Relative Analgesia in Practice Part One

My Relative Analgesia “Happy Air” experience in General Practice

I am delighted to help host the Richard Charon Inhalation Sedation training event on Saturday 27th March 2013 in our modern training facility in Stratford upon Avon. I can highly recommend Richards approach to handling nervous patients and its great to do a day like this and go away fully prepared to start using these techniques.

I have been involved in IV sedation for quite a few years, carrying out over 1000 sedation dental procedures. I am used to it, I like the technique, I like how it makes people feel and I know that even the most phobic patients, those who haven’t been for 20 years, can be treated with the minimum of fuss, pain free and anxiety free.

However, there are quite a few problems and barriers I have come across on my Dental Sedation Journey. I’ll run through them over the coming articles and then explain how Relative Analgesia with Nitrous Oxide has helped me and my patients overcome them. Hopefully you’ll get to see how much more it is possible to become a “Hero” to our patients!

Richard has helped me to understand that IV is not the “be all and end all” and having an “armamentarium” of sedation techniques means we can help the most people with the widest range of comfort levels and dental needs.

The topics I am going to cover are:

Easing Patients expense, making sedation more affordable

Patient having to lose a whole day

Treating Children more easily, so helping to prevent future phobias

Those who don’t feel that things are bad enough to require “knocking out”

Hygienists and therapists making patients lives easier on a day to day basis.

Lets talk about Patient Expense.

In my private practice, I allow generally an hour for an IV sedation session. Once I have consented the patient again, confirm the treatment plan and gone through aftercare, cannulated, induced, reached end point, I am ready to start dentistry. This may be 15-20minutes into the session already.

I can then do about 30 minutes dentistry, take out a few teeth, do lots of root surface debridement or maybe a few fillings.

Then the patient recovers and is ready to go 50 or so minutes after they came in.

This is fine, I enjoy working like that but it does mean that what could be a simple extraction ends up being unaffordable for a lot of people.

I could finish the procedure, get the patient out of the chair, into a wheelchair and out into a recovery facility with a recovery nurse but I always feel I’ve got part of my brain in with them. I’m also conscious that as its just me doing IV, if the sedation was complex or difficult and my attention is required, I have to leave another potentially sedated patient. One thing at a time for me…..

Since my coaching with Richard, I have been able to do more RA procedures in half the time with patients feeling very relaxed and with really great analgesia from the nitrous. They recover in the chair in two minutes and are on their way home in 15 or so. This makes safety even better and allows me better control over my working situation.

So the patients who want “oblivion” get the IV, those who want to make it pleasant and really comfortable, I can use RA. It actually opens up my market of patients to those who are on more of a budget whilst still providing a chargeable service to my patients.

The next thing I will talk about is patients having to lose a whole day because if dentistry. Thanks for reading!

Dr Rob Endicott is a General Dentist and Sedationist based in Stratford upon Avon, carrying out dentistry for patients under sedation almost every day.

Saturday March 23rd sees the training centre at Stratford Dental ( hosting an RA training day with Dr Richard Charon, the RA Coach ( for the whole dental team.


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