Dental Sedation

Moderate IV Sedation

Moderate IV sedation works to put patients in an altered state of consciousness, lowering their nervousness, memory, and perception of pain. Patients become highly relaxed, comfortable, and, upon completion of their procedure, many believe that they have been asleep because they cannot recall what occurred after the sedation. Whether it is for a standard cleaning or dental surgery, moderate IV sedation is a reasonable option for any healthy patient, but it is particularly useful for those patients who tend to experience anxiety prior to a procedure. This type of sedation differs from general anesthesia in a number of ways: general anesthesia leaves a patient unconscious, with their reflexes significantly limited, whereas moderate IV sedation keeps a patient awake; due to the potency of the drugs and their side effects, general anesthesia carries more of a risk than moderate IV sedation, as complications are common the longer a patient is unconscious; general anesthesia requires additional recovery time compared to moderate IV sedation; and overall, general anesthesia is the more expensive route because of the specialized staff needed to monitor a patient throughout the procedure. A dentist will administer the proper amount of sedative to ensure that the patient is calm, while also monitoring their blood pressure, breathing, and heart rate. If necessary, the dentist can provide oral pre-medication to assist in easing the patient's tension. As the procedure is underway, a patient might also receive oxygen through a mask placed over their nose and mouth or via small tubes put into their nostrils. After the procedure is complete, a patient will likely feel weak, groggy, or disoriented from the after-effects of the moderate IV sedation for up to two hours. Certain symptoms, like short-term memory loss and difficulties focusing, should not last upwards of 24 hours. Patients are advised to have someone available to bring them home after their appointment. 

Nitrous Sedation

Nitrous oxide (N2O) is a mild sedative agent that effectively manages pain and anxiety during dental treatment. Colorless and odorless, the nitrous oxide is combined with oxygen that is inhaled through a small mask that fits over the patient's nose. Within minutes of breathing, a patient will feel the effects of the nitrous oxide as it slows down their nervous system, putting them in a calm, comfortable state. Dentists often elect to use nitrous oxide due to its safe and productive results. Not only does it work swiftly to relax patients and keep them awake to hear a dentist's instructions, but the side effects are brief because pure oxygen is also being breathed in through the mask. Some potential side effects might include headaches, shivering, excess sweating, sleepiness, nausea, or vomiting; however, these generally occur only when the nitrous oxide levels exceed the intended level or if the amount being inhaled suddenly changes. Once the nitrous oxide is turned off completely, patients must receive oxygen for a minimum of five minutes to help them avoid headaches and become more alert as their lungs are cleared of the remaining gas. Nitrous sedation is recommended for patients who have special health care needs, gag reflexes that interfere with dental care, trouble responding to local anesthesia, feelings of fear or anxiety, and younger patients who must undergo lengthy dental procedures. 

Oral Sedation

Oral sedation also helps patients stay calm during a dental procedure, though the sedative is taken prior to the appointment. This oral sedative is a type of Benzodiazepine, such as Halcion, Valium, or Xanax, which diminishes activity in the parts of the brain that control trepidation and apprehension. Oral sedation is the easiest to administer because it merely requires a patient to swallow the sedative about an hour or so before the appointment. This is specifically beneficial for patients who are stressed at the thought of being pricked by a needle at their dentist's office. Despite the sedative having a slower effect than IV or nitrous sedation, it still causes patients to have practically no memory of the procedure, which is another valuable outcome for timid patients. All sedatives are regulated by the FDA and Health Canada, making it very unlikely that a patient will experience any worrisome side effects. Similar to the nitrous sedation, the oral sedative alternative will keep a patient awake and responsive to whatever questions or instructions the dentist communicates. With oral sedation and its additional time needed to take effect though, altering the dosage is somewhat more challenging. All patients metabolize medication at varying rates and that makes it difficult to gauge how much time is needed for a sedative to kick in.

If you are curious about which sedation option is best for you, you should connect with our office and book an appointment.