Blog

What is Sedation Dentistry?

There are many benefits of sedation dentistry. The most common one that comes to mind is that it offers a healthy solution for the many American adults (about 30 percent of the population) who are afraid of needles. Conscious sedation dentistry assists this segment of the population in actively engaging in their own dental health – a health priority that might otherwise go ignored.

The immediate benefits are the minimization of anxiety. Sedation dentists have to be almost as skilled in the psychology of patients as they are in the knowledge of dental science in order to be able to deal with anxiety. They must be able to recognize both the visible physical signs of this disorder (nausea, fatigue, insomnia, trembling, tense muscles, headaches, sweating, frequent urination, jumpiness) as well as some of the psychological signs (unrealistic views of the circumstances, excessive worry, difficulty concentrating). Keeping all of these symptoms at a minimal level of expression can ensure that the dentist has the freedom to focus only on dental work.

Reduce Dental Stress

Sedation in dentistry is also very helpful for minimizing movement. One of the most difficult circumstances to navigate for a dentist is a “moving” patient. In children, this is to be expected, and dentists are usually prepared with some countermeasures before having to resort to deep sedation practices. In adults, however, it is a much larger task to control movement. Adults cannot be lulled into believing “against” pain or distracted with the niceties of toys or artwork in the room. Sometimes, in order to control adults, it is important to use all the tools of oral sedation dentistry to get the job done.

One of the most common anti-anxiety drugs is nitrous oxide, also known as “laughing gas.” It completely relaxes the patient and is used in combination with a local anesthetic, since it does not manage pain. In cases of moderate or extreme anxiety, some doctors must use IV sedation dentistry, in which the medicine is administered directly into the bloodstream of the patient. The dentist must monitor heart rate, blood pressure, and breathing if IV sedation is used.

Sedation dentistry has allowed many patients who would not otherwise have made good on dental appointments to come out of hiding. Dentists and patients alike can be thankful that the wonders of sedative dentistry have been available to them in order to ensure good dental work. For the dentist, it comes down to sound dental practice and fostering good dental health. For the patient, it is all about a good, healthy smile.

How Sedation Dentistry Works

There is no real mystery to how sedation dentistry works. It is not quite the same as anesthetic injections. It involves three different degrees of depressing the central nervous system and can range from minimal to moderate to deep sedation.

When sedation dentists administer minimal sedation, the patient has reduced anxiety, but can still respond verbally and physically to his surroundings. In moderate sedation, the patient is even more relaxed but will respond only to a larger stimulus in his environment. In deep sedation, the patient usually does not who any signs of consciousness and is not responsive to anything going on in his local environment. Oral sedation dentistry offers the flexibility of all three sedation states, depending on the level of anxiety of the patient.

What usually happens is a dentist will give a patient a prescription for a sedative to be taken the night before the procedure is scheduled. The sedative serves two purposes: 1) It helps the patient to get a good sleep during the night, and 2) it ensures the patient will wake up relaxed for the procedure. This is considered a no-needle approach. The patient can either take whole pills or allow the dentist to give the pills to him sublingually (under the tongue). Drugs taken sublingually in sedative dentistry get to the bloodstream much quicker.

Dentists who administer the meds used during conscious sedation dentistry have usually already measured the safety of these drugs on the therapeutic index. The larger the med measures on the scale, the safer it is. Because some of the meds make you remember little after you take them, they are sometimes lumped into a category called “comfort dentistry” or “relaxation dentistry.” The terms are meant to describe how patients feel after taking the meds: free of fear and quite relaxed.

Sedation in dentistry requires that a dentist knows which drug is appropriate for weight, height, and level of anxiety. Some of the drugs a patient will take are given after he arrives for the procedure and after he has taken the sedative pill the night before. Those drugs might include laughing gas (also called nitrous oxide), valium, Ativan, Sonata and a few others. They take a while to wear off after the procedure, so the patient may need someone to drive him home. The patient may also experience an amnesic side effect and not remember much, but memory does return.

Sedation dentistry has become a safe, viable alternative to patients who cannot overcome the fears they have of dental procedures. Even IV sedation dentistry (meds injected directly into the bloodstream) offers hope for extreme cases of anxiety. The entire process seems to rest squarely on a single belief: fear and anxiety are conquerable. After the fear is gone, pretty smiles are more than possible.

video courtesy of Austin Cosmetic Dentistry

How to Choose a Sedation Dentist

If you are a patient who must experience sedation dentistry, how do you ever know when you have the right sedation dentists working on your mouth? Going through the usual procedure, where a dentist simply numbs your gums with Novocain, might not qualify as experience for a more complex procedure.

There are some serious questions you can ask your dentist, however, that should help settle any questions of competence or professionalism and allay your fears about your procedure.

  • Ask what percentage of patients has dental problems like yours. If your dentist says a small percentage, you might opt for another professional to handle your procedure. You can always continue to see your dentist for routine visits and cleanings, so the relationship does not have to end if you really like him.
  • Ask if the dentist is affiliated with any local hospitals. While it might seem a bit out of the ordinary to ask such a question, it might tell you if the dentist is qualified to perform a procedure like IV sedation dentistry, in which medication is injected directly into the bloodstream through the veins. Do not feel embarrassed to ask this. No professional will be offended. Oral sedation dentistry can offer just as many risks as sedation for other kinds of surgery and should be taken just as seriously.
  • Ask what kinds of sedation methods are available to you. If your dentist does the same sedation for every single patient, it is time to look elsewhere for help. Conscious sedation dentistry should be offered with options. Each patient is a different person with a different need. Your dentist should be able to address any of those needs. While he might need to be a one-stop-shop in order to keep you as a patient, he should not be a one-size-fits-all dentist. If so, he does not believe in individualization.
  • See if the dentist can make a proper recommendation if you were not to use his services. Does he have partnerships with other dentists in your city, or is he knew enough about his colleagues to make a proper referral? If not, you might consider changing dentists. Sedation dentists might be slightly competitive with one another in order to stay in business. Those who are in it for the right reasons, however, realize that there is an inherent comradely among professionals that promotes sedative dentistry and puts the patient first. The future of sedation in dentistry will always depend on how well all the players embrace this concept.

Sedation dentistry is a specialized enough field that dentists must also consider that they have patients with special needs. Those with real (or imagined) anxieties present a different set of challenges. Root canals, full mouth reconstruction, and gum disease are just three of the many reasons to seek a dentist who can competently perform this kind of work. The first task, however, is up to the patient: find the right dentist.

Sedation Dentistry – Why So Popular?

A looming fear of needles has created a credible need for sedation dentistry. According to national statistics, more than 10 percent of the population has “needle phobia” to the extent that they avoid medical care. Thirty percent of the population avoids dental care because of fear. Many develop the phobia because of a previous traumatic condition, but some needle phobics have a real fear the medical condition that the needle represents rather than an actual fear of the needle itself.

Sedation dentists know all about these kinds of fears. They specialize in creating an anxiety-free experience for their patients in order for the patients to receive relaxed dental care. Without good application of sedation in dentistry, many more people would put their own dental health and good smiles at risk. Dentists use sedative drugs that can be administered in a number of ways. In some moderate to extreme cases, IV sedation dentistry is necessary in order to subdue the level of anxiety in the patient.

Primarily, dentists and other trained professionals make sure these sedatives get into the bloodstream by injecting the patient with needles. For those who have a fear of needles, alternative methods like laughing gas have been effective. Oral sedation dentistry techniques make some patients so relaxed that they do not remember their dental experiences at all.

If you are the patient, it is very easy to lose track of time while you are in the dental chair. It might seem as if you have just arrived and spent only a few minutes with your dentist. Properly sedated, you do not realize that hours could have passed while you were receiving treatment. You are awake during the procedure and feel no pain as the dentist completes the work on your mouth. Such is the magic of conscious sedation dentistry.

Sedative dentistry was designed to help those who have a fear of dentists overcome the fear long enough to get the dental work they need. It is the safest, most effective way to treat patients who have endured trauma or have deep reservations about needles or dental work. Patients can experience minimal, moderate or deep sedation. Any of these methods work by suppressing the central nervous system. While these types of procedures administered as dental approaches are not considered the same as administering a local anesthetic, they have the same goal: reduction of anxiety. It makes the job of sedation dentists a lot easier.

As an anxiety therapy, sedation dentistry offers a chance for 30 percent of U.S. adults who avoid dental work to finally do something about their oral health. They can shift the focus from fear of needles to fear of bad dental hygiene.