Sedation Dentistry

Sedation dentistry refers to medications that help you feel less stressed during dental procedures. Your dentist may recommend certain medications if you have general dental anxiety or if you’re going to have a time-consuming procedure like periodontal surgery

In sedation dentistry, you’re awake and able to respond to questions, but you don’t notice pain. It’s sometimes called conscious sedation dentistry or twilight sleep. Your dentist may recommend that you have sedation dentistry if you have:

• Fear of dental treatment
• Fear of needles that makes you anxious about shots to numb your mouth or gums
• Very sensitive gag reflex
• Very sensitive teeth
• Claustrophobia that makes it hard for you to relax while sitting in a treatment chair
• Difficulty controlling your movements
• Have physical, behavioral or cognitive needs that make it difficult for you to relax

Sedation types

The most common types are nitrous oxide, oral conscious sedation and IV sedation. Each type affects you in different ways. Your dentist will recommend a sedation type based on factors like your level of anxiety about a procedure, how long the procedure will take, your health and your personal preferences.

Nitrous oxide

You inhale nitrous oxide through a mask or nosepiece. You’ll start to feel calm and relaxed within three to five minutes. Your dentist will check how much you receive and adjust the dosage throughout your procedure. They’ll give you pure oxygen through the mask when the procedure is complete. Pure oxygen quickly flushes out nitrous oxide. You won’t feel woozy, and you’ll be able to drive after your procedure.

Oral conscious sedation

This refers to prescription medication that your dentist gives you about an hour before your procedure. Common sedatives are triazolam (Halcion^®), which is in the diazepam (Valium^®) family. But your dentist might use other medications like zaleplon (Sonata^®) and lorazepam (Loreev XR^®). If your child is anxious about a procedure, their dentist may give them liquid sedation like midazolam syrup (Versed^®).

Oral conscious sedation can make you feel very tired. You may even fall asleep during your procedure. Your dentist won’t mind if that happens. They’ll wake you up if they need you to do something like open your mouth wide or turn your head.

IV sedation

Intravenous (IV) sedation is the deepest form of conscious sedation available in a dental office setting. This option is best if you have severe dental anxiety or need to have a dental procedure that may take a long time to complete.

If you’re receiving care from an oral surgeon, they’ll give you anesthesia and then do the procedure. Otherwise, a dental anesthesiologist will provide IV sedation, and your dentist will do the procedure.

In IV sedation, your provider will insert an IV line into your arm. This sends the medication directly into your bloodstream. They’ll check your heart rate and blood pressure during the procedure and adjust the dosage as needed. You may fall asleep during the procedure. When you wake up, you won’t remember anything about the procedure.

Do I need to do anything before my treatment?

Your dentist may ask what medications you take. Certain medications may affect how sedation works. Your dentist may ask you to stop taking your medication for a few days before your procedure.

You may need to avoid food and drink for several hours before your appointment (fast). Your dentist will explain how long you should fast.

If you’re going to have IV sedation or oral conscious sedation, be sure to arrange for someone to take you home after your procedure.

What happens during sedation dentistry?

Your dentist gives you sedation before beginning your procedure. Once you’re feeling relaxed and comfortable, they’ll give you shots to numb your teeth and gums.

What are the potential benefits and risks of this treatment?

Sedation dentistry may:

• Make it possible for you to get the dental care you need, even if you have severe dental anxiety or other issues that cause you to avoid treatment.
• Cut back on the number of appointments you need. Your dentist can work more quickly when you’re calm and comfortable. They may be able to complete procedures in fewer appointments.

Some people have allergic reactions to sedatives. Your provider will quickly take steps to ease any reactions.

Sedation side effects

The medication used in sedation dentistry may cause side effects, including:

• A bruise on your arm from the IV
• Dry mouth
• Drowsiness that lasts for a long time
• Headaches
• Nausea and vomiting

Most side effects go away within a day.

Your child may experience different kinds of sedation side effects, including:

• Fever
• Irritability
• Nausea and vomiting
• Snoring

Your child’s side effects should go away within 48 hours. But some children are slow to wake up after receiving sedation. You may feel anxious about how your child reacts to sedation. Their dentist will keep a close eye on your child after the procedure. They’ll take time to be sure sedation wears off before you take your child home.

Recovery times vary. They depend on what type of sedation you choose and how your body responds to the medications:

• Nitrous oxide recovery: You’ll recover within 15 to 30 minutes. You’ll be able to drive and go about your day.
• Oral sedation or IV sedation: You’ll recover within 24 hours. But you shouldn’t drive for 24 hours after your procedure. And you should plan to take it easy the day after your procedure. Everyone reacts differently to sedation. Your dentist will explain what you can expect.

When should I call my dentist?

Call your dentist if you still feel groggy 24 hours after your procedure or if you have side effects like nausea and vomiting.

Do dentists ever use general anesthesia?

An anesthesiologist in a hospital or ambulatory surgery center may use general anesthesia so a dentist can do treatment. Dentists who use general anesthesia must have advanced specialized training.

Your dentist may arrange for general anesthesia when they’re caring for a young child, an adult with special needs or someone who has severe dental anxiety.

Can I have sedation dentistry if I’m pregnant?

You should have your regular check-ups during pregnancy. But your dentist may recommend you wait until after pregnancy to have dental procedures that involve sedation. That’s because some sedatives may affect fetal development.