Many people become anxious at the thought of being in the dentist’s chair. For these individuals, sedation dentistry is a blessing. Certainly sedation is extremely helpful for long, complicated dental procedures, but for patients who are phobic, it can be used even for dental cleanings.
Candidates for Sedation Dentistry
Patients with a fear of dentistry are usually good candidates for sedation dentistry. Other who may require sedation dentistry are those who:
- Can’t sit still in the dentist’s chair
- Have a low threshold for pain
- Have an abnormally pronounced gag reflex
- Have extremely sensitive teeth
- Require an unusually large amount of dental work
While most dentists can administer nitrous oxide or pills, in order to legally administer deep sedation or general anesthesia, dentists are required to complete the Commission on Dental Accreditation (CODA) program. Typically the small percentage of dentists who undergo this training are oral and maxillofacial surgeons, but some are general dentists who specialize in sedation dentistry. There are also dentists who employ dental anesthesiologists who have further training in administering all levels of sedation to all ages of patients. Special care must be taken when a child undergoes sedation because doses must be carefully calculated to correlate with the child’s age and weight.
Types of Dental Sedation
There are several levels of sedation used by dentists. These include:
- Minimal sedation in which the patient is awake but fully relaxed
- Moderate (“conscious”) sedation in which the patient is partially “under,” may slur words, and may not remember the procedure afterwards
- Deep sedation during which the patient remains at the edge of consciousness but can be roused
- General anesthesia during which the patient is completely unconscious
Means of Administering Dental Sedation
Dental sedation can be administered in a number of ways. These include:
During inhalation sedation, the patient inhales a combination of nitrous oxide (“laughing gas”) and oxygen through a mask placed over the nose. This helps the patient relax. Because nitrous oxide wears off quickly, patients may be able to drive themselves home after the procedure.
- Oral Sedation
This methods involves patients taking a pill, usually Halcion (related to Valium), about an hour prior to the dental procedure. Patients typically become groggy enough from this medication to sleep through the procedure, but can be awakened.
- IV Moderate Sedation
This form of sedation is administered intravenously and works quickly. Because the dentist has control of the amount of medication entering the patient’s vein, the dentist can adjust the sedation level as necessary.
- Deep Sedation and General Anesthesia
This type of sedation renders the patient almost or entirely unconscious, depending upon the amount administered.
Regardless of the type of sedation administered, the patient typically receives a local anesthetic as well to relieve pain at the treatment site.
Safety Factors Involved in Sedation Dentistry
When properly administered, sedation and anesthesia are quite safe, but there is always some risk involved. People at greater risk of complications are those who are obese or who suffer from obstructive sleep apnea.
Patients should always make sure that the dentist administering sedation or anesthesia has the proper training and has performed many such procedures previously. In addition, the dosage being administered should always be within the dose recommended by the FDA and there should always be oxygen, artificial ventilation, and medications to reverse the effects of sedation available in case of a problem.
Over all, sedation dentistry is a safe method of dental care with many advantages. For patients who require it, sedation dentistry is invaluable since it enables them to have regular dental care which they otherwise could not tolerate. This is extremely important because maintaining teeth and gums is essential to preserving general health.