Sedation Dentistry

Overview

Sedation dentistry is a method employed by a dentist to perform dental treatment on a patient in an environment that’s stress and anxiety free. It’s a way for dentists to help patients overcome common dental phobias that people usually have. Many people neglect going to the dentist, or getting their teeth taken care of because of this phobia. Often, dental problems are left unattended till the very last moment when extreme treatment measures are needed. Through sedation dentistry, patients are able to undergo dental treatments without any of the fear and anxiety that accompanies the treatment. Moreover, sedation dentistry reduces the number of visits required for dental treatment to just a couple of sessions. Sedation dentistry can be used to correct almost any kind of dental condition.

What is sedation?

Sedation is a procedure that makes use of sedative medications, to produce a relaxed experience for the patient, enabling the dentist to perform dental procedures. The Central Nervous System (CNS) is affected through the use of drugs including tranquilizers and anxiolytics that can be administered to the patient in several ways.

Sedation dentistry is sometime erroneously referred to as sleep dentistry. This term, however, is not the fullest meaning of sedation, because the medications you receive don’t exactly put you to sleep, although you are likely to feel sleepy while under sedation. Sedation dentistry is different from general anesthesia, which leads to a deeper state of sleep.

Who is eligible for sedation dentistry?

Any person who is in need of dental treatment, either for health or cosmetic purposes, but has anxiety and fear about undergoing treatment, or has an extreme fear of needles is likely to benefit from sedation dentistry.
If you have had a history of frightening dental experiences, you may be wary of being in a dentist chair again and sedation dentistry can help you overcome this fear.
People who have painful or extremely sensitive teeth will find it hard to co- operate with the dentist while the treatment is going on. Such people can be made to relax using sedation dentistry, facilitating dental treatment.
Other persons who have severe gag reflexes and find it hard to tolerate treatments in the mouth or persons who suffer from medical conditions like Parkinson’s Disease or Cerebral Palsy who find it difficult to control their body moments can also benefit from the physical relaxation that sedation dentistry offers.
Also, people who are in need of complex and lengthy dental treatments that require a series of dental appointments, or those who want to complete their dental treatment quickly due to lack of time, can also benefit from the reduced dental treatment time that sedation dentistry offers.

Types of Sedation?

There are a few different types of sedation dentistry that facilitate performing dental procedures. You can read about the different types of sedation dentistry by clicking on the links below:

• Oral concious sedation
• Inhalation sedation
• Intravenous sedation

ORAL CONCIOUS

In oral conscious sedation, the patient is given oral sedatives to take before he undergoes dental treatment. These sedatives will relieve most of the stress and anxiety that the patient feels before dental treatment. The patient will not lose consciousness; instead he or she will continue to be conscious, and will be able to follow any instructions given by the dentist.
Your dentist will prescribe a sedative to be taken before you go to bed at night. You will also be prescribed another sedative that you will have to take while waking up in the morning. These sedatives produce a drowsy effect that diminishes the ability to filter or respond to sounds, smells or pain. These sedatives also have an effect similar to amnesia in the patient, and you may not be able to remember a lot about what transpired during the procedure. Oral sedatives cannot relieve pain because they are not analgesics. Your dentist will use a local anesthetic to prevent pain. They relaxes feeling induced by the sedatives will prevent you from experiencing the administering of the anesthetic itself.
Remember that these oral sedatives can lead to extreme drowsiness, and you are not advised to drive yourself to and from the dental center. Ask a friend or family member to drive you to the venue.

INHALATION SEDATION

Inhalation sedation is also known as nitrous oxide or more commonly, as laughing gas. This pleasant smelling and colorless gas has the effect of eliminating pain, and bringing on a warm and desirable feeling. Nitrous oxide can take effect just 5 minutes after you inhale it. Dentists prefer nitrous oxide because of its extremely fast effect, and also because of how quickly a patient recovers from the gas. Patients can sometimes fall asleep after the administering of nitrous oxide, and may remember few details of the actual procedure. The nitrous oxide that you will receive before your dental treatment actually contains at least 30% of oxygen, with the ratio usually being 70% oxygen to 30% nitrous oxide. Nitrous oxide sedation can induce warm and tingling sensations in the body, especially in the extremities, and feelings of happiness. These effects will depend on the concentration of nitrous oxide, and the amount of time for which you are sedated.

Advantages of Inhalation Sedation

A gap between the two teeth is called as diastema and the procedure is called as diatema closure. Usually white coloured composite material are used to minimize the gap between the two teeth. A little material is added on both the teeth to reduce the gap. The material is then bonded with the help of a light cure unit. It is then polished to give it a smmoth and finished look. The material put usually matches the color of the teeth. However, these fillings can get stained on prolonged use and may require a repeat after some time.

• Nitrous oxide takes effect very rapidly with the relaxed euphoria being induced as quickly as a couple of minutes after administering the gas.
• It can also be used to determine the exact time span for which sedation is needed. This is unlike oral sedatives, which have a specific and limited effect time.
• Nitrous oxide can be administered in incremental doses until the patient reaches the desired level of sedation. There is therefore, no risk of an accidental overdose.
• The nitrous oxide is expelled from the body within a few minutes after the supply of gas is stopped. There are no lingering after effects, and no drowsiness after the procedure.
• If you have a fear of injections, nitrous oxide can make you calm enough for the treatment without the need for needles.
• Nitrous oxide also has pain relieving properties, although these can vary from case to case, and person to person.
• Nitrous oxide has been found to have few side effects, and is safe to use

INTRAVENOUS SEDATION

In intravenous sedation or IV sedation, a drug is administered though an injection to make people feel like they are asleep. IV sedation does not actually induce sleep; instead, you actually remain conscious and can follow instructions from your dentist. However, the feelings of relaxation will be intense enough for you not to remember much about what happened under treatment. This is because the kind of drugs that are used in this kind of sedation can bring about amnesia, either in part or in full, from the time you begin to feel the effects of the sedation, to the time the effect wears off.
The sedation drug is administered into a vein using a very thin needle that is encased in a soft plastic tube. When the needle is removed from the vein, it leaves the plastic tube behind, and this tube is used to administer the drug. The common anti anxiety sedatives that are used for IV sedation are benzodiazepine, propofol and other medications. IV sedation, when it is administered and supervised by an experienced and trained dentist, is extremely safe. IV sedatives are not meant to be used during pregnancy, glaucoma, lung or kidney problems and allergies to the sedative drugs. Older patients are generally not recommended for IV sedation.

Advantages of IV Sedation

• The sedative takes effect very quickly, and your dentist can manipulate the drug dosage to bring about the level of sedation that’s desirable.
• IV sedatives can also lead to an extreme level of sedation that is deeper, and more intense than other sedation methods.
• Persons who suffer from a severe gag reflex can benefit greatly from IV sedation.

Disadvantages of IV Sedation

• If you have an extreme fear of needles, however, you may not find it easy to have the needle inserted intravenously.
• Occasionally, hematomas may occur.
• The drugs may not stop affecting you even after the dental procedure is complete. For this reason, you need to be accompanied by a friend or family member.

Other types of sedation:

Intramuscular Sedation
Here, a sedative drug is injected into the upper thigh or upper arm muscles to induce sedation. It’s not very commonly used in dentistry.

Local Anesthesia
For minor dental procedures, dentists may use a topically applied anesthetic gel that has a numbing effect on the area, before a local anesthetic injection is administered. Under local anesthesia, you continue to be fully aware of your surroundings. The anesthetic however, dulls the pain, so you don’t feel any of the effects of the treatment.

General Anesthesia VS Sedation Dentistry

General anesthesia is used to facilitate oral surgery. It can also be used in people who for any reason are not eligible for sedation dentistry. General anesthesia can lead to a state of unconsciousness, and the side effects may remain for several hours after the surgery or procedure is completed

Benefits of Sedation Dentistry

Sedation dentistry has several benefits both for dentists as well as patients. For patients, it can mean freedom from anxiety or fear during dental procedures. In cases where a patient has not been able to undergo dental treatment for many years because of this fear, sedation dentistry allows him to have several years worth of dental treatment in just a few sessions.
For dentists, sedation dentistry facilitates easy of performing of dental procedures. Patients are likely to be more co operative under the relaxing effects of sedation. Treatments can also be quicker, because a number of procedures can be performed in a single session.

• Patients with a history of abuse are less likely to co-operate during dental treatment, and may need some form of sedation.
• Even if you have no dental phobias, you can still benefits from sedation when you have to undergo a procedure that can be extremely painful, including gum surgery.
• Some people can also have unusually located nerves making it difficult for a dentist to locate this while administering a local anesthetic.
• Under certain forms of sedation like IV sedation that cause memory loss, you are less likely to remember anything about the procedure.

Non Eligibility for Sedation Dentistry

• If you are currently taking other medications, let your dentist know before you begin taking oral sedatives.
• If you have a history of allergic reaction to other medications also, you will need to inform your dentist before hand.
• People who have an extreme fear of dentists themselves, rather than the dental treatment are not likely to be good candidates for sedation. Other persons may have control issues that make them resist sedation. For instance, if you feel that taking sedatives will impair your judgment or that you will not be able to voice your concerns to the dentist, you are likely to resist sedation.
• Some people are also very scared of sedation itself, making them poor candidates.