I have patients, young and old, who are terrified of the dentist, for reasons they themselves sometimes can’t even pinpoint. For some, it is the drilling; for others, it is the close proximity to their mouths; for others still, it is all the weird sounds coming from all around them. No matter the reasons though, these phobias are keeping many patients from getting their teeth taken care of properly. Because of this, many of their dental problems go left unattended, until the very last moment when extreme measures are needed.
For years, this has plagued dentists, as there was absolutely nothing they could do about it. I myself found that no matter how gentle I was with particular patients, and no matter how much I tried to eliminate potential phobia inducing sounds and techniques, a dental phobic patient would always squirm, making it impossible to get to and fix the root of their problems. That is, until sedation dentistry.
What It Is
Sedation dentistry has been letting dental phobic patients undergo treatment—sans fear and anxiety—since its introduction to the dental industry. Not only does it get these normally fidgety patients to stay still in the chair, but it actually reduces the number of visits required for treatment to just a couple of sessions. How is this possible, you wonder?
To begin with, sedation dentistry uses sedative medications to produce a 100% relaxed patient. The result is phenomenal. The use of these sedative medications, which include tranquilizers and anxiolytics, affect the Central Nervous System (CNS) in such a way that produces a sleep-like effect. Because of this effect, sedation dentistry is often erroneously referred to as “sleep dentistry.” However, while you are likely to feel sleepy under the medication, chances of you actually falling asleep are very slim.
Types of Sedation
For many of you dental-phobes reading this, you are probably (rightfully) wondering how the medication is administered. After all, you’re terrified of all my probing and prodding already, so what makes me think that you will be okay with me, say, sticking a needle in you? I honestly don’t expect you to be, and neither did the mastermind behind sedation therapy. Rather, you have several options when it comes to the administration of the drugs. The three most common types are:
· Oral Conscious Sedation
· Inhalation Sedation
· Intravenous (IV) Sedation
Oral Conscious Sedation:
Oral conscious sedation is exactly what it sounds like—oral sedatives that are given to you before you undergo dental treatment. This type of sedative relieves any of the stress and anxiety you may feel about dental treatment, without making you sleepy or unconscious; instead, you are able to follow any directions your dentist gives you.
Unlike other sedation methods, which are administered in office, oral conscious sedation is to be taken before you go to bed the night before treatment, and again when you wake up in the morning. Though these sedatives have a similar effect to anesthesia in that they diminish your ability to filter or respond to sounds, smells or pain, they are not a pain reliever, so you will need a local anesthesia as well, if the procedure calls for it.
Inhalation sedation, aka, laughing gas, is basically nitrous oxide. It is colorless, smells nice and can bring on a warm, fuzzy feeling within 5 minutes of breathing it in. It also eliminates pain. Many patients like it because its effects kick in really fast, and they are able to recover from it quickly (or as quickly as your dentist wants you to).
Intravenous sedation, or IV sedation, is administered through an injection. For you people who don’t like the whole poking and prodding aspect of dentistry, this may not be for you. IV sedation has the effect of making you feel as if you’re asleep, but you’re not; rather, you are able to follow all directions from your dentist, while remaining so relaxed that by the end of your appointment, you won’t remember much of what happened.
The sedation drug is administered into a vein using a very thin needle that is encased in a soft plastic tube. When the needle is removed from the vein, it leaves the plastic tube behind, and this tube is used to administer the drug. IV sedation, when it is administered and supervised by an experienced and trained dentist, is extremely safe.
If you are not comfortable with any of the three main ways of administering the sedative drug, there are other, less conventional ways of dulling the pain. Intramuscular sedation is done by injecting the sedative drug in the upper thigh or upper arm muscles. It’s not commonly used, but it’s an option in some offices. Local anesthesia is another option, but this is used for minor dental procedures only. Local anesthesia is a numbing gel that affects only the area it was applied to, and lets you stay conscious and cognitive throughout the entire treatment process. General anesthesia is used in oral surgery, and is only an option for people who are not eligible for sedation dentistry. This is because general anesthesia can lead to a state of unconsciousness, and the side effects will remain with the patient for several hours following treatment.
Are You Eligible?
Now, the big question is, are you eligible for sedation therapy? If you have an extreme fear of the dentist, or if you get overwhelming anxiety before coming in, then you will no doubt benefit from its use. However, if you are currently on other medications, have a history of allergic reactions to other medications, are terrified of sedation in and of itself, or are just plain scared of your dentist, then sedation therapy probably won’t help you. However, other than those four reasons I just mentioned, sedation therapy is a safe way for dental-phobes to finally get that treatment they’ve been wanting and needing.