficient in pediatric sedation a more intensive and longer duration training experience is necessary.

This course is appropriate for those with no previous experience with Nitrous Oxide or oral sedation as well as those who utilize these techniques regularly. There will be something for everyone. As well, we encourage questions and patient care discussion from participants' own practices and experiences. 

This course will follow objectives and course content based on the current American Dental Association (ADA) guidelines for teaching combined inhalation enteral conscious sedation. This information is designed to cover material necessary to apply for a Class I oral moderate sedation permit in the state of Maryland. This case-based course will offer an in-depth discussion of each aspect of the sedation regimen including scenarios of how to do things correctly as well as what can go wrong. Case reviews and published reports will be presented with question-and-answer periods. All the objectives in the ADA Guidelines will be covered and a comprehensive set of reference materials will be provided as a handout.

The following is a brief synopsis of included material: Presentation of videos of 20 actual sedation cases; patient selection; description of the CNS levels ranging from the conscious to unconscious state; the technique of pharmacological-induced sedation using Nitrous Oxide and appropriate sedative drugs focusing on benzodiazepines. A review of respiratory and circulatory physiology and airway management; the pharmacology of commonly used sedative drugs, their interactions; indications, and contraindications; proper patient monitoring and necessary equipment; record keeping, patient instructions; medical emergency preparedness; a review of local anesthesia as related to sedation; proper use of inhalation sedation equipment and hazards of trace gases; and finally, the abuse potential and hallucinatory effects of sedative drugs.

This course includes all the necessary material to fulfill the Maryland State Board of Dental Examiner’s guidelines for a 2-hour CE course in “Proper Pharmacologic Prescribing and Disposal for Dental Practitioners” as related to the Opioid Epidemic.

This course will include a participation section with simulated emergencies. Participants will learn how to ventilate and use airway adjuncts on an airway manikin. As well, medications and syringes will be supplied for learners to practice drawing up appropriate emergency medications into syringes and administering them to a simulation manikin.

Course Objectives

Review of oral and inhalation conscious sedation 

Adapted from ADA Guidelines 

  1.   Describe the basic components of inhalation sedation equipment.  
  2. Discuss the function of each of these components.  
  3. List and discuss the advantages and disadvantages of oral and inhalation sedation 
  4. List and discuss the indications and contraindications for the use of oral and inhalation sedation 
  5. List the complications associated with oral and inhalation sedation 
  6. Discuss the prevention, recognition, and management of these complications.  
  7. Discuss the abuse potential, occupational hazards, and other effects of oral and inhalation agents. 
  8. Discuss the pharmacology of the oral and inhalation drugs selected for administration. Discuss the precautions, contraindications and adverse reactions associated with the oral and inhalation drugs selected.  
  9. Describe a protocol for management of emergencies in the dental office and list and discuss the emergency drugs and equipment required for management of life-threatening situations. 
  10. Discuss the pharmacological effects of combined drug therapy, their implications, and their management. Nitrous oxide/oxygen when used in combination with oral sedative agent(s) may produce minimal, moderate, deep sedation or general anesthesia. 
  11. Understanding the opioid epidemic:  
    • Identify the problem of prescription drug abuse. 
    • Identify patients at risk for abuse 
    • How to manage post op pain without narcotics 
    • Review proper use and disposable of prescription medications 
    • Writing of prescriptions and protection of prescription pads 

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