What is Sedation in Dentistry?

 “Sedation dentistry uses medication to help patients relax during dental procedures. It’s sometimes referred to as “sleep dentistry,” although that’s not entirely accurate. Patients are usually awake with the exception of those who are under general anesthesia.” WebMD

Who should consider sedation dentistry?

Sedation dentistry is suitable for people who have dental anxiety, patients with an overactive gag reflex, or those who require long dental treatments. Many people may postpone their dental treatment due to fear of the dentist, which can lead to further dental complications or deteriorate their oral health.

Some individuals may have specific medical conditions that require special care during dental procedures.

People who lack the necessary cooperation for dental treatments, such as those with dental anxiety (this fear may persist in adults due to previous negative experiences), severe gag reflex, intellectual disabilities, or individuals with conditions such as autism or Down syndrome, etc.

Some patients have a long treatment period, want to perform treatments in one session, and travel less. We could try to do their work in one or two sedation sessions.

What are the types of dental sedation?

There are several types of sedation used in dentistry, depending on the patient’s needs and the complexity of the procedure:

• Nitrous Oxide Sedation (Laughing Gas): A mild sedative inhaled through a mask, commonly used for less invasive procedures. It helps reduce anxiety and allows the patient to stay awake.
• Oral Sedation: A sedative medication is taken by mouth before the appointment to help relax the patient. It can range from mild to moderate sedation.
• IV Sedation: Administered directly into the bloodstream, this type of sedation induces a deeper level of relaxation. The patient remains conscious but deeply relaxed and unaware of the procedure.
• General Anesthesia: A deeper level of sedation where the patient is fully unconscious. This is usually reserved for more complex or lengthy procedures or for patients with severe anxiety.

Sedation Dentistry Pros and Cons

Advantages of Oral Sedation

• The treatment process is very comfortable for the patient.
• The number of visits to the dentist is reduced to one or two sessions.
• If a higher dose of sedation medication is used, it can help the patient forget the initial procedures, such as the insertion of the IV, which can significantly alleviate anxiety.
• All the medicines used during the treatment are injected intravenously. They are injected under the supervision of an anesthesiologist and are generally safe with minimal side effects.

What are the disadvantages of sedation?

Dental treatment under sedation has several possible side effects that will ultimately resolve within one to two days after the treatment.

• Drowsiness and dizziness
• Nausea and vomiting
• Possible tooth pain, depending on the type of treatment, which is normal and can be controlled with the medicines prescribed by the dentist.

Preparing for Dental Sedation

• Fasting for 6 hours before starting sedation treatment.
• If you have a history of allergies or sensitivities to food or a specific medication, tell your anesthesiologist.
• If you have a history of cardiovascular disease, high blood pressure, diabetes, or are taking any medications, inform your dentist and anesthesiologist.
• Share your history of any recent respiratory illnesses, including cold or COVID-19, with your anesthesiologist.
• Share your history of your last hospitalization and your last anesthesia with your anesthesiologist.
• If you have nail polish on your nails, please remove one finger before the treatment.
• It is mandatory to bring a blanket (for children and adults) and a set of clothes (for children).

The difference between anesthesia and sedation

During sedation, the child maintains their own breathing, whereas in general anesthesia, a machine may assist with breathing. Only supplemental oxygen is given to the patient through the nose so that the patient does not suffer from oxygen deficiency. 

The cost of sedation is generally lower than that of general anesthesia, meaning that the patient is not unconscious, and no additional fees are imposed on the patient.

Effects of Sedation on Children

In the United States, studies have shown that short-acting anesthetic drugs used in pediatric sedation are rapidly cleared from the child’s body, and generally, they have minimal side effects on the nervous system. 

For example, a large study conducted by the American Society of Anesthesiologists, which included over 10,000 children, concluded that there were no significant differences in memory or IQ scores between children who underwent general anesthesia and those who did not. 

These findings have been consistent with previous research suggesting that short-term exposure to anesthesia does not impair cognitive development in children.

Conclusion

• “The use of sedation in dentistry is both effective and safe when monitored by trained professionals, ensuring a stress-free experience” – American Dental Association.

Some people are afraid of the dentist or have strong gag reflexes or nausea, which may prevent them from even allowing the dentist to examine them or use a mirror. Some children are uncooperative due to their age or bad memories of the dentist. 

During sedation, you remain asleep, but anesthetics are used to ensure comfort. An IV line is inserted, and sedatives are injected, making you fall asleep within 20 seconds. Your heart rate and oxygen levels are monitored throughout the procedure.

Afterward, you’ll feel drowsy and fatigued for a few hours, so it’s advised to have someone accompany you and avoid tasks that require focus until fully alert. The process is carefully monitored to ensure safety and comfort.

FAQ – Sedation in Dentistry

1. What drug is used for IV sedation in dentistry?
   Common drugs for IV sedation include Midazolam, Propofol, and Fentanyl.
2. Who can perform sedation in dentistry?
   Dentists and anesthesiologists (or certified nurse anesthetists) can perform sedation, depending on the level of sedation.
3. Which sedation is best for dental procedures?

• Nitrous Oxide for mild anxiety
• Oral Sedation for moderate anxiety
• IV Sedation for deep relaxation
• General Anesthesia for complex procedures or severe anxiety

Sources:

https://www.asahq.org/

https://www.webmd.com/oral-health/sedation-dentistry-can-you-really-relax-in-the-dentists-chair