Sedation Dentistry Basics

Statistics have shown that 30% of all Americans have a fear of going to the dentist. It is this dental phobia that keeps most people from ever going to the dentist until they have no choice like when an abscess or a severely painful tooth develops.

For those who suffer from this type of fear, sedation dentistry is the choice for a relaxed and anxiety-free experience. Sometimes referred to as sleep dentistry, this form of dental work allows the patient to be at ease while the dentist does his work.

Some of the common methods used to sedate a patient are through the use of sedative drugs like depressants and anti-anxiety medications. Other techniques involve using nitrous oxide and administering drugs through an intravenous injection.

If you choose to go through with sedation dentistry, the most important factor is to have a caregiver (or designated driver) because you will be in no condition to drive after being medicated. They should also stay with you for several hours afterward to make sure you don’t fall asleep and burn the house down.

The level of sedation can vary depending on the modality of the sedative. This level can range from mild to deep depending on several factors including type of surgery, length of time of surgery and the patient’s level of anxiety.

The most common analgesic is through inhalation of nitrous oxide and is also the mildest use of sedation. After the patient inhales this “laughing gas”, they will experience a mild numbness and a general sense of wellbeing. This level can also be achieved through the use of certain medications.

A moderate level of sedation can occur through the use of oral sedation. This will diminish overall awareness of pains, sights and sounds.

A deeper level of sedation occurs through the use of intravenous sedation where the patient is in deeper depress consciousness where movement and breathing might need to be controlled. These effects can linger for hours after surgery.

Also, to note, that these sedation methods do not replace the local anesthetics that are used during the operation but are more for the treatment of anxiety associated with visits to the dentist.

The American Dental Association does require dentists and their staff to have specialized training in the use of sedative equipment, techniques and medications used during sedation. Most of this training happens during a course that runs about 25 hours and is similar in length to an advanced CPR course. Just because a dentist has been trained in sedation dentistry does not make him an expert. They have to also know how to evaluate a patient’s medical history to determine which method of sedation is right for them.

Organizations like 1-800-DENTIST are a good place to start to get recommendations for a qualified sedation dentist in your area. For those that want a sedation dentist who specializes in cosmetic dentistry, you should also make a few inquiries into this field as there are no currently recognized specialists in the field of cosmetic dentistry and teeth whitening procedures.

Over the years, as sedation dentistry has progressed, oral sedation has now become the most popular method of sedation. What makes it successful is that it is really easy to administer and involves no needles. It usually works so well that the patients seem to sleep through the whole procedure and find the overall visit extremely relaxing and pleasant, but they are always conscious despite their perceptions.

A local anesthetic is still applied to help block responses to pain but this usually occurs after the oral sedation has taken place and the patient is relaxed and comfortable.

For those that have higher level of anxiety, intravenous sedation dentistry is still used to help sedate patients. There is not much of a difference between oral and IV sedation dentistry other than the way it is administered. As it is given through an injection, it sedates the patient instantly, relaxing them into a deep level of consciousness.

Amnesia has been known to be a side effect to IV and oral sedation which leads the patient to feel as if the dentist has done absolutely nothing to their mouth because they don’t remember the procedure.

Since the popularity of oral sedatives, intravenous sedation dentistry is not as common as it used to be.

The major problem with sedation dentistry is most health insurance policies do not cover this form of dentistry, so most patients have to foot the bill from their own pocket. The costs for the sedatives vary depending on the type and this cost is above and beyond the cost of the dental work.

Basic oral sedation can cost between $200 to $400 depending on the geographic location and your dentist.

Other forms of sedation like intravenous and general sedatives vary in cost and are billed by the hour. This cost can be much higher than oral sedation due to the fact that a dental anesthesiologist has to be used.

If you do have to use sedation dentistry, check with your insurance company first to see if any methods are covered.

The American Dental Association has stated that sedation dentistry risks are the same as with any type of general anesthesia and, as long as they are administered by a skilled dentist and his staff, there is very minimal chance of complications.

Before you do decide to get sedation dentistry, do discuss with your dentist all known drug use and side effects you have had in the past. It is through a patient’s failure of disclosure that most incidents do occur due to the dentist not receiving the right information.

Another very rare incident with sedation lies in the ethics of male dentists and female patients. Over the years, several women have report sexual assaults happening to them while being sedated by their dentist. If you are a female patient and are worried about this happening, insist on your caregiver being present during the procedure or select a female dentist.

I state again, this is a very rare occurrence, and should never be considered a reflection on the field of sedation dentistry.

For those that have fears of going to the dentist, you should not put off going if you have pain or an abscess as this can lead to more complicated issues that could even include death.

For more information on sedation dentistry, watch the video below.