Dental patient information about preparing for sedation dentistry (often called sleep dentistry):
If you are going to have a dental procedure done for you that you anticipate would otherwise be painful or stressful, such as extraction of wisdom teeth, root canal treatment, or lengthy operative dentistry, sedation may be the best thing for you. Conscious sedation differs from the general anesthesia that you receive in the hospital is some important ways. Under general anesthesia, you are totally unconscious. This means that your protective reflexes (such as coughing to clear your airway, for example) are not functional and vital functions have to be supported artificially. With sedation, however, since you are still conscious, all of your protective reflexes are functional. This permits it to be done safely in an office setting. However, you are so sleepy and relaxed that you are indifferent to the dental treatment. Your memory of treatment may be spotty.
A dentist can use a rather light sedative dose. This would more accurately be called anxiolysis rather than sedation. On this page we will be talking about the stronger dose, which would produce sedation.
Method of Administration
The sedation dentistry is achieved mostly with medications that are given orally. There are a number of dentists who use these oral medications. The most popular drug to use is triazolam (the brand name is Halcion). But diazepam (brand name Valium) is also used. Both drugs are of the same family of benzodiazepines. Halcion has a much shorter half-life–about 3-4 hours, as compared with 20-100 hours for Valium. But Valium has a stronger safety record.
Throughout the appointment, the dentist will monitor your vital functions, as a precaution. Though when administered in proper doses to patients that are not medically compromised, there is little that can go wrong.
Those dentists who use conscious sedation for patient treatment report that it is tremendously successful, with a very high level of safety. Dr. David Hall, the author of this site, used his dental practice for over twenty years on over a thousand cases with a perfect safety record with no complications of any sort. He had the great satisfaction, during that time, of helping many patients overcome their fears and anxieties about dental treatment. Additionally, he found that when patients are handled in this gentle manner, they are able to receive higher quality care. When a patient is uncomfortable, their anxiety is a constant distraction and their movements make quality care difficult. But when the patient is comfortable and still, the dentist is able to concentrate on the quality of the care.
If people have certain risky medical conditions such as heart disease, epilepsy, or are at risk of stroke, sedation is a great way to make dental treatment safer. By taking the stress out of the dental appointment, it greatly decreases the likelihood of a catastrophic event occurring during treatment.
Patients should not expect to be totally unconscious for the appointment. The medications most often used are in a class called benzodiazepines. They are excellent for this purpose because they affect consciousness and memory but have very little to no effect on the vital functions of breathing and circulation. However, they do require your cooperation to be fully effective. Some people are able to fight it off–it won’t forcibly “put you to sleep.” But if you are cooperative and “let yourself go,” the dentist will be able to keep you comfortable, and you will likely not even remember your appointment.
There are some states where oral sedation dentistry is regulated out of existence. Iowa regulations, put into place in the late 1990s by the Iowa Board of Dental Examiners, due to the method in which the regulations have been implemented, have eliminated this practice in that state. However, most other states in the country allow oral sedation dentistry. Usually the dentist is required to obtain additional licensure or certification to demonstrate a knowledge of how to administer it safely.
Click here for additional information about sedation dentistry and how to treat anxious patients.
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This content was written by Dr. David Hall.