Why Sedation May Be Necessary in Dentistry, and How It Helps Patients
When we work on patients who are pretty nervous or have had a really bad experience, it's hard for them to sit in the chair. The next step up is to try some sort of sedation aside from local anesthetics and topicals or injections, which could be mild forms like gas, or moderate and major forms where you pretty much go out for the treatment. It becomes really helpful and handy for patients who are traumatized and can't sit in the chair.
What types of sedations are commonly used in dentistry?
The answer is pretty simple. There are some pills that the dentist can give you 24 hours before, and you can also take them one hour before your appointment. There's also gas, which is nitrous oxide, that can help you relax during the procedure. You will not be fully out but will be calm and relaxed. Then there's also general anesthesia where you're completely out, and that requires a driver.
Who is a good candidate for sedation dentistry?
You have to be pretty healthy. If you do the simple measures of local pills or gas, there are things you can't have, like glaucoma or ear pressure or eye pressure. You cannot be claustrophobic with a mask.
If you are interested in general anesthesia or to be out, we have our own anesthesiologists who will screen you to see if you're healthy enough for sedation.
What is the difference between sedation dentistry and general anesthesia?
The difference between sedation dentistry and general anesthesia is that sedation is the main word to sedate or calm someone overall, and it comes in different levels. Whether it's via pills, which is a very mild form of calming or sedating, or pills that also require a driver, you don't need to be completely out.
General anesthesia is when you go completely asleep, requiring a driver with you, and then you wake up with no memory of what happened. Everything will be a blur.
What is nitrous oxide and why do dentists still use it?
Nitrous oxide is called laughing gas. It's a relaxing gas, and it's called laughing for a reason. When the gas increases beyond a certain point, the patient starts to get giggly and laugh, which means you're already way higher up than where you should be. That's pretty much what nitrous oxide is. Patients need it because it helps them relax quite a lot. It's a very safe measure, and it leaves your system right away. You do not need a driver, and it's a great tool, especially for kids.
How does oral sedation work in dentistry?
Oral sedation is via the mouth or pills. It could be some prescribed pills that the patient takes 24 hours and 1 hour before their appointment or scheduled time. That's a very simple form. We still do need a driver. There's also a degree of pills during the appointment called conscious sedation. That's pretty much the oral form of sedation, those two forms that we just mentioned.
What is an IV sedation in dentistry and why is it recommended?
IV sedation means general anesthesia, where you're completely under, and the medication is administered through the bloodstream in your arm. Usually, if it's kids, it's most likely through the foot.
It's when you have so much fear of the dentist and major work to be done. Instead of sitting under the dentist's hand for hours awake and not getting through your appointments, sedation, general anesthesia, and IV sedation become amazing to help you. You'll go to sleep, take a long nap, and wake up with probably half of your mouth, if not all, done while you're under.
Is sedation dentistry safe for everyone, including children?
No. Sedation dentistry for children two years and under is pretty unsafe. According to the pediatric dentist I've been working with, they do not recommend sedation under two years old. If the patient has a large neck, wide tongue, severe sleep apnea, or large neck size where airways are constricted, you might not be a candidate for sedation. If you have a severe allergic reaction or history with some medications, you might not be a candidate.
To help answer that question, you'll need to come in, and we'll screen you, then have you talk to the anesthesiologist.
How does pediatric sedation dentistry differ from adult sedation dentistry?
Kids' sedation requires a lot of parental consent. It requires a new health history within the past 3 months, including weight, height, and an extensive health history review. Depending on that, the anesthesiologist will discuss the risks with the parents, obtain their consent, and the anesthesia is administered through the foot.
Kids are usually intubated with a tube through their throat to monitor breathing at all times. Adult sedation is a bit different. If they're candidates, they get a little needle through their arm, go under for a certain amount of hours, and then wake up needing someone to accompany them.
Are there risks or side effects associated with sedation dentistry?
Absolutely yes. The major risk, which doesn't usually happen because our anesthesiologist is amazing at screening patients, is that if you're not a candidate, they'll let you know. If your kid is sick, they'll also let you know we have to postpone the procedure. They'll also talk to your physician if you have a certain health condition that needs attention. The obvious very mild risks include a little bit of hallucination, maybe crying after waking up, and some people say funny things when they wake up. That's pretty much all I've seen throughout my career.
What can I expect during a dental procedure with sedation?
Whatever the patient signs consent for, we usually go for the expected treatment plan. As far as pain, zero pain. You'll never feel pain. You pretty much are asleep and well taken care of. You can have your significant other, loved one, or parent in the room as assurance.
Expectation-wise, if something needs to change within the treatment plan, the person who brought you in will have to make decisions on the spot, as you're sedated, or the parent will have to give consent if there's a change.
How long does it take for sedation to wear off after a dental procedure?
If it's via the gas, the laughing gas, that's right away. You do not need a driver. If it's pills, on the other hand, you'll be super loopy for the day. It's recommended to stay hydrated. You still wouldn't want to drive or make sound decisions. Like general anesthesia, the next day you should be fully restored.
Can I request sedation for my dental appointment or procedure?
Absolutely. You absolutely can. We need to come in and discuss that with you in person.
Can sedation be used for all dental procedures including cleanings and implants?
Absolutely yes. Depending on your comfort level, we still need to discuss that.
How do I prepare for a dental appointment with sedation?
If it's a GA, you just need to have a very light breakfast. If it's pills, there are certain medications and things you can't be taking the night before. If it's general anesthesia, you usually come in really early in the morning with no breakfast and no food from the night before.
What should I do if I have concerns about the safety of sedation dentistry?
What you need to do is communicate your concerns to us so we can cover all of them. It's always done right in our office and it's always safe as long as we're communicating and you're very transparent about your own health or your kids' health. There are things that sometimes we don't know about the patients, and things can become a bit dangerous. What we ask is that you be fully honest and transparent with us, and there shouldn't be any risks with sedation.
At MA Dental, you come first. Whether you need dental care or simply have questions, call us at (951) 467-4399 or email [email protected] to schedule your visit. Our team is here to help you every step of the way.