Is Sedation The Answer?

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, they can be uncomfortable. Some people don't like the noise of the dentist's drill. And just being afraid can make things worse. Research shows that the more anxiety 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 cause you to forget about what happens during the dental appointment (amnesia). You might feel some discomfort during the procedure, 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. Most dentists are licensed to use it. It reduces anxiety and helps you relax.
Oral sedatives — These include anxiety-reducing drugs (such as Valium) and mild narcotics for pain. Oral sedatives are slower to start working than nitrous oxide. Oral sedatives can be given to young children instead of a drug injection.
Intravenous (IV) sedation — This form of sedation 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. The drugs that are used in IV sedation are often the same ones that can be given by mouth. However, IV sedation is more likely than oral sedation to affect your breathing. The dentist or anesthesiologist will check your oxygen levels during the procedure. You may be given extra oxygen.
General anesthesia — This is the most complete form of anesthesia, in which you are "put to sleep." General anesthesia is complicated. Some dentists have the facilities and trained personnel to perform general anesthesia in their offices. But general anesthesia for dental work is often done in a hospital. It's usually used only for those who need a lot of work done, or who can't use other forms of sedation.

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 after midnight the night before. You'll also be required to have someone drive you to the office or 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.

Most drugs used for dental sedation have few side effects, except for some drowsiness. Dentists who use sedation follow strict rules. They watch your blood pressure, pulse, breathing and oxygen levels. They make sure you do not drive yourself home.

If you decide you'd like to have sedation, call your dentist ahead of time to make sure that he or she can arrange for it. Ask your dentist about his or her training to provide sedation. It is also important to remember that anesthesiologists can provide sedation in the dental office, in case your dentist does not provide it.

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