Dear Friends and Colleagues,

On behalf of our Faculty of Dental Medicine, it is indeed a great pleasure for me to welcome you today to Jerusalem and to our dental school….

For you who are visiting us for the first time on the occasion of the Israeli-European Scientific Meeting on Sedation in Dentistry, I would like to say a few words about our dental school, the oldest and largest of the two dental schools in Israel. This year we celebrate our 55 years of existence, which was made possible due to a joint initiative of the Hebrew University–Hadassah Medical Organization and the Alpha Omega Dental Fraternity.

Ten years ago on one of the floors in our new wing, we established a Center for Dental Implantology. Two years ago when the plans for the additional two floors were discussed, it was only reasonable to allocate the necessary space towards establishing a Center for Aesthetics in Dentistry and a Center for Sedation and Anesthesia in Dentistry.

The venue of the center that you will see today will allow us to move one step forward to accomplish our objective to provide the best possible service for our patients, the most beneficial education for our students, and to contribute to the field of research associated with this important area.

I would like to take this opportunity to thank Hebrew University–the Hadassah Medical Organization and the Alpha Omega Dental Fraternity who were instrumental in helping us build the two new floors which house this new center as well as several educational and research facilities and the Heritage Legacy Auditorium, where we are now.

We would especially like to thank those visitors from abroad who are with us today, despite the news you hear regarding the situation in the southern part of Israel and neighboring Gaza. Yesterday, I spent the day in the town of Sderot, providing free dental care to the inhabitants of this bombarded town. A program that was initiated and implemented by our dental school. This is the strange mosaic, which our life here is made up of. On one hand, we proudly open a state-of-the-art center for sedation, while on the other hand we travel to aid a troubled town.

And, of course last but not least, I would like to commend Professor Kaufman who has definitely been the driving force behind the establishment of the new center. I would also like to thank the center's mother, the Department of Oral Medicine, for all of their assistance. I will end with our traditional blessing:

‘May you go from strength to strength.’

Prof Adam Stabholz, Dean

Dear Friends and Colleagues,

The annals of recorded history cite the first anesthesia to have been given over 5768 years ago: “And the Lord caused the man to fall into a deep sleep…” (Genesis/Bereshit 2∶21), detailing the first thoracoplasty and arrival of a helpmate for Adam.

We assume that unconsciousness was needed to avoid the pain and anxiousness of the surgery. With a similar aim we, as healers in Dentistry and Medicine, seek to provide treatments while minimizing discomfort. We teach dentists how to manage their patients' concerns, both physical and mental. What a marvelous educational opportunity the teaching of pain and anxiety provides. It offers the chance to integrate the basic sciences into a more meaningful curriculum: Anatomy, Cardiorespiratory and Neurophysiology, Pharmacology and Psychology all find their roles and reason when applied to patient management. Safety and satisfactory care are enhanced.

Over the millennia pain relief was sorely lacking until the middle of the 19th century when two dentists developed inhalation agents capable of obtunding pain. Horace Wells introduced nitrous oxide and William T.G. Morton demonstrated ether to be efficacious, while James Simpson, an obstetrician, used chloroform. Then, the parade of anesthetic agents began with a growing concern for efficacy, safety, and control.

We learned to administer newer sedative and inhalation agents such as halothane, and sevoflurane; intravenous drugs such a pentobarbital, diazepam, midazolam, as well as pentothal, methohexital, and propofol. Opioids such as meperidine, fentanyl, and others were added as adjunctive medications. Effective antagonists became available to reverse narcotics and benzodiazepines, providing better control when indicated.

Another remarkable advancement has been made in monitoring our patients with the use of continuous cardiorespiratory equipment such as automated blood pressure, pulse oximetry ECG, end-tidal CO2 and we expect newer devices to soon measure central nervous system depth and depression of the brain as well.

When dealing with moderate sedation we continue to use the conscious patient's response to question and command to obtain cooperation and tranquility, especially in the case of dental treatment where effective local analgesia obtunds pain. In my 55 years of practice I have learned two important principles: each individual being treated is unique and defies the concept of “average” dose or “mg/kg.” This leads to the second principle which relies on “titration” and the ability to rapidly assess sedative effects and patient cooperation. Sedation is a conscious technique; it requires that the team maintains an atmosphere which is reassuring.

While a great majority of patients can be treated with sedation, a small percentage will need general anesthesia, and this modality should be made available. The use of deep sedation/general anesthesia requires further advanced education and training of the dentist and physician. Periodic emergency drills involving all office personnel are helpful in learning how to manage unanticipated responses.

We have progressed very well over the past one and a half centuries in developing better methods of controlling pain and anxiety. I look forward toward newer methods of achieving even better control. Allow me to look into the future: perhaps WITHOUT the use of drugs, it may one day be possible to identify those specialized areas in the brain which emit at a specific frequency and transmit to adjacent synapses. We will develop mechanisms with the aid of nanotechnology to scan these frequencies and use transponders to intercept these signals, providing a readily reversible and controllable cessation of pain impulses. Shutting off the input from the transponder will completely restore the original neural status without lingering side effects.

I applaud the efforts of the Hadassah School of Dental Medicine for establishing a Center for Sedation. It will serve to educate, to conduct clinical research, and to provide for patient care. Dr Eliezer Kaufman deserves special recognition for his creative efforts in bringing this Center to fruition after many years of determined teaching and practice.

Finally—I end my remarks by citing an important blessing to observe this event: “Blessed are you, God, King of the Universe who has granted us life, sustained us, and enabled us to reach this moment in our lives.”

Prof Norman Trieger