What is Sedation Dentistry: Everything You Need to Know

April 03, 2024

Let's face it, a trip to the dentist isn't exactly everyone's cup of tea. The mere thought of someone prodding inside your mouth with strange instruments can send shivers down anyone's spine. But what if I told you that there's a way to make your dental appointments as relaxing as a spa day? Enter: sedation dentistry. Read on, and we'll break down the nuts and bolts of this procedure.

What is Sedation Dentistry?

Sedation dentistry, in a nutshell, is a practice where patients are administered sedatives to ensure they remain calm, relaxed, and anxiety-free during dental procedures. If the sound of a dentist's drill gives you the heebie-jeebies, then sedation dentistry might just be your saving grace. But hold your horses! Before you rush to the nearest dental clinic, there's a lot you need to know.

Conscious sedation: A minimally depressed level of consciousness that retains the patient’s ability to independently and continuously maintain an airway and respond appropriately to physical stimulation or verbal command and that is produced by a pharmacological or nonpharmacological method or a combination thereof.

Deep sedation: A drug-induced depression of consciousness during which patients cannot be easily aroused but respond purposefully following repeated or painful stimulation. The ability to independently maintain ventilatory function may be impaired. Patients may require assistance in maintaining

Why Opt for Sedation Dentistry?

  • Ease Anxiety: Dental phobia is real, folks! Many people would rather endure toothache than sit on that dreaded dental chair. Sedation can take the edge off, making the experience more bearable.

  • Complex Procedures: For treatments that require you to keep still for extended periods, sedation can be a godsend.

  • Less Discomfort: Some treatments can be, well, a bit of a pain. Sedation ensures you're comfy throughout.

Types of Sedation Used in Dentistry

  1. Inhalation Sedation: Ever heard of laughing gas? That's nitrous oxide. Inhale, and the world becomes a happier place – just what the doctor ordered for minor procedures. This is the recommended route for conscious sedation in pediatric dentistry. The inhalational route is the most reliable in terms of onset and recovery. Efficacy is reduced when children object to the nasal hood or have difficulty breathing through the nose. The use of a rubber dam improves the effect of sedation and reduces atmospheric pollution.

  2. Oral Sedation: No needles here! Just pop a pill, and you're off to la-la land.It is the most universally accepted and easiest route of drug administration.Disadvantages associated with this are objectionable taste, variable results, variable consistency, difficult reversal of unwanted effects, and slow recovery time. This route is mostly recommended for premedication and combination therapy.
    The oral sedative agent should only be prescribed and administered by the operating dentist within the facility where the dental procedure is to take place. Children who are given an oral sedative should
    be placed in a quiet room together with their escort and a competent member of staff and should be monitored
    clinically and electronically

  3. IV Sedation: Administered through a vein, this ensures a deeper sedative effect.This is the easiest most efficient and safest method of parenteral sedation next to inhalation.
    The onset of action of the drug is within 30 seconds. A few disadvantages include frequent monitoring and incidence
    of phlebitis and hematoma at the site. Intravenous sedation is not recommended in precooperative children. Dentists should consider whether the provision of an elective general anesthetic might be preferable in such circumstances. Single-drug intravenous sedation, e.g. midazolam, is recommended for adolescents who are psychologically
    and emotionally suitable. Intravenous sedation should only be administered by an experienced dental sedationist with a trained dental nurse in an appropriate facility. A pulse oximeter, at least, should be used to augment alert
    clinical observation. Intravenous sedation for children below the age of 14 years should be carried out in a hospital facility. Patient-controlled sedation may be of value for anxious adolescents.

  4. General Anesthesia: When you need to be completely out, this is the way to go.

  5. Intramuscular Sedation
    Anatomic consideration of the injection site and additional training of the operator is required. For most patients, the upper outer quadrant of the gluteal region is safest but in small children anterior thigh (vastus lateralis
    muscle) is the preferred site. Operators should consider whether the alternative provision of a general anesthetic might carry a lower risk and give greater long-term psychological benefit to the child. This is not recommended in children.
  6. Submucosal Sedation
    This involves the deposition of the drug beneath the mucosa. The best method is intranasal. The oral site usually chosen is the buccal vestibule
  7. Rectal Sedation
    Rectal administration is not socially acceptable in the UK. It is currently not recommended without a hospital facility and requires the assistance of a qualified anesthetist

FAQs About Sedation Dentistry

  • How safe is sedation dentistry? When administered by trained professionals, it's as safe as a house. Regular monitoring ensures everything goes smoothly.

  • Will I feel any pain? Sedation's main job is to keep you relaxed. Anesthetics take care of the pain.

  • Can I drive after the procedure? Well, that depends on the sedation type. For some, you might need a designated driver.

  • How long does the sedative effect last? Typically, it wears off after a few hours, but it varies based on the method used.

  • What's the cost? Your wallet won't be over the moon, but it's worth the peace of mind. Costs vary based on the procedure and sedation type.

  • Any side effects? Like any medication, there might be some, such as dizziness or nausea. But severe side effects are rare as hen's teeth.

Preparation for Sedation

Before you float off into dreamland, there are a few boxes to tick:

  • Medical History Review: The dentist needs the 411 on any health conditions or medications you're on.

  • Fasting: Depending on the sedation type, you might need to fast for a few hours prior.

  • Attire: Wear comfy clothes. You're in for a relaxed experience, after all!

A commonly used acronym useful in planning and preparation for a procedure is SOAPME:
S=Size-appropriate suction catheters and a functioning suction apparatus
O=An adequate oxygen supply and functioning flow meters/other devices to allow its delivery
A=Airway: Size-appropriate airway equipment
P=Pharmacy: All the basic drugs needed to support life during an emergency, including antagonists
M=Monitors: Functioning pulse oximeter and other monitors as appropriate like capnograph
E=Special equipment or drugs for a particular case.

Monitoring during Sedation
A dentist, or at the dentist’s direction, an appropriately trained individual, must remain in the operatory during active dental treatment to monitor the patient continuously until the patient meets the criteria for discharge to the recovery area. The appropriately trained individual must be familiar with monitoring techniques and equipment. Monitoring must include oxygenation, circulation, and ventilation.

Post-Procedure Care

Post-treatment, remember the three R's: Rest, Rehydrate, and Reflect. Take it easy, drink plenty of water, and consider how the procedure went for future visits.Oxygen and suction equipment must be immediately available if a separate recovery area is utilized. The qualified dentist or appropriately trained clinical staff
must monitor the patient during recovery until the patient is ready for discharge by the dentist. Postoperative verbal and written instructions must be given to the patient, parent, escort, guardian, or caregiver. 

Emergency Management
If a patient enters a deeper level of sedation than the dentist is qualified to provide, the dentist must stop the dental procedure until the patient returns to the intended level of sedation. The reversal agents and emergency drugs must be
available at all times to the dentist for usage. The qualified dentist is responsible for the sedative management, adequacy of the facility and staff, diagnosis and treatment of emergencies related to the administration of minimal sedation, and providing the equipment and protocols for patient rescue

What the Internet Says

"Sedation dentistry has been a game-changer for countless patients. Making dental visits less intimidating and more comfortable." - A statement from a renowned dental association.

In a world where time flies, but dental anxiety remains, sedation dentistry comes as a breath of fresh air. It's about time we toss our fears out the window and embrace a relaxed, stress-free approach to dental care. So, the next time you ponder over the question, "what is sedation dentistry?", you'll know it's the bridge between you and a smile-worthy dental experience.