Sedation Options

The level of sedation you require will depend on many factors, including the type of procedure, how your body responds to anesthesia, your age and medical conditions and your health habits.

There are three basic levels of sedation – minimal, moderate and deep. Minimal sedation helps you relax but you will likely be awake. You will be able to respond easily to verbal and physical stimulation. Minimal sedation is often achieved using oral medication or laughing gas. Most general dentists can provide minimal sedation. However, it may not be adequate if you require invasive dental procedures.

Sedation is commonly referred to as monitored anesthesia care. It is recommended by your dentist when they think your procedure requires an additional agent to make you more comfortable, in addition to local anesthesia (“freezing”). It will help you to be more comfortable and relaxed for your periodontal, implant and/or oral surgery.

Nitrous Oxide (“laughing gas”)

Nitrous oxide is to allay anxiety that many patients may have toward dental treatment, and it offers some degree of painkilling (analgesia) ability. The benefits of nitrous oxide and oxygen inhalation analgesia are many, and the risks are few. The gas is administered with a comfortable mask placed over the nose, and the patient is instructed to breathe in through the nose and out through their mouth. As a precaution, patients should not eat anything for about two hours prior to use of the gas. The patient begins to feel a pleasant level of sedation in anywhere from 30 seconds to three or four minutes. The cheeks and gums will also begin to feel numb in about a third of the patients.

You cannot eat or drink 2 hours prior to the procedure. After the gas is adjusted to the appropriate dose, and the patient is relaxed and sedated, the dentist can comfortably give the anesthetic injection (if needed) to the patient, and then proceed with dental treatment. After the treatment is completed, the patient is given pure oxygen to breathe for about five minutes, and all the effects of sedation are usually reversed. Unlike Moderate Conscious IV sedation or Deep Sedation, the patient can almost always leave the office by themselves, without an escort.

Nitrous oxide has few side effects although high doses can cause nausea in some patients, and about 10% of patients do not benefit from it. Patients that are claustrophobic or have blocked nasal passages cannot use nitrous oxide effectively. Nitrous oxide is one of the safest forms of sedation available.

Oral Sedation (“Pill”)

The most commonly prescribed dental related drugs that treat anxiety belong to the “benzodiazepine” family. Drugs such as Valium, Halcion, Xanax, or Ativan. These drugs decrease anxiety by binding and toning down activity within “fear” receptors in the brain. Our office primarily uses Halcion (triazolam) for oral sedation. You will be instructed to attend at the office one hour earlier than your procedure start time for in-office administration of the pill(s) by our certified dentist(s).

Advantages of oral sedation, as either minimal or moderate sedation, include:

  1. Treatment is completed when you are in a more relaxed mood.
  2. You will have less difficulty sitting through a lengthy procedure.
  3. Multiple treatments and full mouth restorations can occur at during the same visit.
  4. Less discomfort after treatment.

Please note that you shouldn’t travel on your own after you’ve taken any of these drugs. Make sure you have a responsible escort, even if you traveled by bus or foot! It’s easy to become disorientated.

MODERATE CONSCIOUS IV Sedation

Our office offers our patients the option of Intravenous (IV) Sedation for their dental treatment. This is what sets our office apart from other dental practices; it is our niche, if you will.

Moderate sedation is when you feel even more drowsy and you may even fall asleep during the procedure. You may or may not remember much of the procedure. It might be more difficult to arouse you. This is typically achieved using one intravenous medication named Versed (midazolam). Your dentist requires special training to perform this type of sedation.

Intravenous Sedation or “twilight sleep” helps you to be comfortable and calm when undergoing dental procedures. Your treatment can be completed for you under intravenous sedation, if you so desire. Intravenous sedation or “IV sedation” (twilight sedation) is designed to better enable you undergo your dental procedures while you are very relaxed. It will enable you to tolerate as well as not remember those procedures that may be very uncomfortable for you. IV sedation will essentially help alleviate the anxiety associated with your treatment. You may not always be asleep but you will be comfortable, calm and relaxed, drifting in and out of sleep – a “twilight sleep”.

If you choose the option of moderate conscious intravenous sedation your IV sedation is administered and monitored by our registered nurses and associate dentist(s) are ACLS certified, therefore eliminating the costly expense of having your treatment carried out in an operating room or same-day surgical facility.  Our clinical staff includes fully qualified Registered Nurses (RN) to assist with IV Sedation within our office setting. Patients are continuously and safely monitored during surgery as well as following in a Recovery Room. All of our staff are CPR certified. 

The goal of IV sedation is to use as little medication as possible to get the treatment completed. With IV sedation, a constant “drip” is maintained via the intravenous tube. At any time an antidote can be administered to reverse the effects of the medications if necessary. IV sedation is very safe!

DEEP SEDATION

Deeper forms of sedation are beneficial if you are anxious, or uncomfortable in keeping your mouth open for an extended period, or have a sensitive gag reflex, or you require an invasive surgical procedure such as wisdom teeth (third molar) extractions or full mouth clearance (extraction of many teeth). 

Deep sedation is like twilight sedation where you feel very dreamy and will fall asleep. You are not totally unconscious, but it would be harder to arouse you. You do not respond to verbal and physical stimulation as readily as moderate sedation. You will sleep through the procedure and you will have little memory of the procedure. This is usually recommended for more complex oral surgery procedures such as wisdom teeth extractions or other difficult extractions, or if you have a significant dental phobia or are very anxious.

Deep sedation requires even more specialized training and in our office it is administered by anesthesiologist medical doctor(s), with the support of trained registered nurses.