Sedation Dentistry

A significant number of Americans do not visit the dentist for regular checkups because they are too fearful or suffer from dental anxiety.  Sedation dentistry offers an excellent way to provide a safe, anxiety-free, dental experience to those who are afraid of the dentist. Sedation dentistry is often mistakenly thought to induce sleep.  In fact, most sedatives allow the patient to stay awake during the procedure.  Sleepiness is a side effect of some medications, but nitrous oxide, oral conscious sedation and IV sedation only work to calm anxiety throughout the dental visit.

Sedation dentistry is popular because most sedatives can be taken by mouth, meaning no injections, no anxiety and no pain.  Some sedatives work so effectively that even the smells and details of the procedure cannot be recalled afterwards.  Safety and compliance are two important aspects of treatments, so sedation dentistry offers both the individual and the dentist the best alternative.
Whatever the form of sedative, it is essential to be accompanied by a caregiver.  Sometimes, sedatives are provided the night before the dental visit, which means that driving to or from the appointment is not advisable.

Here are some advantages associated with sedation dentistry:

• Anxiety is alleviated.
• Few side effects.
• More can be accomplished during each visit.
• No needles.
• No pain.
• Perfectly safe.
• Procedures seem to take less time.

What kinds of sedatives are available?

The most popular types of dental sedatives are nitrous oxide, oral conscious sedation, and IV sedation.  Different levels of sedation (mild, moderate and deep) can be utilized depending on individual needs.  Before administering any sedative, the dentist must analyze the full medical history of the patient, taking note of any current medications.

Here is an overview of some of the most common types of dental sedatives:

• Nitrous Oxide - Nitrous oxide, or “laughing gas,” is used as a mild sedative.  It is delivered through a nose hood, and is administered throughout the entire procedure.  Nitrous oxide elevates the general mood and can evoke a general sense of well-being.  Most importantly, it relieves anxiety and reduces pain during the procedure.  In addition, some tingling and numbness may be felt. There are few side effects associated with nitrous oxide, and it has been safely used in dentistry for many years.
• IV Sedation - Intravenous sedation is a moderate type of sedation.  Patients who have previously experienced IV sedation often report feeling like they slept through the entire procedure.  Generally, IV sedation is used for shorter treatments.  It is administered via direct injection into the bloodstream, which means the effects are immediate.  Sometimes patients feel groggy and sleepy when the IV sedatives are withdrawn.  This is why it is important to bring a designated driver for the drive home.
• Oral Conscious Sedation - Oral conscious sedation is an excellent choice for people who fear needles.  Oral medication is provided prior to treatment in order to induce a moderate state of sedation.  Though oral sedatives do not cause sleep, they usually dull the senses.  This means that most patients cannot remember the pain, smells or noises associated with the procedure.  Usually, a dose of medication is taken prior to the appointment, and then topped up during the procedure as required.

What types of drugs are used in oral conscious sedation?
Most of the drugs used in sedation dentistry are classified as benzodiazepines.  Benzodiazepines reduce anxiety, muscle spasms, insomnia and seizures.  Each medication has a different half-life, meaning that the effects last for varying amounts of time.  The estimated length of the procedure determines which type of drug is going to be most effective.
Here are some of the most common drugs used in oral conscious sedation:

• Valium® – This sedative has amnesic properties and a long half-life. It is usually used for time-consuming, complex procedures.
• Halcion® – Usually used to treat insomnia, Halcion is an effective sedative with amnesic properties.  A short half-life makes this sedative useful for shorter procedures.
• Ativan® – This sedative is best known for reducing anxiety.  It has amnesic properties and a medium half-life.  Ativan is typically used for treatments shorter than two hours.
• Versed® – This sedative has the shortest half-life and is therefore less commonly used.  It alleviates anxiety in much the same way as nitrous oxide, and is used for visits that will take less than 30 minutes.

If you have questions or concerns about sedation dentistry, please contact our office.