Patient Information
Please download the MEDICAL HISTORY, PATIENT INFORMATION and CONSENT FORMS below and return it to your dental practice
2 weeks prior to your procedure

Your Sedation and Sedationist:
  1. To ensure your safety, intravenous sedation in the dental practice setting should be administered by a suitably qualified medical or dental practitioner as laid out by the requirements of the Australian Health Professionals Regulation Agency (AHPRA) and the Australian and New Zealand College of Anaesthetists (ANZCA) as stipulated in their "PS9" Document.
  2. Dr Vivian Mascarenhas BDSc(UWA), BSc (UWA),  GradDipClinDent (Sedation and Pain Control) (Uni of Syd), has registered qualifications in Dental IV Sedation from Sydney University and is board endorsed for sedation with AHPRA.
  3. Your sedationist is with you throughout and immediately after your procedure and is responsible for your well-being. Your sedationist also takes an active role in conjunction with your surgeon in your pain management after the operation.
  4. A full and through pre-sedation medical history is essential for your sedationist to find out about any potential complicating factors, request further medical information and investigations from your GP/Specialist (if required) and plan the most suitable sedation for your particular situation.
  5. Please take the time to accurately complete the attached medical history form and return to Dr Mascarenhas at least 1 week prior to your procedure.
  6. Prior to your sedation appointment Dr Mascarenhas will contact you to discuss your medical history and the sedation process.  Generally this can be done by phone.  However some patients may require an appointment at the surgery if their medical requirements are complex. Please feel free to discuss any questions or concerns with Dr Mascarenhas directly.
  7. As your safety and well-being is our primary concern, on extremely rare occasions your sedationist may decide not to proceed, or shorten your sedation time due to any medical contraindications or failure to adhere to instructions prior to sedation.
  8. The duration of dental treatment can be difficult to predict and as a result, all of the required treatment may not be completed in the estimated time and as a result of this the sedation time may have to be extended on the day or a further appointment may be required, in which both would incur an additional fee.
Risks and Complications
  1. As with any anaesthetic procedure, IV Sedation is not without risk and there is an extremely remote risk of serious medical complications. Our service is specially equipped and qualified for administering IV Sedation; and for managing sedated patients and medical emergencies.
  2. Where medications are placed in the vein, there may be bruising, swelling or inflammation (phlebitis), which may cause discomfort and temporarily restrict arm and hand motion. Nausea and vomiting can occasionally take place.
  3. Other common, but temporary minor complications include shivering, nausea and vomiting, dry sore throat and drowsiness.

Pre-Sedation Instructions

  1. You must fast for 6 hours before sedation to ensure an empty stomach. This means strictly no food or drink (including water, lozenges or gum) is to be taken for 6 hours before the sedation. TO DO OTHERWISE MAY BE LIFE THREATENING. Patients with afternoon appointments may have 200mls of water only, 4 hours before their appointment.
  2. If you take any medications please discuss them with Dr Mascarenhas prior to treatment. Usually any regular medications are to be taken as normal with only a small sip of water on the morning of sedation, whereas some medications will need to be altered or skipped procedure (e.g. blood thinners, diabetic medications; you will be advised if required to do so) depending on the medical condition and the medication.
  3. As a precaution please ensure to bring all prescribed medications with you on the day of your sedation appointment.
  4. Do not drink alcohol, smoke or use any recreational drugs for at least 48 hours before and after the sedation.
  5. If you have a cold, flu or respiratory infection, you must tell us as soon as possible as you may need to be re-appointed to another day.
  6. Please wear warm comfortable, loose fitting clothing to allow access to your arms and torso for an IV line and for monitoring of your heart & blood pressure. Please wear comfortable enclosed footwear (avoid flip-flops).  Remove any jewellery, makeup, nail polish (on one finger) and contact lenses.
  7. You must advise us of any changes to your medical history, including any new pills or medications, or any allergies prior to the procedure.
  8. Please arrange a responsible adult to escort you to the surgery on the day of sedation and be available after the surgery for post-operative instructions, and to escort you home where they will be required to look after you for the next 12 hours.
  9. You cannot go home on public transport or by walking, and you cannot go home without someone who is responsible for your care for the remainder of the day.
  10. If you are responsible for caring for others (children, elderly or disabled) please arrange for a responsible adult to assume responsibility and care for 24 hours.

Post- Sedation Instructions

  1. After the treatment, you must be taken home in a private car or taxi and must be escorted by a responsible adult who will spend the next 12 hours with you at home.
  2. You must not drive; operate machinery or potentially harmful equipment (including kitchen utensils) for 24 hours.
  3. As you will have consented to the procedure and the treatment plan prior to the sedation, your payment will be processed immediately after your procedure, at/during recovery. Apart from the paperwork associated with your (prior approved) payment, we recommend that you do not sign any important documents until the next day.

Fees, Payments and Cancellations

The fees for sedation are dependent on time and booked according to your length of treatment (Minimum of 1 hour). The sedation fees include post-operative monitoring and recovery and will generally require 30 minutes more than your actual treatment time. Some patients may require additional drugs and/or recovery time and the fees charged may reflect this.
A non-refundable deposit may be required to book your sedation and treatment time, depending on the duration of the appointment. Sedation bookings are often lengthy and are exclusively set aside for you. For this reason if you miss your appointment or cancel without a minimum of 48 hours’ notice, you will incur a cancellation fee of $150 per 1/2 hour of booking time.

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