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 popular because you have the opportunity to "sleep" through your dental procedure and when you wake up, your work is completed. Sedatives work so effectively that virtually none of the details of the procedure can 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.
Sedation dentistry comes in many forms. You can choose between nitrous oxide (laughing gas), oral conscious sedation or IV sedation all of which allow you to remain calm and be anxiety-free throughout the dental visit.
With the oral and IV forms of sedation, it is important that the patient have someone with them as a caregiver, as the sedation medications will likely make the patient feel groggy or sleepy. With any patient choosing oral or IV sedation options, it is required that the patient have someone drive them to and from the dental office as well as monitor the patient for a few hours once they arrive home. Additionally, sedation works best when the digestive tract is empty, so we ask our patients to not eat or drink 8 hours prior to any sedation dental appointment.
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, as well as taking note of any current medications.
Here is an overview of some of the most common types of dental sedatives:
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. There are few side effects associated with nitrous oxide, and it has been safely used in dentistry for many years. However, it is not a safe option for women who are pregnant.Oral Conscious Sedation
Oral Conscious Sedation
Oral conscious sedation is a moderate type of sedation. 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 will not remember any of the details associated with the procedure.
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 longer treatments. It is administered via intravenous line directly into the bloodstream, which means the effects are immediate.
What types of drugs are used in conscious sedation?
Most of the drugs used in sedation dentistry are classified as benzodiazepines or narcotics. Benzodiazepines reduce anxiety, muscle spasms, insomnia and seizures. Narcotics are medications that reduce pain, alter moods and behaviors, and usually induces sleep. 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 conscious sedation:
Halcion® (Triazolam) – Usually given in oral form. Halcion is an effective sedative with amnesic properties. A short half-life makes this sedative useful for shorter procedures.
Versed® (Midazolam) – Usually given in IV form. It alleviates anxiety in much the same way as nitrous oxide, and is routinely used for longer surgical visits.
Sublimaze® (Fentanyl) - Usually given in IV form. It is a potent synthetic narcotic analgesic with a rapid onset and short duration of action. It reduces pain and is routinely used for longer surgical visits.
If you have questions or concerns about sedation dentistry, please ask your dentist.