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Conscious Sedation Dentistry

Many people feel fear or anxiety about going to the dentist. This can be because they’ve never been before and don’t know what to expect. But more often, it’s due to a past negative experience when the dentist didn’t answer questions, criticized them or how they care for the health of their mouth or performed services that led to pain or discomfort. Honestly, it’s only natural to feel some discomfort with the idea of someone poking around in your mouth. Not all dentists are the same, and it’s important to find a dentist office that helps you feel relaxed, listened to, and comfortable during and after your appointment. One option to help is conscious sedation dentistry.

What Is Conscious Sedation Dentistry?

For people who feel anxious or fear getting fillings, crowns, root canals, minor surgeries, or even routine cleanings, conscious sedation starts by providing medications or local anesthesia to help the patient relax and get more comfortable. It provides a typically mild sedative to help minimize pain and discomfort.

In the past, it’s been called laughing gas, happy air, sleep dentistry, or twilight sleep. Today, it’s more often called procedural sedation or analgesia by medical professionals.

The patient is provided with either a pill, a shot, an intravenous (IV) line in the arm, or a mask that delivers nitrous oxide. With conscious sedation, the patient isn’t put completely under and made unconscious. Instead, they remain mostly awake, can communicate and respond appropriately, and will typically remember most of the procedure.

Who Is Conscious Sedation Dentistry For?

A variety of people can benefit from sedation dentistry, from children to adults. It’s often helpful for people who experience:

  • Anxiety or fear around dental work or visiting dentists
  • An overly sensitive gag reflex or teeth sensitivity
  • Fear of needles
  • A very low pain threshold
  • Difficulty sitting still or controlling movements
  • Special needs, such as physical, cognitive, or behavioral
  • A large amount of dental work.

What Can You Expect from Conscious Sedation Dentistry?

The particulars can vary depending on the procedure and the dental office. For minor procedures like routine cleanings, fillings, or crown replacements, many dental offices provide only local numbing agents, and you may need to request conscious sedation.

Once you’ve discussed and agreed to conscious sedation dentistry with your dentist, for most procedures, you can expect to start by being given a comfortable chair to lie back and relax. You’ll then be given either an oral drug (such as diazepam or triazolam), a mask that goes over the nose to allow you to inhale a sedative (nitrous oxide), a shot in the muscle (such as midazolam), or an IV line (midazolam or Propofol).

After a few minutes to an hour, as the sedatives metabolize and start to take effect, you’ll begin to feel more relaxed and at ease. The entire time, the dentist will check in with you on your breathing, blood pressure, oxygen levels, alertness, and how you’re feeling. You may feel groggy or even fall asleep, but you’ll also be able to communicate with your dentist and will wake easily with a gentle nudge.

Once the sedative has taken effect, you can relax as your dentist begins the procedure.

What Does Conscious Sedation Dentistry Feel Like?

The feeling of conscious sedation dentistry can vary from person to person and can also depend on the medication provided. Typically, however, you can expect to feel drowsy, relaxed, and at ease. You may also feel tingling throughout the body, including the arms, legs, hands, and feet. You may also feel weighed down and sluggish, like it’s more difficult to move as the world around you slows, your reflexes dim, and you react more slowly. With the use of nitrous oxide, you may even find you smile or laugh for no reason. (That’s why it’s called laughing gas or happy air!)

What Are the Side Effects of Conscious Sedation?

There is always a risk when getting anesthesia; however, it is generally safe when provided by experienced dentists. That said, be sure to discuss any concerns with your dentist before beginning, including any drug allergies, sleep apnea, or other health concerns as they may make complications more likely.

With any medications, you can expect some lingering effects, such as feeling drowsy, heavy, sluggish, or slow. Difficulty remembering the details of the procedure is also common, though it’s typically only temporary. Other less common side effects include low blood pressure, headache, and feeling sick, which can occur both during and after the procedure, which is why it’s not recommended you leave and get into a car right after. The one exception is with nitrous oxide which tends to dissipate rather quickly as the dentist provides pure oxygen to flush the gas out of the system, so it leaves your system quickly, and you can drive yourself home.

As you recover from conscious sedation from a pill, shot, or IV, you’ll be asked to stay in the office for up to an hour as your heart rate, breathing, and blood pressure return to normal. Have a friend or family member provide a ride if you are using anything other than nitrous oxide to allow the medication to wear off completely. You may feel a bit drowsy, sluggish, or nauseated after the procedure for the remainder of the day. So, your dentist may recommend taking the rest of the day off, avoiding work, school, manual tasks that require precision, intense physical activities, driving, or operating heavy machinery, again depending on the medication provided and the procedure performed. You’ll be provided with full written and verbal instructions to take home.

Some people can experience a brief period of amnesia, others may have headaches or dry mouth, feel like they have a hangover, or vomit after the procedure. Fortunately, these side effects are less likely and short-lived.

Who Should Opt for Conscious Sedation Dentistry?

If you feel anxious or fearful of getting dental work performed, speak with your dentist to ensure they listen and understand your concerns. While there are costs and some side effects associated with conscious sedation dentistry, it can often make an uncomfortable procedure relaxing and easy. It’s worth it, especially if it helps ensure you don’t put off having important or necessary procedures done, which protects not just the health of your teeth and mouth but can help improve overall health and even quality of life.

At Relax Dental, we offer minimal, moderate, and general anesthesia, depending on the procedure and your comfort level. Call today for a consultation, so together, we can create a game plan for your comfort, health, and level of anxiety or stress.

References:
de Oliveira Araújo J, Motta RH, de Cássia Bergamaschi C, Guimarães CC, Ramacciato JC, de Andrade NK, Fiqueiró MF, Lopes LC. Effectiveness and safety of oral sedation in adult patients undergoing dental procedures: protocol for a systematic review. BMJ Open. 2018 Jan 1;8(1):e017681. https://bmjopen.bmj.com/content/8/1/e017681
Symington L, Thakore S. A review of the use of propofol for procedural sedation in the emergency department. Emergency Medicine Journal. 2006 Feb 1;23(2):89-93. https://emj.bmj.com/content/23/2/89
Kapur A, Kapur V. Conscious sedation in dentistry. Annals of Maxillofacial Surgery. 2018 Jul;8(2):320. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6327823/
https://www.aana.com/docs/default-source/patient-education/sedation_brochure03.pdf?sfvrsn=9b1d49b1_4
https://www.mouthhealthy.org/~/media/ADA/Education%20and%20Careers/Files/anesthesia_use_guidelines.pdf
https://my.clevelandclinic.org/health/treatments/22275-sedation-dentistry