Making Dentistry Safer Through Capnography

By Jason Sims December 12, 2016

“Statistically, you’re more likely to get into a car accident on your way to the dentist’s office than you are to have anything go wrong while you’re being sedated,” says Dr. Geoffrey Archibald, a dentist who uses sedation in his clinic in Forest Lake, Minnesota. “Monitoring a patient’s carbon dioxide levels helps make a safe process even safer.”

Dr. Archibald praises The American Dental Association’s recently-adopted guidelines designed to help protect patients. The ADA is now recommending all dentists – not just oral surgeons – use CO2 monitors that sound an alert within moments if a patient stops breathing.

Dr. Archibald explains the importance of capnography, “With sedation, we are slowing down certain parts of the brain, including the area that controls your breathing. In sedation dentistry, dentists need to keep an eye on whether the patient is breathing, and capnography is one of the most reliable ways to do that.”

"With sedation, we are slowing down certain parts of the brain, including the area that controls your breathing. In sedation dentistry, dentists need to keep an eye on whether the patient is breathing, and capnography is one of the most reliable ways to do that."

-Dr. Archibald

Most general dentists use pulse oximetry to monitor a patient’s breathing. A pulse oximeter measures the amount of oxygen in a patient’s blood, and it can take a minute or more to warn the dentist of trouble. A capnograph, on the other hand, monitors the carbon dioxide emitted. It can raise an alarm within seconds, saving valuable time for the dentist and patient.

Patients with breathing problems, like sleep apnea or asthma, are some of the most at risk to stop breathing under anesthesia. Children and the elderly are also susceptible to breathing issues. And the number of patients using sedation is growing. Sedation has long been used for procedures like wisdom teeth removal, but more and more patients are opting for mild sedation on even minor procedures like fillings or teeth cleanings.

“What you’re seeing is patients who have ‘white knuckled’ it for years at the dentist realizing they don’t have to put up with it anymore. They’re requesting mild sedation to help them get through their discomfort in the dentist’s chair,” says Archibald.

Dr. Archibald started using capnography in his practice back in 2011, relying on technology by the industry leader, Nonin Medical. When the monitor sounds the alarm, he begins by tapping the patient on the shoulder and asking him or her to take a deep breath. 99% of the time, he says, that’s all they need to start breathing again.

“I like my patients to be safe,” he says. “Capnography is good for the patient and good for the dentist. It provides peace of mind all around.”

At Nonin, we applaud Dr. Archibald’s mission, and we’re proud to be a partner in his effort to improve patient safety.