For many patients, the thought of a trip to the dentist is something which causes a great deal of fear, despite the fact that the nature of the average dental surgery has changed vastly in the past few years. For some, the fear is linked back to a negative experience many years ago, or may represent learned behaviour from a parent or older sibling, whilst other people simply have an irrational fear over which they have little or no control. For patients such as these the concept of relaxed and stress free treatment may seem very far-fetched, but the truth is that the latest forms of sedation offered make this a genuine reality. In the past, longer and more complex treatments would require general anaesthetic, with the patient being ‘put to sleep’ using an anaesthetic and probably spending the rest of the day struggling to get over the effects. IV sedation, on the other hand, means that the patient is fully conscious throughout but finds themselves in a state of calm relaxation. The type of IV sedation administered will differ from patient to patient, since one of the advantages of the technique is that it can deliver varying levels of sedation, from mild through to moderate and deep. There are various different types of dental sedation and the choice offered to you by your dental technician and anaesthetist will be governed by factors such as your medical history and any medication which you may be taking. The types of sedation offered by your dentist will probably include the following:
Nitrous oxide is more commonly known as ‘laughing gas’ and works as a mild sedative. It is delivered via a hood attached to the nose and will be used for the entire length of the procedure being carried out. It lifts the mood of the patient and generates a sense of general well-being, as well as acting as a pain killer and lowering anxiety levels. Although it may cause some tingling and numbness, there are few side effects to nitrous oxide and it has been used safely for many years.
IV sedation offers the patient a moderate level of sedation. It is introduced directly through an injection into the bloodstream and is topped up throughout. Although patients remain conscious, many report feeling as if they have slept throughout, and have no memory of the treatment being carried out. Though the effects of IV sedation are immediate, the patient may feel groggy and unsteady afterwards, which means that it is vital for them to be accompanied by someone who can help them get safely home again.
Oral Conscious Sedation
Many patients fear of dental treatment is based upon a fear of needles and injections, and this kind of sedation is ideal for people affected in such a way. It is administered via the mouth before treatment begins. The sedation induced is moderate, with patients remaining awake but having their senses dimmed. After the treatment, patients have no memory of the treatment, including any sights, sounds or, most importantly, feelings of pain.
The medications used by anaesthetists to calm patients are known as benzodiazepines. These drugs are known to help with seizures and muscle spasms, as well as reducing levels of anxiety. The main difference between each of the drugs lies in its’ ‘half-life’, which is a term referring to the length of time for which the drug will continue to be effective. This means that certain drugs are suitable for particular treatments. Amongst the medications generally used are Valium, Halcion, Ativan and Versed, with Valium being used for the most complex and lengthy treatments, whilst Versed is the choice for procedures which take less than thirty minutes.