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, 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. 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.
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 ask your dentist.
Prior to your dental surgery you will have the opportunity to address any concerns you might have during your pre-op appointment. We encourage you to ask questions and make us aware of any fears you might have. Our main goal is to create a secure, comfortable environment for our patients on the day of surgery so the more you communicate with us, the easier we can accommodate your needs. The following guidelines are meant to serve as reminders in helping you prepare for your dental surgery. If you have any questions, feel free to contact our practice.
Leading Up to the Day of Surgery
- Fasting must begin at midnight the night before surgery for patients with a morning appointment. If you have an afternoon appointment, do not eat anything 8 hours prior to your scheduled dental surgery.
- While fasting, the patient may only drink clear fluids (Ex: water, apple juice, black coffee, and sports drinks). Beverages that are not allowed to be consumed are alcohol, orange juice, milk, creamer, and other opaque drinks. Patients should avoid drinking all fluids within 6 hours of their surgery. If you are unsure about what can and cannot be consumed, please ask during your pre-op appointment.
- Patients may continue taking the following medications with a small sip of water prior to surgery:
– Cardiac medications
– Pulmonary medications
– Anti-seizure medications
– Anti-Parkinson’s medications
- Medications that patients are prohibited from taking are MAO inhibitors, anti-depressants, aspirins, anti-coagulants, and anti-inflammatory drugs. We request that patients stop taking these medications at least two days prior to surgery because they can create complications during dental surgery.
- Patients are not to consume alcoholic beverages or use tobacco products within 24 hours of their appointment and are asked to refrain from drinking or smoking for 24 hours after their surgery.
Day of Surgery
- If you are a minor, you must have a parent or guardian present for the extent of your surgery. All patients are required to have a licensed driver take them home after their appointment, and we prefer that you are accompanied by someone for at least 12 hours after your surgery.
- Brush your teeth as usual, but be sure not to swallow any water or toothpaste. Do not wear any make up or nail polish.
- If you regularly wear contact lenses, please remove them prior to surgery. Jewelry and dentures will also need to be removed before surgery.
- We prefer that you wear loose, comfortable clothing and flat soled shoes. Shirts that have ¾ sleeve or shorter are ideal.
- After surgery, you will not be fully aware, therefore cannot return to work or school, and cannot drive or operate other hazardous devices. Also, please make sure that you have assistance when climbing stairs or attempting other difficult tasks.