Sedation Dentistry

Conscious Sedation

With General Anesthesia, a patient is completely asleep and unable to respond. In contrast with “Conscious Sedation”, a patient is able to respond to commands and breathe on their own.

“Conscious Sedation” produced by pharmacological or non-pharmacologic methods (or a combination), is defined as minimally depressed level of conciousness. During this state, the patient retains the ability to breathe independently and continuously and respond appropriately to physical stimulation and verbal commands.

Enteral Conscious Sedation: “Orally Administered Sedation”, sometimes called “Sedation or Relaxation Dentistry”, is administered by taking a pill. All body functions remain normal and the person is able to breathe on their own. The patient will often fall asleep. Some degree of amnesia is common. The disadvantage with this method of sedation is that the level of sedation for each person is not predictable. Additionally, the patient must have an adult drive them to and from their dental therapy appointment.

Inhalation Conscious Sedation: “Nitrous Oxide/Oxygen Sedation”, which is also known as “laughing gas”, is the most frequently used sedation method used in dentistry. All bodily functions remain normal and the person is able to breathe on their own. The patient will often fall asleep and experience some degree of amnesia about what happened during their dental appointment. Inhalation Sedation has been used by dentists for many years to control anxieties.

The two most common types of sedation (Sedation Dentistry) used by dentists who utilize sedation are:

Oral Conscious Sedation
Inhalation Sedation

With Oral (Enteral) Conscious Sedation and Conscious Sedation, the patient will experience a state of very deep relaxation. The patient can still speak and respond to the requests of others.

Oral Sedation

The oral medications used for Oral Conscious Sedation in dentistry are from a group of drugs known as Benzodiazepines. Not only do these medications have a sedative effect, most people also experience some degree of amnesia. Patients remember little or nothing about their dental appointment.

Advantages of Dental Oral Sedation:

Easy to administer – just a small pill to swallow
Safe and easy to monitor
Works well for most people
Low cost

Disadvantages of Dental Oral Sedation:

The level of sedation is not easily changed
You must be driven to and from your dental appointment
There is no analgesic (pain relief) effect

What medications are used for Dental Oral Sedation?

The most common medication is Halcion (triazolam). Halcion provides a deep level of relaxation and has an amnesiac effect.

Inhalation Conscious Sedation

Nitrous Oxide and Oxygen (“laughing gas”) have been the primary means of sedation used in dentistry for many years. 35% of all dentists in the United States offer Nitrous Oxide Sedation to their patients.

Advantages of Dental Inhalation Sedation:

Works well for mild to moderate anxiety
Rapid onset
Flexible duration – can be used for any length of appointment
Absolute Control – easy to control the level of sedation which can be altered from moment to moment
Rapid recover from it’s effect
Very few side effects
Analgesic effect
You can drive yourself to and from your dental appointment
You can return to normal activities immediately

Disadvantages of Dental Inhalation Sedation:

Severe anxiety may require a deeper level of sedation
Not indicated for people who have respiratory problems (Asthma and Emphysema)
Claustrophobic patients do not like anything covering their nose

What medications are used for Dental Inhalation Sedation?

Nitrous Oxide (N2O)
Oxygen (O2)

The safety features of the equipment used to deliver this type of inhalation sedation ensures that a patient receives no less than 30% Oxygen mixed with Nitrous Oxide. Usually the patient receives 50 – 70% Oxygen.