Sedation allows dentists to create a state of relaxation and thus manage the fear and pain patients may experience during dental procedures. There are several different types of sedation used in dentistry:

·        Local anesthesia is administered by injecting medication (Lidocaine, Septocaine)  into mouth or by applying a medication topically to an area to eliminate sensation.

·        Minimal sedation is used most frequently in dentistry and usually involves taking medications orally. All bodily functions remain normal and the person is able to breathe on his or her own. With nitrous oxide sedation, “laughing gas” used to achieve minimal sedation and in combination with a recommended dosage of oral medication.

·        Moderate sedation is achieved by using medications that can be taken orally (PO) or intravenously (IV). Patients who undergo moderate sedation are awake and respond to touch and/or verbal commands. All bodily functions remain normal, and the patient does not need assistance breathing.

·        Deep sedation can be achieved by injecting medication, giving oral medications, and in combination with gases.  Patients who are deeply sedated are not easily awakened but may respond to some stimulation. Patients may need some breathing assistance at deeper levels.

How does it work?

Patients who are minimally sedated inhale nitrous oxide through a mask during their dental appointment and/or may take a recommended dosage of a single oral sedative medication. Moderately sedated patients generally have taken a medication or a combination of medications while in the dental office. The medication causes the patient to become sleepy and feel relaxed.

What kinds of medications are involved?

To reach a level of minimal sedation, a mixture of nitrous oxide and oxygen (50-70 percent) may be used, possibly in combination with a minimal dose of an anti-anxiety (benzodiazepine) pill. In combination with nitrous gas, it is important that patients take only one type of drug under minimal sedation.

Moderately sedated patients also generally take benzodiazepines. The most common benzodiazepines prescribed are: Valium®, Triazolam, Xanax, Ativan and Versed.

What are the advantages and disadvantages of sedation in dentistry?

Minimal and moderate sedation reduce anxiety that is typically associated with dentistry and allow the patient to relax and have any necessary dental care.  The amnesia associated with these methods also is a plus for many patients.

Sedation in dentistry has some disadvantages. Minimal sedation usually cannot be administered to patients with does have respiratory problems like emphysema or asthma or those who have allergies to the class of drugs used.

With moderate sedation,  the patient must be supervised after the dental visit until the effects of the medications have passed. The patient will need to not eat or drink for at least 6 hours before the appointment and have a responsible adult with them to drive them home. This applies to sedation administered both orally and intravenously.

Is it safe?

Sedation is safe; you should talk to your dentist and/or the specialist and gain a thorough understanding of how it works and what is expected of you before the procedure. Your medical history will be examined thoroughly to ensure safe sedation and your vital signs will be monitored throughout the procedure to confirm that your blood pressure, pulse rate, and blood oxygen levels are normal. Our doctors are certified in Advanced Cardiac Life Support (ACLS), have a defibrillator in the office (AED) and train regularly in management of medical emergencies. If you feel like you can benefit from sedation dentistry, please call us at 615-383-3690 or email us at: drappt@dentistryofnashville.com.

Resources

www.agd.org  At the Academy of General Dentistry’s web site, you can search more than 300 oral health topics, post dental questions and sign up for e-newsletters.