Dental Sedation – What Is Dental Sedation?

Dental sedation covers a broad range of techniques used to calm patients before and during procedures. The goal is to help patients overcome anxiety that leads them to avoid necessary dental care, with serious health consequences.

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Nitrous oxide, commonly known as laughing gas, is inhaled through a mask over your nose. It causes you to feel relaxed and euphoric but doesn’t cause any lasting effects.

Oral Sedation

Oral sedation is one of the most commonly used methods for eliminating dental anxiety and fear. We prescribe a pill that you take about an hour before your appointment, which will help you relax by the time we start your treatment.

The medication usually comes in the form of a benzodiazepine, like Valium or Xanax. These are antianxiety drugs that help reduce the activity in parts of your brain that cause anxiety & fear. Unlike the nitrous oxide method, oral sedation will not make you lose consciousness, but it can leave you feeling groggy & sleepy. This groggy state often helps patients feel as though they slept through their dental appointment, which adds to their sense of peace & calmness.

Many patients who choose oral sedation also report that they have very little to no memory of their dental procedure, which further contributes to the sense of peace & calmness they experience. The sedative will typically wear off quickly, so you’ll be able to drive yourself home after your appointment. You will want to plan ahead for this, as you may experience drowsiness, nausea, headaches or a general feeling of sluggishness.

It is best to have a friend or family member ready to drive you to & from your sedation appointment, as these medications can impair your ability to operate machinery or vehicles. You should avoid working or participating in any intense physical activities until the sedation has worn off completely.

Nitrous Oxide

Nitrous oxide, better known as laughing gas, is an inhaled sedative that creates a state of euphoria and relaxation. It is safe to use, and it minimizes pain during treatment. This form of sedation is great for patients who fear dental procedures or have a condition that causes stress and anxiety.

You will breathe in the gas through an apparatus that fits over your nose. The gas starts working quickly, as early as 30 seconds after you start breathing it in. Unlike other forms of sedation, it does not make you lose consciousness and you can still respond to verbal cues. The effects also wear off as soon as the nitrous oxide is flushed out of your body with oxygen, which makes it an ideal choice for short or minor procedures.

While oral sedation is a great option for many patients, it is important to find out how much training your dentist has with this method of sedation and how many procedures they have performed under its influence. You should also read the informed consent form carefully before undergoing this type of sedation to ensure that you understand what to expect. You should also bring a trusted friend or family member to drive you home from the dentist and stay with you while the effects of the sedation wear off.

Benzodiazepines

The benzodiazepines are an established group of drugs with a long history of safe use. These medications are prescribed and administered orally for the purpose of moderate sedation (anxiolysis). A well-documented example is triazolam, which has been described as “near ideal” for oral sedation in dentistry because it produces a high level of sleep and amnesia with minimal residual drowsiness. Its onset of action is rapid within an hour, and it has a short half-life without active metabolites.

Unlike barbiturates, benzodiazepines are much more stable. These drugs have the added benefit of being available in a variety of tablet forms that are easy to administer. The patient simply swallows a single dose of the drug prior to the dental appointment, and is ready for treatment by the time they sit in the dentist’s chair. The drowsiness produced by the medication enables the dentist to complete several dental procedures before the patient is woken and able to drive home.

As with other sedation techniques, the practitioner must be fully familiar with the pharmacology and therapeutics of the medications used in oral sedation. The patient must also be screened for any medical conditions that might be affected by the administration of the drug. Depending on state regulation, written informed consent must be obtained before a patient is given an oral sedative to assure that the dentist is not performing any work while the patient is in an altered state of consciousness.

Intravenous Sedation

With intravenous sedation (IV sedation), also known as “twilight sleep”, you are put into a dream-like state and will be largely unaware of your dental treatment taking place. This type of sedation allows you to tolerate longer and more involved procedures with ease. You will most likely remember nothing about your appointment, but you will be awake and able to respond to questions from the dentist.

For IV sedation, the dentist inserts a thin needle into a vein, usually on the top of your hand or arm. They may first apply a numbing cream to the area if you are afraid of needles. A tube is then connected to the needle and the sedative drugs are delivered directly into your bloodstream, ensuring that you receive the desired dose of medication.

The main advantage of IV sedation is that it works immediately. This means that there is no need to take a pill an hour in advance of the procedure, as with oral sedation. It is also very efficient and can enable the dentist to carry out multiple treatments at once in a single dental appointment.

The disadvantages of this method are that it is more expensive than oral sedation, requires a higher level of training to administer safely, and increases malpractice liability and costs for the dental practice. Furthermore, IV sedation cannot be titrated as precisely as oral sedation and may not be suitable for every patient.