In Address The Dental Anxiety With Sedation Dentistry
Because our family has been taking care of people’s teeth since 1922, the date our grandfather started his dental practice in Milwaukee, we know all about dental anxiety. For some, the thought of a trip to the dentist can create dread akin to sitting in the theater at the latest horror movie. There’s no explaining it — it could be the sound of a drill, the pulling down of the hanging dental light, maybe even the overall smell of the office — but the fear is real. At Hampton Dental Associates, we treat our patients like our family, so we do everything we can to make you feel at ease in our offices. To that end, we offer sedation dentistry.
What is Sedation Dentistry?
Sedation dentistry involves the use of medications to keep patients relaxed during dental procedures. Sedation dentistry doesn’t really include general anesthesia (although it is a level of sedation) because in sedation dentistry patients are usually awake and able to respond to requests from the dentist. The sedation simply allows the patient to relax and overcome his or her anxiety.
What are the levels of sedation?
There are four levels of sedation:
When under minimal sedation, you are awake but relaxed. Your dentist can induce minimal sedation through the inhalation of nitrous oxide or “laughing gas”. This is done with a mask placed over the patient’s face. The patient may also elect to for oral sedation with a pill, usually Halcion, a drug in the same drug family as Valium.
Also called “conscious sedation,” you may slur your words when talking and not remember most of what occurred during the procedure. Your dentist can induce this level of sedation with a pill as well.
While in deep sedation, you will be on the edge of consciousness but your dentist can still awake you. Your dentist will likely use and IV to achieve this level of sedation. This allows the dentist to continuously adjust your level of sedation.
You’re completely unconscious. Your dentist will also administer general anesthesia intravenously.
What types of sedation are used?
Inhaled minimal sedation involves breathing nitrous oxide, also known as “laughing gas,” to help the patient relax. The patient uses a mask placed over the nose to breath a mixture of nitrous oxide is combined with oxygen. After the procedure, the gas wears off quickly. The patient usually can drive home following the procedure.
Oral sedation can be minimal to moderate. The patient takes a pill (usually Halcion, in the same drug family as Valium) usually about 30 minutes before the procedure. The pill makes the patient drowsy. Oral sedation is most commonly associated with sedation dentistry.
IV sedation works more quickly as the sedative drug if your dentist administers it through a vein. The method allows the dentist to adjust sedation levels continually.
Deep sedation and general anesthesia are delivered intravenously, as well. A patient under general anesthesia cannot be awakened easily until the anesthesia wears off or is reversed using a different medication.
We use sedation with medication and nitrous oxide at Hampton Dental Associates and for more complex surgeries we refer to our specialists when I.V. sedation is required.
Am I a candidate for sedation dentistry?
Patients can misunderstand the difference between sedation and anesthesia. Anesthetic ensures you’ll feel nothing during our dental procedures. Sedation isn’t to handle pain — that’s the role of anesthesia — but to help patients deal with strong feelings of fear and anxiety that arise when they visit the dentist. After receiving sedation and successfully completing their appointment, patients often completely change how they view dental appointments going forward. Sedation could be a great option if you:
- Have difficulty overcoming anxiety about the dentist
- Have a low pain threshold
- Have very sensitive teeth
- Have a very strong gag reflex
- Need a large amount of work done
Once you are sedated and comfortable, we then properly numb, or anesthetize, the area we are working on, ensuring your procedure is pain free.
How safe is sedation dentistry?
At Hampton Dental Associates we provide oral sedation and nitrous oxide, referring to specialists if IV sedation is necessary. Oral sedation has an amnestic effect. While technically a side effect, most patients love this benefit because they have no recollection of their visit to our offices or of their procedure. Oral sedatives can also cause dry mouth, headaches, dizziness, and occasional nausea, but these pass quickly.
Nitrous oxide can create pressure changes in the middle ear and in the intestines. This can lead to short-term pain, but this is a very rare reaction. In most cases, nitrous oxide is very safe and very effective for alleviating your anxiety.
We don’t perform IV sedation at Hampton, but the biggest risk with IV sedation is over-sedation. Reaching too deep a level of sedation can be dangerous for medically compromised patients. Over-sedation can also lead to respiratory depression. Continual monitoring of the patient’s vital signs mitigates these risks. That’s why we refer these situations to a specialist.
Can you feel any pain during sedation dentistry?
As discussed above, there is a little misconception here. Sedation is not anesthesia. Sedation has the goal of helping the patient overcome his or her anxiety or fear that they associate with the dentist. Sedation has the pleasant side benefit of usually also creating an amnesia-like effect, so the patient has little or no memory of their appointment.
Anesthesia is what keeps you comfortable and pain-free. Modern dental anesthesia ensures our Hampton Dental Associates patients don’t feel anything during any of our treatments.
Is there recovery after dental sedation?
There isn’t any recovery from our sedation dentistry at Hampton, but you will need some planning, depending upon the type of sedation you choose.
If you have nitrous oxide to take the edge off, as soon as the mask is removed the effects wear off almost instantly. That means you’re fully capable of safely driving yourself home after your appointment.
If you opt for oral sedation, you’ll need to arrange to have someone drive you home. That’s because the effects of sedation last from two to four hours after your appointment. With sedation, you are not allowed to drive a car for 12 hours afterwards.
How long before I can drive if I have dental sedation?
If you had nitrous oxide, its effects wear off almost as soon as we remove the mask. In just five or 10 minutes, you have no after-effect, and you can drive without risk.
But if you’ve had oral sedation, Wisconsin law (and that of every other state) declares you must wait at least 12 hours before driving a car.
What is the difference between sedation dentistry and sleep dentistry?
This is a bit of a misnomer. Patients sometimes think they will be put “under,” as they are with general anesthesia. This is not the case. With nitrous oxide, oral, and IV sedation, you’re always awake, but sedated.
Dentists rarely use general anesthesia. This is used for more involved oral surgery, such as wisdom teeth or various periodontal procedures.
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