Does the mere thought of a teeth cleaning lead to severe mental agony and fear? Indeed, many individuals would rather endure the agony of a toothache than step foot in a dentist’s office. Many people are so phobic about going to the dentist that they prefer not to have any treatment at all.
For people who avoid dentists like the plague, sedation dentistry may take away some of their anxiety. Sedation can be used for everything from invasive procedures to a simple tooth cleaning. How it is used depends on the severity of the fear.
What Is Sedation Dentistry?
Sedation dentistry uses medication to help patients relax during dental procedures. It’s sometimes referred to as “sleep dentistry,” although that is not entirely accurate. Patients are usually awake with the exception of those who are under general anesthesia.
The levels of sedation used include:
- Minimal sedation — the patient is awake but relaxed.
- Moderate sedation (formerly called “conscious sedation”) — patients may slur their words when speaking and not remember much of the procedure.
- Deep sedation — patients are on the edge of consciousness but can still be awakened.
- General anesthesia — the patient is completely unconscious.
What Types of Sedation Are Used in Dentistry?
The following types of sedation are used in dentistry:
- Inhaled minimal sedation. The patient breathes nitrous oxide — otherwise known as “laughing gas” — combined with oxygen through a mask that is placed over their nose. The gas helps the patient relax. The dentist can control the amount of sedation received, and the gas tends to wear off quickly. This is the only form of sedation where one may be able to drive themselves home after the procedure.
- Oral sedation. Depending on the total dose given, oral sedation can range from minimal to moderate. For minimal sedation, the patient takes a pill. Typically, the pill taken is Halcion, which is a member of the same drug family as Valium, and it is usually taken about an hour before the procedure. The pill will make the patient drowsy, although they will still be awake. A larger dose may be given to produce moderate sedation. This is the type of anesthesia most commonly associated with sedation dentistry. Some people become groggy enough from moderate oral sedation to actually fall asleep during the procedure. They usually can, though, be awakened with a gentle shake.
- IV moderate sedation. Not all dentists provide IV moderate sedation. When they do, the patient receives the sedative drug through a vein, so it goes to work more quickly. This method allows the dentist to continually adjust the level of sedation.
- Deep sedation and general anesthesia. The patient will get medications that will make them either almost unconscious or totally unconscious — deeply asleep — during the procedure. While they are under general anesthesia, they cannot easily be awakened until the effects of the anesthesia wear off or are reversed with medication.
Regardless of which type of sedation the patient receives, they will also typically need a local anesthetic — numbing medication at the site where the dentist is working in the mouth — to relieve pain if the procedure causes any discomfort.
Who Can Have Sedation at the Dentist?
Sedation is most appropriate for people with a real fear or anxiety that is preventing them from going to the dentist.
Sedation dentistry may also be appropriate for people who:
- have a low pain threshold
- can’t sit still in the dentist’s chair
- have very sensitive teeth
- have a bad gag reflex
- need a large amount of dental work completed
Sometimes, children are given sedation if they are terrified of going to the dentist or refuse to cooperate during the visit. Nitrous oxide tends to be safe in children, and just about any dentist can administer it. A smaller percentage of pediatric dentists are trained to give children oral sedation. Oral sedation can be safe when kept within the recommended dose for the child’s age and weight.
Can Any Dentist Perform Sedation?
Most dentists can administer minimal sedation (such as nitrous oxide or pills). An increasing number of dentists can give moderate sedation. However, only a small percentage of dentists who have completed the Commission on Dental Accreditation (CODA) program in deep sedation and general anesthesia can use these more complex techniques. These dentists are typically oral and maxillofacial surgeons and dentist anesthesiologists. Some dentists use a dental anesthesiologist who is specially trained to give all levels of sedation and anesthesia to both children and adults.