Conscious sedation dentistry, also known as procedural sedation and analgesia, is the procedure whereby sedatives are administered before a dental procedure to help you relax. You remain awake and responsive during your dental treatment, and you won’t feel any pain. The sedative just helps ease dental fear, so you get comfortably through your procedure.
Dental fear and anxiety keeps millions of people away from the dental office every year. For them, local anesthesia isn’t enough because while it numbs the pain, it does nothing to minimize the fear and other psychological factors that patients away from their dentists. Many dentists use conscious sedation as a way to put patients at ease during dental treatment.
Most forms of conscious sedation are considered "light" or "moderate". But conscious sedation is also referred to as sleep dentistry despite most patients remaining awake during their procedures. There are different types of sedation dentistry available for treating different levels of dental anxiety. Each of these options puts you in varied states of relaxation:
Light Sedation – You are minimally sedated. You will be able to relax while remaining awake and alert.
Moderate Sedation – You remain conscious during the procedure, but afterward you likely won't remember much about it. You’ll be able to communicate, and you may slur your words and feel groggy. Some patients fall asleep with moderate sedation, but wake up easily.
Deep Sedation – Deep sedation is usually not categorized as conscious sedation. Under deep sedation, most patients are either semi- or completely unconscious while their dentist works. With deep sedation, you will not regain consciousness until the drug wears off or is reversed, and it will take you longer to recover from the effects of the sedation.
There are several options for how your dentist will administer conscious sedation:
Inhalation Sedation -- Nitrous oxide, or laughing gas, is a light form of dental sedation. Your dentist will administer the nitrous oxide through a mask that's placed over your nose. As the gas is inhaled through the nose, you perceive less pain and experience feeling of euphoria. Once the procedure is over, the nitrous oxide wears off almost immediately with virtually no effects or recovery time.
Oral Sedation -- Depending on the strength of the prescription, oral medication produces a light to moderate level of sedation. Oral sedation usually comes in the form of a pill, and is taken an hour before the procedure. Although you'll be able to respond to your dentist, you may feel sleepy. With this option, recovery time will be longer, and you won’t be able to drive from your appointment. Some uncommon side effects are nausea and vomiting.
IV Sedation -- Like oral sedation, IV sedation is considered moderate and has a longer recovery time. Since the sedatives are delivered intravenously, the effects are felt much sooner. IV sedation also allows your dentist to adjust the level of sedation needed during the procedure.
General anesthesia is a form of deep sedation, and it is the only dental sedation that puts you to sleep, so it isn’t included on the conscious sedation list. The thought of sleeping through the entire dental visit is intriguing to some, but before you decide to use general anesthesia to treat your dental fear, you should understand all that it entails.
General anesthesia can only be administered by an anesthesiologist, dental anesthesiologist or oral and maxillofacial surgeon. If your general or cosmetic dentist doesn't have the facilities or certification needed for general anesthesia -- and most don't -- you may need to have your work done in a hospital, which can significantly increase costs.
There are also certain risks involved with general anesthesia that aren't present with conscious sedation dentistry, like the need for assisted breathing. General anesthesia may be an option for those who don't respond to conscious sedation, need extensive dental work, or because of mental or emotional constraints are unable to understand the nature of their dental visits.
The medications used for conscious sedation don’t contain painkillers, so it’s likely you will need a local anesthetic during your dental procedure. Conscious sedation can ease the fear of needles so you can relax while your dentist easily administers shots of Novocain.
Conscious sedation is considered safe. As with any medicine, there are risk factors. To ensure your safety, dental sedatives should only be administered by trained professionals. Your dentist will consider your overall health when choosing a form of conscious sedation. To avoid any complications, be sure to provide the dental office with your medical history and any medications you're taking.
Conscious sedation can help you ease your mind, and get rid of anxiety, so you can focus on your dental health, not the discomfort associated with it. If you're afraid, anxious, or apprehensive, let your dentist know-- he or she will choose the right form of dental sedation for you.
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