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 in most cases allows you to sleep through the dental procedure. Sleepiness is a side effect of some medications, but nitrous oxide, and oral conscious sedation only work to calm anxiety throughout the dental visit.  I.V. sedation on the other hand allows most people to sleep through the appointment.

Sedation dentistry is popular because no anxiety and no pain and for some people not even any memory of the dental procedure.  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 yourself to or from the appointment is not to be done.

Here are some advantages associated with sedation dentistry:

• Anxiety is alleviated.
• Few side effects.
• More can be accomplished during each visit.
• Safe.
• Procedures seem to take less time.

What kinds of sedatives are available?

The most popular types of dental sedatives are IV sedation, oral conscious sedation, and nitrous oxide.  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.

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  Sometimes patients feel groggy and sleepy when the IV sedatives are withdrawn.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.  The advantage of this form of sedation is that if there is a need to change the level of sedation, the medication can be administered immediately with the affects often in seconds.

Oral Conscious Sedation

Oral conscious sedation is another choice for fearful people.  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.

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.

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.

Demeral^® –   Demeral is used to treat moderate-to-severe pain. It may also be used before or during surgery and can be administered by IV which makes it useful for many dental surgical procedures.

Fentanyl^® –  This medication is used in our office via IV for moderate to severe pain control.  It is a rapid onset short-acting opioid that is 100 times more potent by weight than morphine.

If you have questions or concerns about sedation dentistry, please ask your dentist.