Dental Sedation – Is It For You?

To The Dentist You Go

Ah the joy of going to the dentist. It’s that time again to go climb in that chair and let the dentist drill and dig around in your mouth like Bob the builder.

Sure they give you shots in the mouth that numb the area being worked on, but those aren’t exactly pain free.

Many people experience severe anxiety just at the thought of going to the dentist before they even get there. For these people this can be a horrific experience.

More and more dentist offers their patients different options of what is known as sedation dentistry. These procedures can range from simple numbing to being unconscious.

All dentists offer some means of comfort, depending on your dentist as to what option they use.

When making your appointment it is crucial that you let your dentist know if you have any anxiety or fear of the procedure you are having. Not telling them could lead to you having an unpleasant experience. Some people have been known to experience medical emergencies.

Dentists that offer sedation dentistry use different methods. You may be offered medications or nitrous oxide, otherwise known as “laughing gas”. For those with a fear of dentist the dentist will usually administered anxiety medications that make the patient sleepy.

There are times the dentist will prescribe the patient medications to be taken before the appointment. This gives the medication time for the patient to be sedated upon arrival, assisting with anxiety. There are two types of sedation, oral and conscious.

Options for Oral Sedation

• Novocain – Otherwise known as Procaine
Novocain is an anesthetic that is used to numb a local area before surgery or a dental procedure. Its effectiveness stems from causing numbness, or loss of feeling of the mucous membranes and skin.

Novocain is giving by injection prior to and during surgery or the dental procedure to ensure the patient feels no pain. Novocain is the first option dentist use but for those that suffer from anxiety, other options are available.

Many patients suffer from high anxiety before and during visits to the dentist. Medications are normally given to the patient prior to the procedure to calm and relax them making it easier for the patient as well as the dentist.

Sedation dentistry is often referred to as “sleep dentistry,” although that is not totally the truth. Patients are typically awake other than those under general anesthesia.

The levels of sedation used are:
• Minimal sedation — you are awake but relaxed.
• Moderate sedation -conscious sedation. If you have the ability to talk, you may slur your words or talk about things that make no sense.
• Deep sedation – You are almost consciousness yet can still be awake
• General anesthesia — You are completely unconscious.
There are 3 most common medications dentist use for anxiety relief:
• Valium-generic name Diazepam
This medication changes brain chemicals that cause anxiety when the brain becomes unbalanced. Along with anxiety, Valium is used to treat alcohol withdrawals, muscle spasms and seizures.
• Halcion
This drug made for sleep normally prescribed for those that suffer from insomnia. It is in a class known as hypnotic sedatives that act on the brain producing a calm effect.
• Hydroxyzine
This drug affects the nervous system by reducing its activity. It is commonly used to treat anxiety along with tension.

When medication alone isn’t enough, Dentist will add to the protocol, Nitrous Oxide. This, along with the injections for numbing purposes and medication are for patients that are extremely fatigued and anxious with fear.

Minimal inhaled sedation: Nitrous oxide – “laughing gas” – combined with oxygen flows through a mask that’s placed on your nose. This relaxes you. Your dentist will control the sedation you need. The gas wears off quick. This is the only means of sedation where you are allowed to drive after the procedure.

Nitrous Oxide got the name “laughing gas” due to the feeling it gives once you have inhaled it. It causes a euphoric effect that relaxes the mind and body.

The effect it has on people varies. While it shows no change other than sleep on some people, others display rather odd behaviors. Nitrous Oxide has become a popular recreational drug due to the euphoria feeling it gives. Teenagers like to use it due to it not having a lasting effect.

It is also used in Motorcar racing and in Rocketry to increase the power in the engines.

There are different levels of sedation. The amount of work the dentist is doing along with the amount of anxiety the patient displays will determine the protocol of sedation.

Conscious sedation

Conscious sedation is a mixture of medicines to help you relax. The dentist will use a numbing solution and a sedative. This is for procedures that will only last for no more than 30 minutes. It is a short acting protocol.

For pediatric dentistry this is a widely used and a safe procedure. For the dentist it makes it much easier to do the procedures. Once the medication has worn off, chances are they may not even remember having the procedure done.

General anesthesia and deep sedation is where you are given medications that put you in a state of unconsciousness during a procedure. While you are under the anesthesia, you cannot easily be awakened until the anesthesia wears off or you are given medications to reverse the effects.

Typically even though you are fully unconscious the dentist will also apply a local anesthetic (numbing medication) to the site where he/she will be working to relieve pain.

Sedation dentistry may not be for everyone but for those that do require it, it is a blessing. If you suffer from one of the following, you may consider sedation dentistry:
• Sensitive teeth
• Dental anxiety
• Complex dental issues
• Difficulty getting numb
• Limited time to complete dental work
• Fear of needles
• Traumatic dental experiences
• Difficulty controlling movement

Individuals with Parkinson’s disease or cerebral palsy often are unable to control movements of their body, arms and hands. This can prevent these people from getting proper dental care. Sedation dentistry can relax the patient making it possible for their body to remain calm.

Patients who have any known medical condition should always notify their dentist prior to any procedure. Patients should take a list of all their medication they are currently taking with them to their appointment. Any previous allergic reactions to medications should also be reported.

Sedation dentistry is usually for patients 18 years old and older. However, pediatric sedation dentists are available for children who need assistance tolerating dental work.

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Pedram Soleimani DDS
Dr. Soleimani received his doctoral degree in dental surgery from the University of Southern California, School of Dentistry. He was placed on the dean's list and graduated among the top in his class. Dr. Soleimani continued his training with two years of residency in advanced multidisciplinary training ranging from cosmetic to surgical dentistry at the VA / UCLA Hospital in Los Angeles, California and the Brooklyn Hospital in Brooklyn, New York. His advanced training and dedication to the field allows him to offer the finest in patient care. He has a commitment to excellence when it comes to his patients smiles.
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