Sedation Information

Sedation or "dentistry while asleep" is a procedure that allows for dental work to be completed while patients are unconscious. Sedation can be very useful for adults, children, and people who are otherwise unable to sit through treatment. Sleep dentistry allows a person to have their dental treatment completed in typically one appointment. It is often the treatment standard for complex wisdom teeth extractions, extensive decay to restore, anxious or nervous patients and recommended for young children with multiple dental or surgical restorative needs.

Our Anaesthetist: Dr. Gino Gizzarelli, BScPhm, DDS, MSc (Dental Anaesthesia)

Dr. Gino Gizzarelli completed his first degree in 1995 at the University of Toronto in Pharmacy. He worked as a full-time clinical pharmacist at Toronto General Hospital for 2 years before returning back to the University of Toronto to study dentistry.

Following his dental degree in 2001, he continued his studies in the same university and completed a 3-year Master's degree in Dental Anaesthesia. During these 3 years, Gino trained in the operating rooms of the Hospital for Sick Children and Toronto East General Hospital. Throughout his studies and until present, Gino has maintained a part-time clinical pharmacist position at Toronto General Hospital.

Dr. Gizzarelli is a member in good standing with the Royal College of Dental Surgeons of Ontario, the American Society of Dentist Anaesthesiologists, and the Canadian Academy of Dental Anaesthesia. Dr. Gizzarelli is a diplomat of the American Dental Board of Anaesthesiology and the National Dental Board of Anaesthesiology. He is a certified specialist in dental anaesthesia (in Ontario). He is an itinerant dentist anaesthesiologist and teaches occasionally at the University Of Toronto Faculty Of Dentistry and at various conferences and CE courses.

Who benefits from dentistry while asleep?

People who have dental anxiety or fear
People who have a fear of needles or the drill
People who have fear of noises, smell and tastes associated with treatment
People with very sensitive teeth
People who have a strong gag reflex
People who have had a traumatic previous dental experience
People who may require a lot of dental work and would like to complete treatment in one comfortable visit
People who require wisdom teeth extractions

How does it work with dental insurance?

Our office will help you in understanding your dental coverage. If you have insurance, we will send in an estimate for work needed along with the general anaesthesia fees. This way, we can have pre-approval prior to your appointment and you will have peace of mind knowing what coverage you have before having treatment completed.

If you do not have dental insurance, we will provide you with a detailed written estimate of treatment required, including general aneasthesia fees.

What is the payment policy for dentistry while asleep?

Prior to any sedation treatment, a personal consultation must occur. A comprehensive medical history will be obtained for Dr. Gizzarelli to review prior to treatment. In certain medical situations, communication with physicians and/or specialists may be required to determine the safety and viability of dentistry while asleep.

We do require a deposit of 50% on the day of the consultation appointment and the remainder of the balance to be paid the day of the sedation treatment.

Information for ADULTS undergoing treatment with sedation/general anaesthesia

Important notes before your appointment:

PLEASE DO NOT EAT SOLID FOOD (INCLUDING GUM AND CANDY) IN THE 8 HOURS PRECEDING THE SEDATION/ANAESTHETIC APPOINTMENT

DO NOT DRINK MILK, JUICES OR COFFEE IN THE 8 HOURS PRECEDING THE SEDATION/ANAESTHETIC APPOINTMENT

Food in the stomach may result in vomiting and subsequent pneumonia during anaesthesia. This is unsafe and can be fatal. You may drink 1-2 cups of water or apple juice up to 3 hours before the appointment. No other liquids are permitted. A light meal is strongly recommended for the evening before the anaesthetic appointment.

Take your medication as usual with a sip of water unless otherwise directed
If you are diabetic, please inform your dentist ahead of time
Wear short sleeves, loose fitting clothing and flat shoes

For appointments longer than 2-3 hours, please bring a complete change of clothing

Do not wear contact lenses; do not wear make-up, nail polish or hand/face creams and/or lotions
Please advise of any recent change in your health such as fever, vomiting, diarrhea, cold, or flu in the days before your appointment
Please confirm the person who will be taking you home that day. A taxi driver alone is NOT sufficient. If no arrangements are made, your appointment will be cancelled
Please call Dr. Gizzarelli if you have any questions or concerns 1(416)839-4777

Important notes/what to expect during your appointment:

Before going to sleep, a blood pressure cuff will be placed on your arm and a heart monitoring sensor will be placed on your finger. A small intravenous catheter is placed in the back of the hand. Sedative medications are usually given intravenously and by inhalation, on occasion. When you first wake up, it is normal to feel disoriented and dizzy. It usually takes 20-60 minutes to be alert enough to go home safely.

Important notes after your sedation/anaesthesia appointment:

A responsible adult must accompany you home in a car or taxi
Rest for the remainder of the day. DO NOT WORK OR DRIVE OR MAKE IMPORTANT DECISIONS FOR 24 HOURS FOLLOWING ANAESTHESIA. Ideally, a responsible adult should be with you until the next day
Drink plenty of fluids (water, juice) after anaesthesia but begin with frequent and small quantities. Do not drink alcoholic beverages for 24 hours after your visit. If you are not experiencing any nausea or vomiting, you may eat solid foods as tolerated (please begin with light or easily digested foods)
The area where the IV catheter was placed may be bruised for a few days after your visit
If there is local anaesthetic ("freezing"): be careful not to bite your lips, cheek or tongue
A sore throat is common after an anaesthetic and will resolve on its own
Resume prescribed medications after the anaesthetic
If there are any questions or concerns after the appointment, please do not hesitate to call the office at (519)-273-0580

Information for CHILDREN undergoing treatment with sedation/general anaesthesia:

For children that require extensive dental treatment, general anaesthesia can be a great option to help them in having dental work completed effectively, quickly and most often in one appointment.

Dr. Gizzarelli will greet you and your child and see if there are further concerns or questions.

What to expect for your child before the sedation/anaesthesia appointment:

PLEASE DO NOT ALLOW YOUR CHILD TO EAT SOLID FOOD (INCLUDING GUM AND CANDY) IN THE 8 HOURS PRECEDING THE SEDATION/ANAESTHETIC APPOINTMENT

DO NOT ALLOW YOUR CHILD TO DRINK MILK OR JUICES IN THE 8 HOURS PRECEDING THE SEDATION/ANAESTHETIC APPOINTMENT

Food in the stomach may result in vomiting and subsequent pneumonia during anaesthesia. This is unsafe and can be fatal. Your child may drink up to 1 cup of water or apple juice up to 2 hours before the appointment. No other liquids are permitted.

Medications can be taken as usual with a small sip of water unless otherwise directed
If your child is diabetic, please inform your dentist ahead of time
Dress with loose fitting clothing and please bring a diaper (if applicable) and a change of clothes
Please advise of any recent change in your child's health such as fever, vomiting, diarrhea, cold, or flu
Please call Dr. Gizzarelli if you have any questions or concerns 1(416)839-4777

What to expect for your child during the sedation/anaesthesia appointment:

Your child will be given oxygen and usually sleep medicine through the mask to breathe
Most children toss/turn, stretch out their arms, roll their eyes and their breathing patterns will change as they are going off to sleep
After they are asleep, an intravenous catheter will be placed in their hand or foot that allows fluids and medication be given
A breathing tube may be placed in the nose
Your child will be completely asleep for the entire procedure and no one is allowed to remain in the treatment area after your child is asleep

What to expect for your child after the sedation/anaesthesia appointment:

It usually takes approximately 30-60 minutes after the anaesthetic before your child can go home safely. It is not uncommon for your child to cry when they wake up as they are still dizzy and disoriented. The IV catheter will be in place until your child is awake
A responsible adult must accompany your child home in a car or taxi
Your child should be resting at home for the remainder of the day. They should not run or ride a bike until the next day
Give your child fluids (water, juice) after anaesthesia, beginning with frequent and small quantities. If your child is not experiencing any nausea or vomiting, they may drink milk and eat solid food as tolerated (please begin with light and easily digested foods)
A sore throat or sore nose is common after anaesthesia and will resolve on its own
If there is discomfort: Tylenol, Advil or Motrin may be given based on your child's age and weight. If nausea or vomiting: Gravol may be given based on your child's age and weight
Please do not hesitate to call the office at (519)273-0580: if your child vomits beyond 12 hours, if there is fever longer than 24 hours, if there is any difficulty breathing or if there are any other concerns