Sedation Dentistry
Sometimes called Relaxation Dentistry, refers to the way dentists manage Pain and Anxiety during dental appointments.
Unlike General Anesthesia where a patient is completely unconscious, asleep, and unable to respond, patients under Conscious Sedation, are able to respond to commands and breathe on their own. We Use oral Medication and Nitrous Oxide or Laughing gas for the most of anxious patients. However several medications are available to help create more relaxed, comfortable dental visits. Some drugs control pain, some help you relax, and others put you into a deep sleep during dental treatment. You and your dentist can discuss a number of factors when deciding which drugs to use for your treatment: the type of procedure, your overall health, history of allergies and your anxiety level are considered when determining which approach is best for your particular case. Working together you and your dentist can choose the most appropriate steps to make your dental visit as comfortable as possible.
For some very anxious patients we can provide IV Sedation. IV Sedation – also knows as Moderate Conscious Sedation can be used by Oral Surgeons and dentists with specialized training and special certification. With this type of sedation, medications are administered through an IV. The greatest advantage of IV Sedation is that the patient can be made more comfortable as required.
Sedation Instructions
- You may not have anything to eat or drink (including water) for five (5) hours prior to the appointment.
- No smoking at least 12 hours before surgery. Ideally, cut down or stop smoking as soon as possible prior to the day of surgery.
- A responsible adult must accompany the patient to the office, remain in the office during the procedure, and drive the patient home.
- The patient should not drive a vehicle or operate any machinery for 24 hours following the anesthesia experience.
- Please wear loose fitting clothing with sleeves which can be rolled up past the elbow, and low-heeled shoes.
- Contact lenses, jewelry, and dentures must be removed at the time of surgery.
- Do not wear lipstick, excessive makeup, or nail polish on the day of surgery.
- If you have an illness such as a cold, sore throat, stomach or bowel upset, please notify the office.
- If you take routine oral medications, please check with your doctor.
Some important points to remember:
• Please notify our office if your child develops a fever, a productive cough, and/or heavy nasal drainage within
48 hours of the appointment. For your child’s safety, the doctor may need to reschedule the appointment.
• Upon arrival, the doctor will measure and administer the medication to your child. Depending on the
sedative used, your child may or may not immediately show signs of sedation.
• In most cases, nitrous oxide (“laughing gas”) will also be used for an added calming effect; local anesthetic
will also be administered.
• During the appointment, your child will be closely monitored for heart rate and breathing.
• Because an extensive amount of time has been reserved exclusively for your child, we will require a deposit
to reserve this time. The fee for conscious sedation is non-refundable if the sedation appointment is
unsuccessful or partially non-refundable (i.e. your deposit) if you cancel or reschedule your child’s
appointment without giving our office 24 hours notice.
PRE-SEDATION INSTRUCTIONS:
1. Your child can have NOTHING to eat or drink after midnight. Food/drink in the stomach during
the sedation could result in a life-threatening situation. If these instructions are not adhered to, the
sedation will be cancelled.
2. Please be prompt for your appointment as it takes some time for the medication to take affect.
3. Dress your child in loose, comfortable clothing, preferably with a short-sleeved top. This will
facilitate appropriate placement of the blood pressure cuff and ease patient monitoring.
4. Do not “over prepare” your child for their sedation appointment as this will usually serve only to
increase anxiety and apprehension. Trust that all measures will be taken by our staff to ensure
your child has a successful and positive experience.
POST-SEDATION INSTRUCTIONS
1. Following the appointment your child may be fussy or groggy and accommodations must be
made for adult supervision for the remainder of the day. No school attendance will be possible
until the following day.
2. Your child will not be dismissed until appropriately recovered, but while driving home, please
use a seat belt or car seat to protect your child. Your child’s balance is one of the last reflexes
to return too normal. Public transportation is not acceptable.
3. Please ensure nutrition is restored quickly once returning home, beginning with liquids such as
milkshakes, juices etc.
4. It is not unusual for your child to want to nap when they arrive home. Please ensure they lay on
their stomach or side, and monitor them regularly.
5. Remember that your child’s mouth, lips and/or tongue will still be “frozen” or “numb” for up to
an hour after the appointment. Please monitor them carefully to ensure they do not scratch or
bite themselves. Such actions could result in injuries sever wounds.
Frequently Asked Questions About Sedation
Oral sedation (Minimal Sedation) Oral sedation dentistry is a medical procedure involving the administration of oral sedative drugs in the form of pill or liquid, generally to facilitate a dental procedure and reduce patients fear and anxiety related to the dental work. Sometimes referred to as ‘relaxation’, ‘sleep’, or ‘anxiety free’ dentistry, this comfortable care is now offered by trained dentists . Sedative medication helps relax patients by slowing the action of the central nervous system. People remain aware of their surroundings, but are less responsive to external stimuli Like the sound of the drill or the smell of materials. There are several medication that can be used for oral sedation and in Aquarius dental we use different medication based on each patient’s need. Lorazepam or Ativan: commonly prescribed for the treatment of anxiety.It is an effective sedative with a medium length half-life and is useful for appointments that are longer than two hours. Midazolam has the shortest half-life of all of the oral sedation medications, lasting about an 45 minutes, and making it ideal for short appointments or simple procedures. It has many of the same anxiolytic and amnesic benefits of other benzodiazepines. The most important advantage of the midazolam is that the patient doesn’t remember the dental treatment. Triazolam is also short acting and very usefull for treatment that takes 1 to 2 hour
Nitrous Oxide, also known as laughing gas is an extremely safe adjunct often used by dentists to reduce the apprehension and nervousness associated with dental procedures. Our dentists are specially trained in the administration of nitrous oxide allowing you or your child to have dental treatment completed safely in the dental office setting while remaining fully awake. Nitrous Oxide induces a feeling of warmth and security, gives most people a pleasant “floating” sensation, and reduces sensations during dental treatment. In addition, its effects are absolutely reversible within minutes, allowing you to return safely to work or school that same day. This is one the safest sedation dentistry option. Nitrous oxide is the safest and easiest method of sedation dentistry.
Combination of Oral sedation and Nitrous gas(Moderate Sedation) Administration of combination of an oral sedative with nitrous oxide and oxygen could be used by our trained dentist for more nervous patients. This could provide moderate levels of conscious sedation which means patient still can respond to verbal stimulation. We can control or titrate the level of sedation needed with concentration of nitrous oxide gas.
IV Sedation ( Moderate sedation)
For some very anxious patients we can provide IV Sedation IV Sedation – also knows as Moderate Conscious Sedation can be used by dentists with specialized training and special certification. With this type of sedation, medications are administered through an IV. The greatest advantage of IV Sedation is that the patient can be made more comfortable as required. This is completely different than general anesthesia, and patient can breath on their own and can respond to verbal stimuli. The greatest advantage of this technique is, patient may not recall and remember the dental procedure. We can administer several medication depending on the dental procedure and level of the patient anxiety. The most common medications are Midazolam, Diazepam, and fentanyl. Before the sedation we carefully asses every patient and document their weight, airway, allergies , medical and dental conditions. Then we slowly administer those medication till desired level of sedation and relaxation is achieved.
Sedative medication helps relax patients by slowing the action of the central nervous system. People remain aware of their surroundings, but are less responsive to external stimuli Like the sound of the drill or the smell of materials.
We do check the patient vital signs with automated patient monitors for Blood pressure, Blood oxygen level through out the dental treatment.