How Does Dental Sedation Work?

Millions of people in the U.S. steer clear of dental offices because of apprehension. According to the Dental Fears Research Clinic at the University of Washington in Seattle, up to eight per cent of Americans, about 24 million refuse to visit the dentist because of extreme anxiety, while 20 per cent about 64 million will only see a dentist when absolutely necessary.

If you’re one of these people, you’re not only putting your oral health at risk but potentially jeopardizing your overall wellbeing. Neglecting professional dental care can result in serious conditions such as cancer, heart disease and diabetes.

However, while other people may regard your dental anxieties as groundless, your fears are very real to you. Reasons why people develop dental anxieties include fear of pain, feelings of loss of control, and embarrassment as your mouth is an intimate part of your body.

For people who are frightened at the prospect of dental treatment, conscious sedation dentistry provides an ideal means of treatment without the need for a general anesthetic. Depending on the patient’s level of anxiety, dental sedation can be used for any treatment, from cleaning to invasive procedures such as extractions.

Sedation dentistry is sometimes referred to as sleep dentistry, but in most cases, this is misleading. Patients usually remain awake during sedation, unless they have a general anesthetic. In fact, the whole idea of conscious dental sedation is that the patient remains awake but feels comfortable and relaxed. With sedation dentistry, the patient is given a drug before or during the dental work, and levels of conscious sedation can be minimal, moderate or deep.

Sedative medication relaxes patients by decelerating the responses of the central nervous system. You stay aware of your surroundings but are less responsive to external stimuli. The medication also reduces the sense of pain.

There’s nothing new about sedatives; they date back thousands of years, with pain management being as old as medicine itself. Old methods of sedation included alcohol and mandrake roots. Modern sedative medication originated in the 19th Century with the creation of chloral hydrate and bromides.

Different Types of Dental Sedation

With minimal sedation, you are relaxed but awake. With moderate sedation, you probably won’t remember much of the procedure. Deep sedation entails the patient being on the edge of consciousness.

Oral sedation can vary from minimal to moderate. It is achieved by taking a pill, usually Valium (diazepam) or Halcion (triazolam) – ideal for people who fear needles and intravenous injections. The pill is taken about an hour before treatment, and you’ll feel drowsy but stay awake. A larger dose may be given to produce moderate sedation. Some patients become so drowsy from moderate oral sedation that they do fall asleep but can usually be easily awakened.

With moderate intravenous (IV) sedation, the sedative is injected directly into a vein in the arm or back of the hand, so it works fast and the levels can be easily adjusted. The dosage you’re given will depend on the treatment you need and the time it will take to complete the procedure. IV sedation can be used to induce various degrees of consciousness in which the patient becomes less aware of what’s going on and will probably remember little about the procedure afterwards. Spokane Family Smiles a dentistry in Spokane, Washington says, “The medication takes effect within seconds, and patients will enter a deep state of relaxation. In fact, it’s likely that they won’t remember anything about their appointment.” Intravenous sedation can also be used as a general anaesthetic.

Conscious sedation may also be administered with a combination of oral and IV methods.

During inhaled minimal sedation, the patient breathes a combination of oxygen and nitrous oxide or laughing gas through a mask

Is Dental Sedation Right for You?

Sedation dentistry can help to eliminate worries about pain, vulnerability and discomfort, but is it the right choice for you? If you’re worried about the safety of dental sedation, it should put your mind at rest to know that while powerful sedatives like barbiturates carry a risk of addiction and unpleasant side effects, benzodiazepines, like those used in sedation dentistry, are not addictive and have minimal side effects.

Patients who may benefit from conscious dental sedation include:

• People with a phobia linked to dental procedures.
• Those with a bad experience with dental treatment in the past.
• People with particularly sensitive nerves in the mouth.
• Patients with a small mouth, which can become tender during dental work.
• People with a resistance to local anesthetic.
• Anyone with a general anxiety disorder.

I you fall into one of these categories, dental sedation can help you get through treatments such as tooth extractions, root canal work, and dental implants. If your levels of anxiety are particularly high, your dentist may also consider sedation for routine work such as cleaning and X-rays.

While conscious sedation provides an attractive option for nervous patients, it is vital if your level of anxiety has reached the extent of dental phobia (odontophobia). The line between apprehension and phobia can be blurred, but odontophobia is likely to worsen over time, without professional help.

Find a Qualified Sedation Dentist

If anxiety is deterring you from visiting a dental office, the idea of sedation may alleviate many of your concerns. Look for a dentist licensed in conscious sedation dentistry, who will monitor blood pressure and respiration to make sure you’re completely safe and comfortable throughout the procedure.

While most dentists are qualified to administer nitrous oxide, sedation techniques require extra training. The American Dental Association (ADA) sets out guidelines on providing sedation and the training required.

In rare cases, sedative medication can react adversely with another drug you may be taking. An experienced sedation dentist will ask about your general health and any prescription medication you may be taking.

Finally, bear in mind that while most patients will be able to walk out of the dental office after sedation, you’ll need someone to drive you home.