Is Sedation the Answer?

Less Pain and Stress

Types of Sedation

A Reasonable Option

Pain is among the main reasons people go to the dentist. It's also what keeps them away. About 30% of all Americans are so afraid of pain that they won't go anywhere near a dentist's chair unless pain gives them no other choice.

Less Pain and Stress

People who have had painful experiences in the past might not believe it, but most dental procedures are nearly pain-free. Even so, fears persist. Most people fear the injection of local anesthesia and many dread the noise of the dentist's drill. And just being afraid can make things worse. Research shows that the more anxious you feel, the more uncomfortable a procedure is likely to be.

Sedation can make a difference. Certain drugs help to reduce fear and anxiety. They also have some pain-killing effects. Some people won't visit the dentist without sedatives.

Types of Sedation

Getting sedated doesn't mean that you'll be "knocked out." Most dentists prefer "conscious sedation." With this type of sedation, you are awake, but relaxed.

Some of the drugs used for sedation will cause you to forget about what happens during the dental appointment (amnesia). You might feel some discomfort, but you won't remember it later.

There are several forms of sedation. The main ones include:

Nitrous oxide (or "laughing gas") — This is the simplest form of sedation. Many dentists are licensed to use it. It reduces anxiety and helps you relax. It is especially effective with children.
Oral medicines — These include anxiety-reducing drugs (such as Valium) and mild narcotics for pain. Oral sedatives are slower to start working than nitrous oxide.
Intravenous (IV) sedation — This form of sedation puts medicine directly into a vein. It works well because it's easy to adjust the amount of the drug (dose) in the blood. If you need more sedation during the procedure, fast-acting drugs are injected into the IV line. However, IV sedation is more likely than oral sedation to affect your breathing. If you receive IV sedation, your blood pressure, heart rate and breathing will be continuously monitored.
General anesthesia — This is the deepest level of anesthesia, in which you are "put to sleep." Oral surgeon and dental anesthesiologists usually have the facilities and trained personnel to perform general anesthesia in their offices. But some dental patients need to have general anesthesia in a hospital.

Generally, each type of sedation is moderately safe when used by dentists with appropriate training in relatively healthy patients. However, the deeper the sedation, the greater the potential risks. Also, you usually have to plan ahead if you're going to have sedation. Nitrous oxide can be given to almost anyone on a moment's notice. But to get other types of sedation, you must eat nothing for about 6 to 8 hours before the procedure. You'll also be required to have someone drive you to the office and home afterward.

A Reasonable Option

The widespread use of sedation has come under criticism. Some experts feel that it's not appropriate for "routine" dental procedures. But receiving sedation may be the only way that some anxious people can get adequate dental care. Many dentists believe that the benefits of good oral care outweigh any risks of sedation. You should discuss the risks of sedation and the benefits of dental treatment with your dentist.

It is important to remember that dental anesthesiologists can provide sedation in the dental office, in case your dentist does not provide it.

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