Sedation Dentistry

Are you apprehensive about an upcoming dental appointment? While it’s normal to feel a little anxious, some patients may experience real difficulties visiting the dentist or tolerating treatment due to phobia, anxiety or intellectual and developmental disabilities.

We specialize in treating patients who struggle in clinical environments. One of the most effective ways to carry out treatment on anxious patients, or patients requiring extensive dental work, is conscious sedation dentistry, whereby sedative drugs are administered orally or intravenously to promote relaxation.

All of our dentists are certified to provide mild and moderate conscious sedation. The type of sedation used is assessed on an individual basis, and catered to each patient’s unique needs.

If you are interested in sedation dentistry, feel you may need treatment at your first appointment, or if you have not been to the dentist in years feel free to contact us and we can guide you through any additional questions you may have about your first appointment.

* The above video was produced by the Tennessee Department of Intellectual and Developmental Disabilities at our facility

 

What happens during sedation?
Conscious sedation will allow the patient to relax for long enough to receive the necessary treatment, while remaining able to swallow, talk and respond to simple commands.

Depending on the type of sedation agreed between you and your dentist, medication will be administered via a nasal mask, orally, intravenously or via an injection.

The main aim is to quickly and effectively reduce awareness of unpleasant sights, sounds, and sensations associated with the procedure. You can learn more about Sedation by reading our Consent for Sedation Document here (link).

What else do I need to know?
Patients receiving oral, intramuscular or intravenous conscious sedation will require someone to accompany them to their appointment and care for them for a few hours after treatment.

You will also need to sign a consent form before undergoing sedation. This will clearly state the types of sedation available, and the advantages and side effects of each one, so you can make an informed decision with your dentist. It also contains important information – for example when you should stop eating or drinking prior to a sedation appointment.

Sedation drugs and procedures
There are four primary ways mild or moderate conscious sedation is administered at our Practice.

Nitrous Oxide (N2O): A colorless, slightly sweet gas used to calm mild or moderate anxiety for patients able to breathe through their nose. This is a mild conscious sedation technique, and patients can swallow, talk, and cough as needed throughout the procedure. When inhaled, N2O can induce feelings of euphoria and relaxation. The anesthetic gas is delivered through a nasal mask and is mixed with oxygen in a specific ratio tailored for each patient’s comfort. The patient can expect to feel the effects of the “laughing gas” within a few minutes, and may feel sensations of drowsiness, tingling in extremities, or mild lightheadedness. The effects of the gas are mild, and it is safely and quickly eliminated from the body once it is no longer administered. The patient will be given pure oxygen prior to dismissal to ensure the effects are no longer present in the body. Patients can return to work or drive after receiving treatment under nitrous oxide.

Oral Conscious Sedation: Can be administered in either pill or liquid form and is used to reduce moderate or severe fear and anxiety related to dental procedures. Depending on the medication type, it may be obtained either by prescription or dispensed at the office and can be used in combination with nitrous, IM, or IV sedation as needed to achieve desired effects. During oral sedation, one may be sleepy or asleep but easily aroused and will have little or no recollection of the appointment. The patient can continue to respond to simple commands, but will have reduced awareness of unpleasant sights, sounds, and sensations associated with the procedure. Patients will need to be accompanied to the office and cannot return to work or drive after receiving oral conscious sedation.

Intramuscular (IM) Sedation: Medication is administered via an injection into a muscular region such as an arm or thigh to reduce moderate or severe fear and anxiety related to dental procedures. Often takes longer to achieve sedation than IV sedation, but is quicker acting than oral sedation and can be used in conjunction with other sedation types. Patients will need to be accompanied to the office and cannot return to work or drive after receiving IM conscious sedation.

Intravenous (IV) Sedation: Medication is administered via a slow IV drip in a vein (typically in the hand or arm) to aid with moderate conscious sedation. The use of IV sedation requires advanced training, but is the one of the safest means to titrate medication dosages and achieve immediate effect for an individual. Typically, a benzodiazepine is used alone or in combination with an opioid (see below for medication types). This is the best mode of treatment for lengthy appointments where amnesia and anxiolysis are the desired effects. Patients will need to be accompanied to the office and cannot return to work or drive after receiving IV conscious sedation.