Sedation Dentistry refers to the use of pharmacological agents to calm and relax a patient prior to and during a dental appointment. The pharmacological agents usually belong to a class of sedatives, which exert their action by depressing the nervous system specifically those areas concerned with conscious awareness.
Seeing a dentist regularly is one of the best ways to preserve the health of your teeth and to prevent future, more extensive and invasive dental procedures. The thought of going to the dentist creates a great deal of anxiety in some patients, and some people are so afraid of going to a dentist that they simply never go, which only causes their dental problems to get worse over time.
There are different degrees of central nervous system depression, each corresponding to a level of relaxation which ranges from minimal, moderate, to deep sedation. In general, minimal sedation refers to a patient who has reduced anxiety but is readily responds to verbal or physical stimulation. With moderate sedation the patient is even more relaxed, and will respond to purposeful stimulation. In deep sedation, the patient may not exhibit any signs of consciousness and therefore be unresponsive to stimulation.
Sedation by pharmacologic methods may be obtained by two general routes. The enteral route involves absorption of medication across enteric membranes which line the alimentary canal from the oral cavity, through the digestive tract, ending in the rectum. This route includes medications that are either swallowed, absorbed through the mucosa of the oral cavity, or inserted rectally. The parenteral route involves the administration of sedative drugs other than absorption across enteric membranes (outside of the alimentary canal). These methods include intravenous, inhalation, intramuscular, and submucosal administration, among others.
Who May Benefit from Sedation Dentistry
- Patients who fear needles
- Patients who have difficulty becoming numb
- Patients requiring multiple dental procedures
- Patients who have had bad past experiences at the dentist (not uncommon)
- Patients that have a strong gag reflex (which is quite common)
- Patients suffering with other physical disabilities
Types of Sedation
Nitrous oxide commonly called laughing gas is used as a mild sedative. The nitrous gas is delivered through a nose hood, and is administered throughout the entire 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.
Oral Conscious Sedation
Oral conscious sedation is an excellent choice for people who experience dental fear. During oral sedation patients reach a state of moderate sedation and cannot remember the pain, smell or sounds associated with the dental procedure.
There are many different types of medications that the doctor uses to sedate his patients. Many patients assume sedation dentistry means they will be asleep during the procedure which is sually that is not the case. Some the most commonly used drugs to sedate patients are
- Diazepam (Valium)
- Lorazepam (Ativan)
All of these medications have been proven to be safe and effective. Since all of these drugs work in different ways and last for different amounts of time we will discuss the differences with you and decide which drug is most appropriate for the dental work you are having done that day.
Some of these medications make the patient drowsy enough that he/she will sleep through the procedure. For obvious reasons, we ask that you have someone with you to drive you home after your procedure.
Sedation dentistry is not for everyone, but for those who have been avoiding getting their teeth fixed due to fear of the dentist, sedation dentistry is the excellent solution for the patients.