Types of Dental Sedation

Under conscious sedation, you will be able to hear, see and respond to the action taking place around you in the dental office, but you are much less likely to experience anxiety from it. This also reduces your sense of pain.

Specifically, there are three kinds of conscious sedation used in dentistry:

• Oral sedation

• Inhalation sedation

• IV sedation

Advantages of oral sedation:

• Easy to administer; you swallow a small pill to become sedated
• Works well for most people

Disadvantages of oral sedation:

• The level of sedation is not easily changed throughout your dental procedure
• Someone must drive you to and from your dental appointment

The dentist will prescribe a pill to take an hour before your scheduled dental visit. You must have someone drive you to and from your appointment. When you arrive at the dental office, you will be awake and feeling drowsy and relaxed. While in the treatment area, the dental staff will monitor your vital signs throughout your appointment. Oral sedatives have no pain-relieving qualities, so local anesthetics are used to prevent pain. Because you are so relaxed, and because of the use of painless injection techniques, you will probably not remember when your mouth was being "numbed." When your treatment is completed, your friend or relative will drive you home. When you are fully awake, you will feel comfortable, relaxed and free from stress. You will probably remember very little about your dental appointment. You should not operate a motor vehicle for 24 hours after receiving oral sedation.

Advantages of dental inhalation sedation:

• Works well for mild to moderate anxiety
• Rapid onset
• Can be used for any treatment length
• You can drive yourself to and from your dental appointment and return to normal activities immediately

Disadvantages of dental inhalation sedation:

• Not indicated for people who have respiratory problems (asthma and emphysema) or women in their first trimester of pregnancy

This kind of sedation uses a mixture of nitrous oxide and oxygen ("laughing gas") to sedate you and has been used in dentistry and other medical settings for many decades. When seated in the treatment area, the dentist places a small mask over your nose to deliver the gas mixture. When your treatment is completed, the nitrous oxide is turned off and you will be given pure oxygen until you feel completely normal. When the effects of the nitrous oxide have completely worn off, you will feel fully awake and alert and will probably remember very little about your dental experience. You will be able to drive yourself home and do anything else you would do during a normal day.

With IV (intravenous) sedation, medication is delivered through a very small needle placed in the back of your hand or within your inner elbow. Because of its rapid effect, many patients prefer this relaxation option.

Just like other forms of sedation dentistry, IV sedation will relax you and make you completely comfortable. IV sedation also eliminates your anxiety and pain. If you have a bad gag reflex or difficulty sitting in a dental chair for long periods, IV sedation will help you with that, as well. You’ll be so relaxed that you may be unaware of the sights, smells, and sounds of the dental office, but still able to respond to verbal cues from the dentist. Patients remember little to nothing of their appointment by the next day.

IV sedation gives your dentist optimum control of the amount of medication administered – your level of sedation can be increased or decreased quickly and comfortably.

During your first appointment, the dentist will gather a complete health history, evaluate your needs, perform a preliminary oral exam, and explain the recommended procedures.

It’s critical to tell your dentist about all medications and supplements you take so he or she can check for any potential drug interactions with the sedation medications. Safety always comes first. Your dentist will have you fill out paperwork giving your consent for treatment, answer any questions, and issue pre-appointment instructions and/or medications. He or she may also contact your doctor(s) to ensure that you’re a good candidate for the type of treatment being proposed.

You should not eat or drink anything eight hours before your IV sedation appointment, and a companion is required to take you to and from the dental office. The dentist will monitor your blood pressure, heart rate and rhythm, oxygen level, and pulse throughout the appointment. Upon administration of the IV medication, you will quickly begin to feel relaxed and at ease.

There is no set amount of recovery time, because every patient is different. Many patients begin to feel more alert soon after the IV medication is stopped; however, you should not drive or operate heavy machinery for at least 24 hours after the end of your appointment.