If you are one of the millions of people who would rather go without dental treatment than set foot in a dentist’s office, sedation dentistry may be the solution for you. Many people get such intense anxiety and even panic attacks at the idea of getting dental work, they cannot bear to have even preventive care. Sedation, from mild to total anaesthesia, is useful for dental procedures from routine cleaning to major procedures.
What Is Sedation Dentistry?
Sedation dentistry is the use of medication to help dental patients relax during their procedures. Patients are usually awake, except if they are under general anaesthesia. There are several levels of sedation that a dentist can use, depending on the needs of their patient.
- Minimal: The patient is awake but very relaxed
- Moderate: Once called “Conscious Sedation.” The patient may sound intoxicated when they speak, and they will not remember much about their dental procedure.
- Deep Sedation: The patient is asleep, but they can be awakened.
- General Anaesthesia: The patient is completely unconscious, similar to general surgery anaesthesia.
What Types of Sedation Medications Are Used?
Dentists may use a number of different medications, depending on the level of sedation and relaxation a patient needs to feel comfortable. In every case, the patient’s condition and vital signs are closely monitored throughout the procedure, to ensure maximum safety.
The most common form of minimal sedation is inhaled nitrous oxide, or “laughing gas,” combined with oxygen. The dentist places a mask over the patient’s nose, and the gas and oxygen can be breathed normally, helping the patient relax. It is easy for the dentist to control how much sedation the patient receives, and the effects of the sedation wear off quickly. Inhaled minimal sedation is the only form of sedation dentistry where patients may be able to drive themselves home after the dental procedure.
Another form of minimal sedation may be oral medication. The exact medication used varies depending on the dentist, but one common medication used is Halcion. This drug is in the same family as Valium and causes patients to be relaxed and free of anxiety. Usually, patients are instructed to take the medicine about an hour before their dentist appointment. Some patients become drowsy after taking the medication.
Oral medication, such as Halcion, may also be used for moderate sedation if a larger dose is prescribed. In fact, this is the most common form of sedation dentistry used today. Some people become so relaxed; they fall asleep during their dental procedure. It is usually easy to wake them with a gentle shake.
A few dentists administer medication for moderate sedation via intravenous fluids or IV. This method lets the dentist adjust the patient’s sedation levels throughout the procedure. However, the dentist needs special training to start and administer IV medication.
Deep Sedation and General Anaesthesia
Patients receiving deep sedation or general anaesthesia are given medication that makes them mostly or completely unconscious throughout their dentist appointment. Under general anaesthesia, the patient cannot be awakened until the medication wears off or they receive additional medicines. Deep sedation creates a state of near-unconsciousness. The patient is usually asleep, but can be awakened to a state of moderate consciousness.
Every dental patient receiving sedation also receives pain control, usually a local anaesthetic or numbing medication. The dentist will apply or inject this in the place they are working in the mouth, to ensure the patient experiences no discomfort during the procedure.
Is Every Patient Appropriate for Sedation Dentistry?
Sedation dentistry is for people with a severe fear or anxiety that keeps them from getting needed regular dental care or dental treatments.
Which Dentists Can Perform Sedation Dentistry?
Most dentists can give the medications required for minimal sedation, such as nitrous oxide. The number who can increase medication to include moderate sedation is increasing, as well. However, only a small percentage of dentists have completed the Commission on Dental Accreditation (CODA) programme for deep sedation and general anaesthesia. Without this certification, they may still be able to utilise the services of a dental anaesthesiologist to perform all levels of sedation.
Is Sedation Dentistry Safe?
Any form of anaesthesia has risks. However, sedation dentistry is usually safe when performed by experienced and properly trained dentists. The dentist should always review a patient’s medical history and discuss medications before performing the procedures.
People who are obese or suffer from obstructive sleep apnea might need clearance from their primary care physician before having sedation dentistry procedures. These people and certain others with chronic health conditions may be at higher risk for complications during sedated procedures. Every patient should be aware of what medications their dentist will use and whether these are appropriate to their health status and age.
The dentist should review the procedure, its risks and benefits, with the patient before beginning. Dentists performing sedation dentistry should monitor the patient’s vital signs according to guidelines provided by the Canadian Dental Association or similar organization for your country. The dentist’s office should also have oxygen, artificial ventilation methods and medications to reverse the effects of sedation on hand during every procedure.