What is Sedation Dentistry?
Do you fear going to the dentist? You’re not alone. In our society, “it was like going to the dentist” is code for “it was no fun at all.” However, our society simultaneously places a high value on a perfect smile, and going to the dentist is necessary to maintain that smile. So do you just have to grin and bear it?
For a long time, that was the case. You were just expected to put up with the anxiety, and if you couldn’t, well, you skipped the dentist and lived with the consequences. But recent years have seen a rise in doctors’ compassion for dental anxiety, and Sedation Dentistry has become more widely available.
There are a few types of sedation available. One is oral sedation. You’re prescribed one pill of a sedative, typically in the same class as Valium, and you take it about an hour before going to the dentist. Another type is nitrous oxide, or “laughing gas,” which you inhale just before and during your procedure. Another option which some dentists offer is intravenous (IV) sedation, in which sedatives are infused into your body through a small tube in your vein.
Keep in mind that the sedation is not intended to provide pain relief. Regardless of whether you choose sedation, you’ll receive adequate doses of local anesthetic (Novocain or another similar medication) to numb the area so that you don’t feel pain during your procedure, if you’re having a procedure that could be painful. Sedation is added on top of the pain relief to provide relief from anxiety.
When you’re considering any dental procedure, it’s important to know the risks and weigh them against the benefits. Once you understand the procedure, then you can make your decision about whether or not to proceed. To help you in your decision-making process, we have some information about the risks and benefits of having sedation dentistry at Sedation Dentistry: Risks and Benefits.
Please note that this page is for informational purposes only, and is not a substitute for qualified, individualized medical advice. You should discuss your potential dental procedure with your own dentist.
How it’s done
If you’re receiving oral sedation, you’ll need to prepare ahead of time. You can receive the sedative medication from your regular physician, or your dentist can prescribe it to you. If you’re seeing a new dentist, he or she will likely want to meet you first and go over your medical history in order to determine whether the medication is safe for you. You’ll be prescribed just one pill of the sedative, which is typically a benzodiazepine (in the same class as Valium). You need to remember to take it about an hour before your procedure. Keep in mind that you won’t be able to drive safely for several hours after taking the medication, so you’ll need to plan for someone else to drive you to the dentist and pick you up. (Don’t take a cab; you should be driven by someone you know and trust.) Some people prefer oral sedation even for regular dental cleanings. This class of medications isn’t safe for everyone, so if you have certain medical conditions or take certain other medications that might cause a drug interaction, you won’t be able to choose oral sedation.
Another option is nitrous oxide, or “laughing gas.” Higher doses of nitrous oxide are used in oral surgery to bring the person just to the edge of consciousness; although you’ll be able to respond to the surgeon’s commands during surgery, such as “open your mouth” or “turn your head,” you won’t remember any of the procedure at all. Lower doses of nitrous oxide can be used in less extensive procedures. You inhale nitrous oxide through a mask; you would inhale the sedative, then your procedure would begin, and your dentist would give you the mask back when you need more sedation. Because nitrous oxide wears off fairly quickly, you may need to inhale it several times during your procedure. However, this also means that you might recover enough to drive yourself home after your procedure, although it’s still safest to plan for getting a ride home.
Some dentists also offer intravenous sedation. This can be used in oral surgery or general surgery to provide complete general anesthesia, in which the person is not at all conscious. However, lighter IV sedation can provide relaxation while maintaining consciousness. If you have IV sedation, it can be adjusted during your procedure. This is an advantage over oral sedation; if you find during your procedure that the oral sedation wasn’t enough and you’re still anxious, then it’s too late to take more. IV sedation can be increased slightly to provide an optimal experience. Of course, getting an IV placed can be painful and carries some risk of infection or damage to the vein. This will probably only be used during fairly extensive procedures.
Preparing for the procedure
Choosing your dentist
If you’re interested in sedation dentistry, you should look for a dentist who offers it; not all dentists do so, but it’s becoming more and more common. Sedation Dentistry is not a recognized medical specialty; any dentist is trained and qualified to prescribe sedative agents to his or her patients. It’s important to find a dentist with whom you feel comfortable, who listens to you, tries to understand your goals, and answers your questions. Referrals from friends and family, especially if they’ve had the particular procedure you’re considering, can be especially valuable.
Planning for the Cost
Of course, you’ll want to know the cost of your procedure, whether insurance will cover it, and how you’ll finance it. For more, visit our Sedation Dentistry Cost page.
How quickly you recover from sedation depends on the sedative used. Nitrous oxide wears off fairly quickly, usually within a few minutes. If you receive an oral benzodiazepine, how long it stays in your system depends on the exact medication received, but the effects will usually be noticeable for several hours. If you receive IV sedation, the dentist will keep you at the office until you “wake up” from the sedation, but you may still feel drowsy for several hours afterwards.