There are literally millions of people who avoid even the most basic annual maintenance visits to their Miamisburg or Bellbrook dentist. Why? For the most part, people are afraid of dental procedures because they can occasionally be uncomfortable or painful.
Both sedation dentistry and sleep dentistry are used to describe the same procedure, though “sleep” isn’t quite right. Those who choose to have their dental work done while under sedation can be awake or in a light sleep, where they are still in control of their airway and respond to instructions from the dentist.
Depending on the extent of the dental treatment involved a dental practitioner can choose from one of three types of sedatives: oral sedation, intravenous or IV sedation and inhalation sedation (nitrous oxide). A patient who wants absolutely no awareness of any part of their office visit may opt for an intravenous (IV) sedation where they often fall into a light sleep, while someone who is just overanxious may opt for an oral sedative.
Intravenous sedation is administered directly into the blood stream of the patient, and is frequently referred to as “twilight sleep”. The patient is technically conscious throughout the procedure, but will not be aware of the experience because the medications relax them.
What are the disadvantages of IV sedation? Those who avoid dental appointment because of a fear of pain or needles may prefer an alternative treatment to IV sedation since this form of sedation involves use of needles. Additionally, IV sedation does not provide any pain relief, so traditional injections of a numbing agent will still be required.
Dentists will not advise IV sedation for pregnant women, seniors, patients who are allergic to sedatives, or those who suffer from lung, kidney or liver ailments.
Instead of intravenous sedation, a patient may opt for “inhalation sedation” where laughing gas (really a mixture of nitrous oxide and pure oxygen) is administered through a mask. With only a thirty to seventy percent ratio, nitrous oxide to oxygen, this is a very effective sedative.
Most dentists deliver inhalation sedation through a small mask that fits over the nose of the patient, called a nasal hood, or cannula (nasal prongs). The dentist will instruct the patient to breathe as usual, and the effects of the gas will take effect in about half a minute. Within two to three minutes the gas produces painkilling effects and the dental work can begin.
One of the main benefits of inhaled sedation is that it can be readily controlled, either deepened or lessened, and a patient can be brought out of sedation quite quickly. Because the gas is mixed with oxygen, it can be used for the duration of the procedure, and has no chance of “wearing off” the way IV sedation or oral sedation can. The gaseous mixture also has no continuing effect or “hangover” associated with the other two methods. While some patients might feel a bit dizzy or lightheaded at the initial stages of inhalation this does not last long.
Does inhalation sedation have any disadvantages? The good news is that few safeguards are needed for this method, as no side effect or allergy to the gas is known, and only people who have been extensively trained are allowed to administer it.
The third method of sedation dentistry is oral sedation where the patient swallows sedative pills to reduce their apprehensiveness and nervousness. A sedative or sleeping agent may be prescribed for the night before the appointment in some cases, depending on the level of anxiety. This treatment may be further supplemented by a second oral sedative on the morning of the dental visit, and the patient will need to arrange for someone to escort them to the office.
The types of medications normally used for oral sedation are in the benzodiazepine family, commonly called “benzos,” and provide two possible effects. The first is a drowsy and hypnotic effect, inducing calmness and even sleepiness in the patient. The second is an anti-anxiety effect, which calms the patient’s fears. Different areas of the brain are affected depending on the kind of benzo used, with some causing a feeling of drowsiness and others soothing the bout of nerves.
Can everybody choose oral sedation? No, because the drugs have a number of side effects and are not appropriate for all patients. Some of these drugs can create problems for patients with liver and heart disease; others can cause allergies or affect the kidney, heart or lungs; and pregnant women should avoid them altogether.
The oral sedative used will be prescribed by your Miamisburg or Bellbrook dentist, because the medications are strong and present the risk of addiction. Oral sedatives should be taken exactly as per the doctor’s directions, and restrictions on alcohol or drugs affecting the central nervous system have to be followed.
Fear of pain and loss of control associated with dental procedures and treatments are not silly issues that people should just “get over.” They are realistic reactions to certain situations, and luckily dental experts recognize and respect these fears, and offer a fear-free way of maintaining dental health.