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SEDATION DENTISTRY

A significant number of Americans do not visit the dentist for regular checkups because they are too fearful or suffer from dental anxiety. Sedation dentistry offers an excellent way to provide a safe, anxiety-free, dental experience to those who are afraid of the dentist.

Sedation dentistry is often mistakenly thought to induce sleep.
In fact, most sedatives allow the patient to stay awake during the procedure.
Sleepiness is a side effect of some medications, but nitrous oxide, oral conscious sedation and IV sedation only work to calm anxiety throughout the dental visit.

Sedation dentistry is popular because most sedatives can be taken by mouth, meaning no injections, no anxiety and no pain. Some sedatives work so effectively that even the smells and details of the procedure cannot be recalled afterwards. Safety and compliance are two important aspects of treatments, so sedation dentistry offers both the individual and the dentist the best alternative.

Whatever the form of sedative, it is essential to be accompanied by a caregiver. Sometimes, sedatives are provided the night before the dental visit, which means that driving to or from the appointment is not advisable.

Here are some advantages associated with sedation dentistry:

A composite (tooth colored) filling is used to repair a tooth that is affected by decay, cracks, fractures, etc. The decayed or affected portion of the tooth will be removed and then filled with a composite filling.

There are many types of filling materials available, each with their own advantages and disadvantages. You and your dentist can discuss the best options for restoring your teeth. Composite fillings, along with silver amalgam fillings, are the most widely used today. Because composite fillings are tooth colored, they can be closely matched to the color of existing teeth, and are more aesthetically suited for use in front teeth or more visible areas of the mouth.

As with most dental restorations, composite fillings are not permanent and may someday have to be replaced. They are very durable and will last many years, giving you a long lasting, beautiful smile.

Reasons for composite fillings:

Chipped teeth
Closing space between two teeth
Cracked or broken teeth
Decayed teeth
Worn teeth

Anxiety is alleviated
Few side effects
More can be accomplished during each visit
No needles
No pain
Perfectly safe
Procedures seem to take less time

How are composite fillings placed?

What kinds of sedatives are available?

Composite fillings are usually placed in one appointment. While the tooth is numb, your dentist will remove decay as needed. The space will then be thoroughly cleaned and carefully prepared before the new filling is placed. If the decay was near the nerve of the tooth, a special medication will be applied for added protection. The composite filling will then be precisely placed, shaped, and polished, restoring your tooth to its original shape and function.

It is normal to experience sensitivity to hot and cold when composite fillings are first placed, however this will subside shortly after your tooth acclimates to the new filling.

You will be given care instructions at the conclusion of your treatment. Good oral hygiene practices, eating habits, and regular dental visits will aid in the life of your new fillings.

The most popular types of dental sedatives are nitrous oxide, oral conscious sedation, and IV sedation. Different levels of sedation (mild, moderate and deep) can be utilized depending on individual needs. Before administering any sedative, the dentist must analyze the full medical history of the patient, taking note of any current medications.

Here is an overview of some of the most common types of dental sedatives:

Nitrous Oxide

Bleeding gums– Gums should never bleed, even when you brush vigorously or use dental floss.
Loose teeth– Also caused by bone loss or weakened periodontal fibers (fibers that support the tooth to the bone).
New spacing between teeth– Caused by bone loss.
Persistent bad breath– Caused by bacteria in the mouth.
Pus around the teeth and gums– Sign that there is an infection present.
Receding gums– Loss of gum around a tooth.
Red and puffy gums– Gums should never be red or swollen.
Tenderness or Discomfort– Plaque, calculus, and bacteria irritate the gums and teeth.

Removal of calculus (tartar): Calculus is hardened plaque that has been left on the tooth for some time and is now firmly attached to the tooth surface. Calculus forms above and below the gum line and can only be removed with special dental instruments.
Removal of plaque: Plaque is a sticky, almost invisible film that forms on the teeth. It is a growing colony of living bacteria, food debris, and saliva. The bacteria produce toxins (poisons) that inflame the gums. This inflammation is the start of periodontal disease!
Teeth polishing: Remove stain and plaque that is not otherwise removed during tooth brushing and scaling.

Nitrous oxide, or “laughing gas,” is used as a mild sedative. It is delivered through a nose hood, and is administered throughout the entire procedure. Nitrous oxide elevates the general mood and can evoke a general sense of well-being. Most importantly, it relieves anxiety and reduces pain during the procedure. In addition, some tingling and numbness may be felt. There are few side effects associated with nitrous oxide, and it has been safely used in dentistry for many years.

IV Sedation

Intravenous sedation is a moderate type of sedation. Patients who have previously experienced IV sedation often report feeling like they slept through the entire procedure. Generally, IV sedation is used for shorter treatments. It is administered via direct injection into the bloodstream, which means the effects are immediate. Sometimes patients feel groggy and sleepy when the IV sedatives are withdrawn. This is why it is important to bring a designated driver for the drive home.

Oral Conscious Sedation

Oral conscious sedation is an excellent choice for people who fear needles. Oral medication is provided prior to treatment in order to induce a moderate state of sedation. Though oral sedatives do not cause sleep, they usually dull the senses. This means that most patients cannot remember the pain, smells or noises associated with the procedure. Usually, a dose of medication is taken prior to the appointment, and then topped up during the procedure as required.

What types of drugs are used in oral conscious sedation?

Most of the drugs used in sedation dentistry are classified as benzodiazepines.
Benzodiazepines reduce anxiety, muscle spasms, insomnia and seizures. Each medication has a different half-life, meaning that the effects last for varying amounts of time. The estimated length of the procedure determines which type of drug is going to be most effective.

Here are some of the most common drugs used in oral conscious sedation:

Valium® – This sedative has amnesic properties and a long half-life. It is usually used for time-consuming, complex procedures.

Halcion® – Usually used to treat insomnia, Halcion is an effective sedative with amnesic properties. A short half-life makes this sedative useful for shorter procedures.

Ativan® – This sedative is best known for reducing anxiety. It has amnesic properties and a medium half-life. Ativan is typically used for treatments shorter than two hours.

Versed® – This sedative has the shortest half-life and is therefore less commonly used. It alleviates anxiety in much the same way as nitrous oxide, and is used for visits that will take less than 30 minutes.

If you have questions or concerns about sedation dentistry, please contact our office.

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