The Methods of Sedation Dentistry
While often very necessary for oral and general health reasons, undergoing dental procedures can be extremely frightening and stressful for some people. Even for those who do not generally suffer from anxiety, the thought of the pain and discomfort that may occur during a dental procedure can be unnerving. However, with a variety of sedation methods available, patients are able to experience a drug-induced relaxed state which can significantly reduce anxiety and increase comfort.
Nitrous Oxide is likely one of the most familiar methods of dental sedation. This form of sedation involves breathing Nitrous Oxide (laughing gas) through a nose mask, leading to a very relaxed state. Nitrous Oxide begins to work very quickly and will cause numbing of the cheeks and mouth in addition to a relaxed and, at times, elated sensation.
Oral Sedation is also a popular and widely used method of sedation. With Oral Sedation, a small dose of oral sedation medication is administered to the patient approximately one hour prior to the commencement of the dental procedure. About 30 to 60 minutes after taking the medication, the patient will feel extremely relaxed. Some patients will even fall asleep during the procedure. The medication used in Oral Sedation will typically take several hours to completely wear off.
Intravenous (IV) Sedation is another method of dental sedation. This method of sedation is used to achieve Moderate Conscious Sedation and Deep Sedation, and allows for a high level of control over the level of sedation and the patient's comfort. The recovery time following IV sedation is very short. However, patients who undergo this method of sedation will need to have someone to drive them home following their procedure.
General Anaesthesia is also a method of sedation used for dental procedures. However, General Anaesthesia is usually reserved for major dental procedures and oral surgeries. The reason for this is that General Anaesthesia causes complete unconsciousness. This method of sedation also causes paralysis so breathing assistance is required. General Anaesthesia should only be administered in a hospital surgical setting by an experienced anaesthesiologist.
The Degrees of Sedation Dentistry
Sedation dentistry involves the use of pharmaceutical agents to relax patients who are about to undergo dental procedures. Particularly ideal for patients who suffer from anxiety, the various sedatives used in dental sedation allow patients to experience a very calm state so they can comfortably tolerate their procedure. Depending on the type of dental procedure necessary and the patient's health and circumstances, different degrees of sedation may be used.
The mildest level of sedation is called Anxiolysis. Anxiolysis is typically induced with Nitrous Oxide or Oral Sedation and puts patients into a relaxed state. At this level of sedation, patients may experience some degree of cognitive or coordination impairment. However, patients will still be awake and able to respond to commands.
The next level of sedation is Mild Conscious Sedation. Often achieved through Oral Sedation, Mild Conscious Sedation allows patients to feel little or no discomfort while still remembering the entire procedure. While patients at this level of sedation will not fall asleep, they will feel very relaxed and comfortable.
Moderate Conscious Sedation, the third degree of sedation, causes a depression of consciousness. While patients remain able to respond to verbal commands and/or tactile stimulation, they will have little or no memory of what has occurred during their sedation. Moderate Conscious Sedation puts patients into a sleepy state while still allowing them to breathe on their own so that airway intervention is not required.
Deep Sedation induces a state between consciousness and unconsciousness and is often used for patients who suffer from a very high level of anxiety and fear. Patients under deep sedation are not able to respond to verbal commands and sometimes airway intervention and breathing assistance will be necessary. Deep Sedation is achieved through IV sedation and should be administered by an anaesthesiologist or highly trained oral surgeon.
The deepest degree of dental sedation is Unconscious Sedation. Unconscious Sedation uses general anaesthesia to put a patient in a fully unconscious state. During Unconscious Sedation, the patient is completely paralyzed and thus requires a ventilator to maintain their airway. In this state, the patient will not even be able to respond to painful stimuli and may experience cardiovascular impairment. Consequently, Unconscious Sedation is typically reserved only for major dental procedures and is used in a hospital surgical setting.
