Sedation Methods in Dentistry

Sedation methods are implemented to induce calm and relaxed states to patients during various types of dental treatment. Sedative drugs can come in a lot of forms and they can be administered in several ways. Some of the most common types of sedatives used for dental patients include tranquilizers, nitrous oxide and depressants. Intravenous (IV) sedation was the most common way to sedate a patient and it is still used today. In modern dentistry, however, the field has progressed greatly and there is now a greater variety relaxation methods employed. Currently, the most popular calm-inducing treatment among patients is oral sedation dentistry. This is because it can be performed quickly and does not require needles.

There are four methods of sedation. They are:

1. Oral Sedatives

Oral sedatives are by far the most popular sedation method in both the United States and Canada. These medications are ideal for patients with a low pain tolerance. The sedative is administered to the patient 30 minutes to an hour before the procedure. In fact, the patient can take it the night before the procedure if they have a high level of anxiety. Despite their ability to thoroughly sedate the patient, oral sedatives do nothing to relieve pain. A local anesthesia is also administered to dull any painful sensations the patient may experience.

2. Intravenous (IV) Sedation

Intravenous (IV) sedation, like oral sedatives, does not provide pain relief to the patient. It is simply used to sedate. In this method, sedatives are injected into the bloodstream through the hand or arm. A local anesthesia is administered with this technique.

3. Nitrous Oxide Sedation

Nitrous Oxide gas (commonly known as “laughing gas”) is implemented to bring the patient into a state of relaxation. It is inhaled by the patient in several deep breaths until they are fully sedated. Like the two methods previously described, a local anesthesia is also needed to help reduce the level of pain felt by the patient.

4. General Anesthesia

General anesthesia renders the patient unconscious. This characteristic sets it apart from other forms of sedation where the patient is still conscious or at least semi-conscious. Under anesthesia, the patient is completely unaware of their surroundings. Since this method induces unconsciousness, the use of a local anesthesia is unnecessary.

Accompanying the four methods are three levels of sedation. These are varying degrees in which the patient feels sedated. They are:

1. Anxiolysis

This is the lowest level of sedation. It is considered very light and produces minimal effects. There are several forms of sedation that can produce this degree of calmness. The most common method used is Nitrous Oxide gas.

2. Conscious Sedation

Conscious sedation is a moderate form of relaxation inducement. While it is stronger than the Anxiolysis level, it is still light enough to keep the patient conscious. The patient will still be able to respond to commands in their awakened state, but will simultaneously be in a realm of deep relaxation. Nitrous Oxide gas or Intravenous (IV) sedation methods can be used to induce this level of calmness.

3. Deep Sedation

Deep sedation is a state that exists between conscious and unconscious sedation. Patients will not have the ability to respond to commands and may need breathing assistance if they are unable to keep an open airway. General anesthesia, the method used to induce deep sedation, can sometimes cause the closure of these airways. This method is typically reserved for oral surgery.

Despite the type of method used or the level of sedation a patient may undergo, it is vital to have a caregiver accompany the patient to the procedure. If the patient takes oral sedatives before their appointment, as is sometimes the case with high-anxiety patients, they will also need someone to drive them to the dentist. The caregiver should also drive the patient home and stay with them for a few hours after the procedure.