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Sedation Dentistry

Also called Conscious Sedation

Unlike General Anesthesia where a patient is completely unconscious and unable to respond, patients undergoing Conscious Sedation are able to respond to commands.

There are 3 primary ways that sedation drugs are administered in a Dental office:

  1. IV Sedation, also known as Deep Conscious Sedation, is usually used by Oral Surgeons. Sedating medications are administered directly into the blood stream. The major advantage of IV Sedation is that the doctor can closely monitor and adjust the level of sedation the patient needs by increasing or decreasing the amount of medication given. This form of sedation is not commonly used in general dentistry because of the advanced training required.
  2. Oral (Enteral) Conscious Sedation is achieved by the patient himself orally taking a pill. This is commonly called Sedation Dentistry because patients often fall asleep because of the sedating effects of the medication, but can be easily awaken if needed. The medications given are generally the same as those used for IV Sedation, only in a tablet or capsule form. The major disadvantage of this method of sedation is the variability in the level of sedation achieved by the patients. Body weight, genetics, and other medications taken by the patient all affect the level of sedation achieved with oral medications. Because the medications are taken orally, there is a time delay, which makes achieving the ideal level of sedation difficult.
  3. Inhalation Conscious Sedation is achieved via inhalation of Nitrous Oxide also known as "laughing gas." This is the most common method of sedation in dentistry. The level of sedation is easily adjusted by the dentist by lowering or increasing the amount of nitrous oxide given to the patient.

With Oral and Inhalation Conscious Sedation, the patient will experience a state of deep relaxation, but is still in control of their own breathing and cognition. The term Sleep Dentistry is often used, but is not accurate because you don't always sleep through the procedure, but it is common to feel sleepy and relaxed.

One of the major reasons Conscious Sedation Dentistry is becoming so popular is because the patient often feels that the procedure only lasted a few minutes, but in reality could have lasted a couple of hours. The medications used have the effect of amnesia which causes some patients to not remember the dental visit at all.

Which patients will benefit the most from Sedation Dentistry? Those with severe dental phobias are ideal candidates, as well as patients undergoing extensive, timely dental procedures. Other candidates are people with:

  • severe gag reflexes
  • physical limitations such as back and neck problems
  • chronic and acute jaw problems
  • difficulty getting numb with local anesthetics

With all types of sedation, patients must have responsible caregivers accompany them to their appointment, drive them home, and spend a few hours monitoring them after the procedure.