Surgical Dentistry

Sedation Dentistry for Anxious Patients

While almost no one enjoys going to the dentist, some patients for whom a trip to their dental professional is so terror-inducing that they'll forego treatment of a dental problem to avoid a visit. Other patients suffer from less severe but challenging dental anxiety while undergoing treatment. If you, a family member, or a friend suffer from dental phobias or anxieties, sedation dentistry can help make going to a dental office much easier.

This video provides patients an overview of what to expect before, during and after using local anesthesia and/or oral sedatives for a dental procedure.

What is Sedation Dentistry? 

Sedation dentistry uses medication to help patients relax during dental procedures. Sedation can be used for everything from invasive procedures to simple teeth cleaning. It’s sometimes referred to as “sleep dentistry,” although that’s not entirely accurate: patients are usually awake, except those under general anesthesia.

There are different levels of sedation offered, depending on a patient’s anxiety level and the complexity and duration of their planned procedure:

  • Minimal sedation — The patient is awake but relaxed.
  • Moderate sedation — Formerly called “conscious sedation.” Patients may slur their words when speaking and may not remember much of the procedure.
  • Deep sedation — Patients are on the edge of consciousness but can still be awakened.
  • General anesthesia — Patients are completely unconscious.

Types of Sedation

The following types of sedation are used in dentistry:

  • Inhaled minimal sedation. Patients breathe nitrous oxide — otherwise known as “laughing gas” — combined with oxygen through a mask placed over their nose to help them relax. Your dentist controls the amount of sedation you receive, and the gas tends to wear off quickly. This is the only form of sedation where you may be able to drive yourself home after the procedure.
  • Oral sedation. This is the most common type of anesthesia in sedation dentistry. Depending on the dosage given, oral sedation can range from minimal to moderate. For minimal sedation, patients take a pill, typically about an hour before a procedure. The pill will make you drowsy, although you’ll still be awake. A larger dose may be given to produce moderate sedation. Some patients become groggy enough from moderate oral sedation to fall asleep during the procedure, though they can be awakened with a gentle shake.
  • IV sedation. Patients receive the sedative drug through a vein, so it goes to work more quickly. This method allows the dentist to continually adjust the level of sedation.
  • Deep sedation and general anesthesia. Patients receive medications that make them either almost unconscious or totally unconscious during the procedure. With general anesthesia, you cannot be awakened until the effects of the anesthesia wear off or are reversed with medication.

Regardless of which type of sedation patients receive, they’ll also typically require a local anesthetic — a numbing medication at the site in the mouth where the dentist is working — to relieve any pain associated with the procedure.

Who Can Receive Dental Sedation?

Sedation may be a good choice for patients who have:

  • Had traumatic dental experiences
  • A strong fear of dental work
  • Difficulty being numbed 
  • A low pain threshold
  • A bad gag reflex
  • Very sensitive teeth
  • Complicated dental needs, such as root canals or a dental implant
  • A large amount of dental work to be completed
  • A dislike of the sounds and smells associated with dental care
  • Anxiety about needles or injections
  • A hard time sitting still in the dentist’s chair

Children are sometimes given sedation if they are terrified of going to the dentist, or refuse to cooperate during the visit. Nitrous oxide tends to be safe in children, and almost every dentist can administer it. A smaller percentage of pediatric dentists are trained to give oral sedation. Oral sedation can be safe when kept within the recommended dosage for a child’s age and weight.

Who Can Perform Sedation?

Most dentists can administer minimal sedation, and an increasing number are becoming qualified to give moderate sedation. However, only a small percentage of dentists who have completed the Commission on Dental Accreditation (CODA) program in deep sedation and general anesthesia can use those more complex techniques. These dentists often specialize in oral surgery. Some dentists use a dentist anesthesiologist, who is specially trained in giving all levels of sedation and anesthesia, and monitoring your vital signs including your blood pressure during your dental procedure.

How Safe is Sedation Dentistry?

While there is always a risk in receiving anesthesia, it’s usually safe when given by experienced dentists. However, people who are obese or who have obstructive sleep apnea should talk to their doctor before having sedation, as they’re more likely to develop complications from the anesthesia.

Patients should ensure that their dentist is trained and certified to administer the type of sedation they’ll be receiving. Before the procedure, your dentist should go over your medical history including any relevant health problems, discuss any medications you’re currently taking, outline the risks of sedation, and answer any questions you may have.

Call Us Today

Everyone deserves good oral health, and an upcoming trip to the dentist shouldn’t keep you awake at night, or cause you undue stress during the day — including during the dental procedure itself. If you experience excessive fear about visiting the dentist, contact us to find out more about the sedation treatments we offer.

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