Sleeping on the (Dental) Job: Sedation Dentistry

Dec 11, 2018

Dentophobia (an intense fear of going to the dentist) is one of the most common phobias in the world. If you’re afraid of going to the dentist, you’re not alone. Around 12.6 million people in Australia have specifically avoided going to the dentist (30% of which out of fear). But if dental anxiety is bothering you to the point of not getting your required dental treatment, there is a possible solution: sedation dentistry.

You Snooze but Don’t Lose

Sedation dentistry utilises particular medications that help people relax by depressing the patient’s consciousness. It is sometimes called “relaxation dentistry” or “sleep dentistry”. There are different levels of sedation dentistry ranging from “happy gas” to general anaesthesia.

Inhaled (Minimal) Sedation

This is when the patient breathes nitrous oxide (a.k.a. “happy gas”) through a mask placed over the nose. This keeps you relaxed but fully conscious and, because the effects of the gas wear off quickly, also means this is the only sedation procedure that allows you to drive after the appointment. This is quite effective and painless so oftentimes it works on overly-anxious kids.

Oral (Minimal to Moderate) Sedation

This is a pill or a liquid (ingested through your mouth) that is prescribed by your dentist. For minimal sedation, your dentist will prescribe something like Halcion (in the Valium family) which will be taken before the appointment (your dentist will specify the exact time period). It has a stronger effect than “happy gas” where you will be drowsy but conscious. You will most likely not be able to drive after the procedure unless its effects have worn off during that time.

A larger dose of the prescription will lead to moderate sedation (definitely ruling out driving). You may feel so drowsy that you could take a nap during the appointment (though not so unconscious you couldn’t be awoken by a gentle tap or shake). This oral sedation may be used in conjunction with inhaled sedation but that would be up to both you and your dentist.

IV (Moderate) Sedation

Intravenous (IV) sedation is when the sedative drugs are injected directly into your veins. Unlike the oral sedation, which takes about an hour to get absorbed into your system, IV sedation is much faster as it has direct access to your bloodstream.

The dentist will be able to control the amount of sedation you are experiencing throughout the treatment. You may be conscious but you probably won’t be very aware of the procedure. Be mindful that this does require recovery time and you will definitely need someone to drive you after the appointment.

General Anaesthesia (Deep Sedation)

This is generally only provided in hospitals or where an anaesthetist will administer inhaled and intravenous medication that will render you unconscious for the duration of the procedure. This will also require recovery time after the treatment as this is the strongest type of sedation.

Is Sedation Dentistry for You?

Sedation Dentistry is ideal for anyone who:

  • has dentophobia or is anxious about dental treatment
  • is not very responsive to local anaesthetic (where the normal injection is not achieving the desired numbing effect)
  • has an overactive gag reflex
  • has a low pain threshold
  • has sensitive teeth (sedation dentistry can be used for even simple procedures like scales and cleans)
  • has an extensive amount of dental work needed to be done
  • cannot sit still in the chair (especially applicable to overactive kids)

When dental sedation is administered on kids, it is with a much lower dose than adults to accommodate for their size and weight. Since nitrous oxide is quite mild, almost any dentist can administer this to children. Pediatric dentists are trained to give children oral sedation.

Talk to Your Dentist

Your dentist is the person who can best determine which sedation method is appropriate for you (if at all). Make sure you disclose your current medical history with your dentist to ensure you’re not allergic or taking any medication that may conflict with the sedation.

If you feel dubious about the idea of sedation dentistry, you can always find out how much experience your dentist has administering the different methods of sedation to allay your fears. Go through the dental procedure with your dentist thoroughly before treatment so you understand what will happen. Your dentist is there to look out for you so make sure you ask them if you feel uncertain about anything.