Definition and Overview
Sedation dentistry refers to the administration of sedatives such as general anesthesia to calm and relax the patient during certain dental procedures. It is sometimes called sleep dentistry, although patients don’t always “sleep” during the entire procedure. Rather, the sedative induces the patient to a very relaxed state without affecting the person’s ability to hear and follow commands.
Today, there are many ways to sedate a patient. These include conscious sedation, wherein the patient is wide awake but most likely won’t be able to recall anything about the procedure. Light sedation, on the other hand, is ideal for patients who simply need to be relaxed.
For complex oral surgeries, general anesthesia may have to be administered as the procedure may take a long time to complete.
Sedatives can also come in many forms. More dentists are veering away from using the IV (or needle) since it may only worsen the dental anxiety of the patient. Rather, they use gas (such as nitrous oxide or laughing gas) and, more recently, oral sedation.
Who Should Undergo and Expected Results
One of the most common reasons why sedation is administered is dental anxiety or phobia. It’s estimated that at least 30% of the U.S. population, especially children, don’t want to go to the dentist due to anxiety or fear. This may only prevent them from getting the needed oral care, which may then affect their overall health.
It may also be necessary when the procedure is going to be long such as root canal therapy, multiple tooth extractions, and dental implant installation. Keeping one’s mouth wide open for long periods can be distressing, so sedation can be used to relax the patient.
Some people may also have trouble controlling their movements. This is especially true with facial nerve damage and Parkinson’s disease. The sedative can help minimize tremors that can affect the procedure.
Administering the sedative is quick and efficient. It takes less than a few minutes to complete, although the dentist may have to wait until the full effects of the sedative are seen. Usually, the procedure is outpatient, but the patient may be asked to stay for a while until all the effects have worn off. The patient may also have a friend or a relative drive him home after the dental procedure.
How Does the Procedure Work?
First, the dentist discusses with the patient the best form of sedation. Many factors are considered including the patient’s level of anxiety and the procedure. Once the exact type is chosen, the rest of the procedure is planned.
Normally, there’s no special preparation needed other than to inform the dentist if you’re allergic to the sedative itself or you’re taking medications that can cause an adverse reaction later. It’s essential that people with a heart problem inform the doctor beforehand.
The patient is then led to the dental chair, where he sits as comfortably as possible. The sedative is then provided, and the patient is given enough time for it to work. Once ready, the actual procedure commences.
The anesthesiologist must be around at all times to monitor the patient.
Possible Risks and Complications
As long as sedation is carried out by a well-trained, experienced, and certified dental professional, the process is completely safe.
Sherwood ER, Williams CG, Prough DS. Anesthesiology principles, pain management, and conscious sedation. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 19th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 16.
Vuyk J, Sitsen E, Reekers M. Intravenous anesthetics. In: Miller RD, ed. Miller's Anesthesia. 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 30.