Dental fear and anxiety still keeps millions of patients away from the dental office every year. If you are a patient that falls into this category, local anaesthesia is not enough to treat the psychological factors of this condition and hence a sedative is often needed to put you at ease during dental treatment. Conscious sedation is an excellent way to treat dental anxiety so we can get to work on your teeth!
Various Types of Sedation
Conscious sedation is a combination of medicines to help you relax and to block pain during dental procedures. You will probably stay awake but may not be able to speak. You will enter a state of relaxation while staying awake during the procedure. Conscious sedation is not a painkiller, and in most cases you’ll still need a local anaesthetic during your dental procedure. Although you won’t feel any pain, you’ll be able to respond to questions and commands. As communication is key with any dentist-patient relationship, conscious sedation is an excellent option for fearful dental patients.
Light Sedation – With minimal sedation, you are relaxed while remaining awake and alert.
Moderate Sedation – You will remain conscious during a procedure, but you probably won’t remember much about it. You will be able to communicate, however you may feel groggy and slur your words. Some patients do fall asleep with moderate sedation but can be easily woken up.
Deep Sedation – This renders you either semi- or totally unconscious during your dental procedure, and does not usually fall under the category of conscious sedation. You will not regain consciousness until the drug wears off or is reversed, and recovery time takes longer. General anaesthesia is a form of deep sedation, and it is the only dental sedation that puts you to sleep. General anaesthesia can only be administered by an anaesthesiologist and procedures are most likely carried out in a hospital setting, which includes separate fees.
Most forms of conscious sedation are considered “light” or “moderate” sedation.
The ways in which conscious sedation can be administered:
- Inhalation Sedation – Nitrous oxide, or laughing gas, is considered a light form of dental sedation.
- Nitrous oxide has been used by dentists since the mid-19th century and has been found to be safe and effective. The nitrous oxide is administered through a mask that is placed over your nose. The gas is inhaled through the nose and expelled through the mouth. When the procedure is over, the nitrous oxide wears off almost immediately with minimal to no side effects or recovery time.
- Oral Sedation – Oral medication used to produce a light to moderate effect depending on the strength of the prescription. Oral sedation usually comes in the form of a pill taken an hour before the procedure. Although you’ll be able to respond to commands, you may feel sleepy. Recovery time will take longer, and you’ll need an escort to drive you home. Although rare, side effects may include nausea and vomiting.
- Intravenous Sedation – IV sedation is considered moderate. The difference is the drugs are delivered intravenously, and therefore the effects are much sooner. IV sedation also allows us to adjust the level of sedation needed during the procedure. The drugs used for IV sedation produce either partial or full memory loss (amnesia) for the period of time when the drug first kicks in until it wears off. As a result, time will appear to pass very quickly and you will not recall much of what happened. Many people remember nothing at all. So it may appear as if you were “asleep” during the procedure. “Intravenous” means that the drug is put into a vein. An extremely thin needle is put into a vein close to the surface of the skin in either the arm or the back of your hand. This needle is wrapped up with a soft plastic tube. It makes the entry into the vein, then is slid out leaving the soft plastic tube in place. The drugs are put in through that tube and the tube stays in place throughout the procedure. Throughout the procedure, your pulse and oxygen levels are measured using a “pulse oximeter”. This gadget clips onto a finger and measures pulse and oxygen saturation. It gives a useful early warning sign if you’re getting too low on oxygen. Blood pressure before and after the procedure are checked with a blood pressure measuring machine (a “sphygmomanometer”) IV sedation is extremely safe and the procedure is carried out by an anaesthetist.