So, you have a dental issue that needs to be fixed and you are horror-struck from the idea of receiving a dental treatment which ultimately forces you to somehow get your treatment done with the help of sedation dentistry.

We need sedation dentistry to overcome a patient’s dental fear and offer them the “required” dental treatment. But first, let’s see…

Why people are scared of going to a dentist?

Do I even need to explain this? Dental fear is so common that people often perceive it as an obvious fact. Like, suppose if you are scheduled for a dental appointment, yourself and the people around you expect you to feel nervous and scared from the forthcoming events that you will have to face at the dental clinic. There could be multiple reasons behind people having a fear of facing a dentist. You might have had a “bad” experience at a dental clinic in your childhood or just heard someone having a “bad” experience at a dental clinic without even having undergone any personally. You might be stemming from your fear of dental clinic through some other person without having undergone any dental treatment in your life.

Sedation Dentistry for People Scared of Dentists

Another case could be that you accompanied your relative or a friend to a dental clinic for his/her scheduled appointment and you saw them suffering from pain. There are many possibilities.

Whatever the case may be one thing is for sure, your brain is intensifying and exaggerating the dental fear that you have in yourself. So much so, that it often prevents you from receiving the appropriate dental treatment when you suffer from any dental issues. Ultimately, worsening your oral health and leading to greater loss of tooth and oral harmony. For some people the fear is manageable. They are a bit scared but they go to a dentist and get their treatment done. For others, the fear is too much. They cannot help it and the thought of going to a dentist gives them the ultimate chills of their lives. For such patients, sedation dentistry is the ultimate solution.

You might have heard about this term many times before but now you might be looking to find out the details about sedation Dentistry, maybe because you are wondering whether to go ahead with it, for your dental treatment. Keep reading. You might be able to decide if this is for you.

What is Sedation Dentistry?

Sedation dentistry is a method of offering dental treatment to patients by altering their level of consciousness or reducing their level of anxiety by putting them in a peaceful state of mind.

What Sedation is used for in Dentistry?

Sedation in dentistry is used for patients who are extremely scared to receive any type of dental treatment and have been delaying their treatment since ages because of the uncertainty related to the dental procedures. It comes to a point that their oral health is deteriorating and they have no other option but to receive a dental treatment to prevent worsening complications. Sedation dentistry would make their path easy by various effective methods to control their fear.

Types of Sedation Used In Dentistry:

Oral Sedation

Inhalational Sedation/Nitrous Oxide

IV Sedation

General Anesthesia

Let’s discuss each of these methods used in sedation dentistry in detail:

ORAL SEDATION:

Oral sedation, as the name implies provides sedation via drugs administered through oral routes (via mouth).

Drugs used in oral sedation:

Midazolam, Fentanyl, Propofol, Ketamine, Meperidine, Phenobarbital. Let’s discuss Midazolam in detail as it is one of the most commonly used drugs for Oral Sedation. Midazolam is a Benzodiazepine.

How long does it take for the effect of oral sedatives to kick in?

The effect of Midazolam should peak in the body in approximately half an hour.

How does oral sedation feel like?

You will feel calm and relaxed. Considerable awareness would be present while undergoing dental treatment after taking Midazolam. So, yes, you won’t be completely asleep. You will be able to hear and respond to your dentist’s instructions.

What to expect during and after the procedure?

You will be laying calm and relaxed in the dental chair while the dentist works on your oral cavity. The dentist will also administer local anesthesia around the area which needs to be worked on so that you don’t feel any pain while receiving the dental treatment. After the procedure, you may continue to feel calm and relaxed until the effect of the drug completely wears off.

How long does it take for oral sedation to wear off?

The effect of Midazolam lasts for an hour or two. However, the complete elimination of Midazolam from the body takes place in approximately a day or two. It should be noted that the elimination of drugs depends on various factors such as the age of the patient, general physiological status and presence of other systemic disorders concerning the organs involved in its elimination.

Is oral conscious sedation used in dentistry safe?

Yes, it is if you have not consumed alcohol in the past 24-48 hours. Also, it is important to avoid any other central nervous system depressant well before receiving your dental treatment. As with every drug, certain drugs would synergize the effect of Midazolam. Hence, it is important to communicate with your dentist about the medications you have been already taking along with your medical history.

INHALATIONAL SEDATION/NITROUS OXIDE SEDATION:

In this case, the anesthetic drug is usually administered through a facemask and you are asked to breathe in the drug which is present in the form of air.

Drugs used in Inhalational Sedation:

Isoflurane, Desflurane, Nitrous Oxide. In dentistry, most commonly nitrous oxide or laughing gas is administered. Hence, we will discuss nitrous oxide in this section. Nitrous oxide is mixed with oxygen and delivered through a face mask.

How long does it take for the effect of Nitrous Oxide to kick in?

The effect of nitrous oxide should start immediately., i.e. in less than a minute of the initiation of its administration.

How does Nitrous Oxide sedation feel like?

You will feel calm and relaxed. You might experience an intense feeling of excitement also known as euphoria. You will be awake when the dentist will work on you but might not able to communicate effectively.

What to expect during and after the procedure?

You will feel relaxed during the procedure. You might feel “euphoric.” After the procedure, you will have to wait for a few minutes until the effect of the gas wears off. Once you are normal, you can drive yourself home.

How long does it take for Nitrous Oxide sedation to wear off?

The use of nitrous oxide is discontinued by offering 100% oxygen for a few minutes to avoid diffusion hypoxia. After the administration of oxygen, its effects get reduced rapidly and within a few minutes you will be back to normal

Is the use of Nitrous Oxide sedation in dentistry safe?

It is one of the safest modes of administering sedation during dental procedures. Only contraindications are the ones related to the anatomical issues of the facial structure viz., deviated nasal septum where the drug may not be delivered effectively or the cases where a patient is not able to wear a mask because of some psychological issues.

IV SEDATION:

The anesthetic drug is administered after gaining IV access. The depth of anesthesia can be altered, if the infusion rates are increased, it can be easily shifted from moderate sedation to general anesthesia. Hence, the rate of infusion should be strictly monitored.

Drugs used in IV sedation in dentistry?

Midazolam, Propofol, Ketamine, Dexmedetomidine. For educational purposes, I will discuss Propofol which is one of the most commonly used drugs used for IV sedation.

How long does it take for the effect of IV sedation (Propofol) to kick in?

The Propofol effects are attained very quickly. In approximately two minutes the Propofol effect should peak in the body.

How does Propofol sedation feel like?

The patients under propofol anesthesia are sedated but can respond to physical stimulation. You might be able to hear the words of your dentists, not clear enough though mostly, but you will hear them.

What to expect during and after the procedure?

You will stay calm while your dentist will perform the scheduled procedure. After the procedure, you will regain consciousness quickly. You should suffer from no complications, however, if you happen to suffer from an allergic reaction later on that day or the next day, please report to the dentist’s clinic.

How long does it take for IV sedation (Propofol) to wear off?

The patient usually regains consciousness in approximately four to five minutes after the end of infusion.

Is the use of IV sedation (Propofol) in dentistry safe?

It is safe if monitored properly. It should be administered by a specialized professional. Continuous monitoring of the level of anesthesia, the dose of administration in the body and vital signs are required. As the dentist would be busy with his dental services a separate trained professional in administering IV anesthesia is required.

GENERAL ANESTHESIA:

Loss of consciousness is attained by administering anesthetic drugs by one of the various available routes of administration viz., inhalational or IV among many others. It is usually preferred in patients where co-operation could not be attained by other modes of sedation especially in cases of children and people with special needs.

Drugs used in General Anesthesia sedation in dentistry?

Midazolam, Propofol, Sodium Thiopental, Ketamine, Fentanyl. For educational purposes, I will discuss Propofol which is one of the most commonly used drugs used for IV sedation.

How long does it take for the effect of General Anesthesia to kick in?

The time it takes to kick in depends on the mode of administration preferred. Mostly it takes around a minute.

How does General Anesthesia feel like?

You are not awake and you cannot feel any pain. You will not hear or understand the people speaking around you. Also, you will not respond to any physical stimulation.

Proper Utilization of Sedation Methods Helps in Providing Effective Dental Care

What to expect during and after the procedure?

General Anesthesia procedures are performed very carefully. It is recommended to perform general anesthesia in a hospital setting to encounter any unknown forthcoming complications. A careful medical history is taken before deciding any future treatment plan for you. Food-related instructions would be given to you as per the fasting requirements. While undergoing the procedure, there is no room for mistakes and continuous monitoring of your vital signs and other aspects of your physical state is performed while you are under general anesthesia including the continuous monitoring of the airway. You will be completely asleep when the dentist works on your dental issues. After the procedure, to reverse the effect of general anesthesia you may be given some drugs. You will regain consciousness gradually in a few hours. After the procedure, you may feel nauseatic or sleepy and slowly regain your senses back to normal.

How long does it take for the effects of General Anesthesia to subside?

General Anesthesia usually takes a few hours to wear off. You may stay under observation for 24 hours or may be allowed to go home in a few hours, it depends on your case.

Is the use of General Anesthesia in dentistry safe?

It is a sensitive procedure, hence it should be carried out with utmost care. After the effects wear off, some may experience nausea or mental confusion. It can at times result in certain major systemic complications or you might suffer from sudden intra-operative awakening. However, there is nothing to worry about. It is usually carried out safely. It is advisable to speak with your dentist beforehand in detail about the procedure.

Who should prefer sedation dentistry?

Not everybody needs to undergo the experience of sedation dentistry just by searching on the internet the possible ways to deal with dental anxiety. Before jumping onto the conclusions, I highly recommend one must see the dentist. Not every procedure predisposes a patient to a probability of experiencing pain during the dental procedure. One such great example is simple tooth cleaning, also known as scaling. Other such procedures are simple (class I) tooth filling or any procedures related to your already root canal treated tooth.

Unless you have a major pathological issue with your gingiva (gums) or teeth you will not need to receive any type of sedation.

Sometimes, the pulp of your tooth is dead either pathologically maybe because of some trauma that you sustained on your tooth or because of the previous root canal treatment on that tooth. In such cases, usually no pain is involved and your dental experience would most probably be pleasant and you will not regret taking a risk and avoiding the path of sedation dentistry for such cases.

There are many cases in dentistry that require only prosthetic work, which mostly involves no cutting of oral tissues. Such as missing teeth, blackening of teeth, broken teeth that can be fixed with a bridge or a dental cap. In such cases, one must always consider a dentists’ advice regarding the necessity of sedation dentistry. Most procedures related to prosthesis could be easily provided without causing any considerable pain or discomfort to the patient.

Once you realize that you have a certain dental issue and would require a dental appointment, go ahead without any fear as no dentist would do any treatment on you without your concern. A Patient’s concern for any type of treatment is of utmost importance for any dentist. The dentist will explain the condition to you and advise appropriate treatment plans, feel free to ask whether there is any risk of pain associated with the type of treatment that is going to be offered.

If yes, you can surely go ahead with any one of the methods mentioned above for sedation dentistry. If no, then there is no question of wasting your money and putting yourself at “probable risk” which is associated with sedation dentistry.

The information mentioned above is just for educational purposes and is not meant to replace your dentist’s advice.