If the mere thought of going to the dentist is enough to make you anxious or scared, you are not alone. Every year, millions of people in the United states avoid necessary dental procedures because they experience high levels of fear or anxiety at the dentist’s office. Estimates vary, but it is likely that 20-30% of the population suffers high enough levels of “dental phobia” to avoid going to the dentist for even routine care.
Unfortunately, avoidance of dental care can be extremely detrimental to both your oral health and your overall health. That is why an increasing number of dental offices like Comfort Care Dental in Southeast Idaho offer Sedation Dentistry. This type of care can help people like you receive the care you need. This guide will help you understand sedation dentistry determine if it might be right for you.
What is Sedation Dentistry?
Let’s start with what sedation dentistry is. Simply put, sedation dentistry is the use of medication to help a patient relax so that dental procedures can be completed. Sedation is often used for complex procedures like root canals, but those who suffer from extreme fear can also be sedated for relatively simple procedures like routine tooth cleanings.
The medications create an artificially induced state of relaxation that is designed to dramatically lessen the fear and anxiety you experience at the dental office. Specially trained dentists and dental assistants can use a variety of sedatives to help you relax during your procedure. Your dentist’s choice of sedatives will be based on your level of fear or anxiety, your medical history, the type of procedure that needs to be completed, and the level of sedation desired.
While you are sedated, it may still be necessary for your dentist to use a local anesthetic like novocaine to numb pain associated with the procedure. These numbing agents will usually be administered after the sedatives have taken effect. Also, your vitals and reactions will be monitored while you are sedated. The drugs used to sedate you should not have any long term effects, but you will probably feel groggy or a little “out of it” after the procedure has been performed. It is extremely common for your dental office to suggest that you bring someone you trust with you when you are going to be sedated.
The drugs used for dental sedation are generally considered safe, but it is vitally important for you to be open and honest with your dentist regarding your medical history. Make sure your dentist is aware of any prescriptions, over-the-counter medications, or supplements you take so that they can prevent drug interactions that may lead to dangerous complications.
In rare instances, you may see the term “sleep dentistry” used to refer to dental sedation, but that term is not technically accurate because patients who choose to use sedation are almost always awake and responsive. However, the medications used may cause you to be less aware of what is going on and may result in full or partial loss of memories associated with the procedure. Only patients who are in need of deep sedation or general anesthesia do not remain conscious for their procedures, and those levels of sedation are seldom used in dentistry unless the patient is in need of complex oral surgery.
Levels of Dental Sedation
As mentioned above, there are different levels of sedation used in dental offices. Your level of fear or anxiety and the type of procedure that needs to be done are two of the biggest factors in what level of sedation will be used. For most sedation dentistry visits, you will need to bring a dependable person with you who can drive you home and act as your caretaker for several hours after you leave the dental office. If your dentist gives you medications to take prior to your office visit, you will want to have this person drive you to the dental office as well.
Let’s take a look at the different levels of sedation you may experience.
Mild Dental Sedation
During mild sedation, you are relaxed, but awake and alert. It is sometimes referred to as minimal sedation or anxiolysis, and is typically used to relieve anxiety during simple dental procedures. One of the most common types of mild sedation used in dental offices is nitrous oxide, commonly referred to as laughing gas. Nitrous oxide is generally mixed with oxygen and administered through a nose cannula or nose hood throughout the procedure. The gas tends to wear off quickly and is the only type of dental sedation after which you may be allowed to drive yourself home.
Mild sedation can also be induced with pills like Halcion — a drug similar to Valium — that should be taken about an hour before your procedure. When oral sedatives like this are used for mild sedation, they will probably make you drowsy, but should not actually put you to sleep.
Moderate Dental Sedation
Moderate sedation creates a depressed level of consciousness and is often used for procedures like complex root canals and extraction of impacted teeth. In the past, this type of sedation was commonly referred to as “conscious sedation” because you are still able to breathe on your own and respond to verbal and physical stimulation. In other words, you will still be aware of what is going on around you, but you will likely have a diminished awareness of pain, sounds, and/or smells. These drugs tend to be administered orally or via intravenous (IV) injection, and frequently result in full or partial amnesia of the procedure.
Deep Sedation and General Anesthesia
Patients undergoing deep sedation have a deeply depressed consciousness to the point where they may lose the ability to breathe independently and become unresponsive to verbal or physical stimulation. It is a small step above general anesthesia, and patients are completely unaware of their surroundings. Both deep sedation and general anesthesia should only be administered by an anesthesiologist. In dentistry, deep sedation and general anesthesia are generally only used for complex oral surgery.
Types of Dental Sedation Administration
Sedatives used for dental procedures are carefully regulated and may be administered in a variety of different ways. The most common forms of dental sedation administration are:
- Inhalation of Gas Sedatives – inhaled through a nose cannula or a nose-hood
- Orally Administered Sedatives – swallowed or dissolved under the tongue
- Intravenous (IV) Sedatives – injected directly into a vein
- General Anesthesia – administered by a licensed anesthesiologist
A Brief History of Dental Sedation
But how and when did dental sedation begin? Well, modern sedation techniques were a long time coming. Tooth pain has existed as long as people have, and the desire to avoid or minimize that pain has probably existed since the first toothache. Unfortunately, many of the earliest substances used to fight pain — including alcohol, poppy, henbane, and mandrake — were not always effective and could be very dangerous.
Early History of Nitrous Oxide
Nitrous oxide, a gas commonly used in modern sedation dentistry, was discovered in the early 1770s by a man named Joseph Priestly. It was obvious that inhaling this gas made people act silly, which resulted in it being dubbed “laughing gas” by the general population, and it was used primarily as a recreational drug for more than half a century. Interestingly, toward the end of the 18th century, a man named Humphry Davy became interested in nitrous oxide and published a book on the subject in 1800. Despite noticing that the gas had a beneficial effect on his and others’ tooth pain, he failed to pursue or publicize that observation.
In 1844, a Connecticut dentist named Horace Wells, having noted that those influenced by nitrous oxide seemed to be insensible to pain, had two colleagues administer nitrous oxide to him and extract a painful tooth. He was excited by the nearly painless extraction and conducted additional successful experiments. Sadly, his first public demonstration at Massachusetts General Hospital was an abject failure when surgery was attempted before a sufficient amount of the gas had been administered.
Despite this early setback, nitrous oxide would eventually begin to gain traction in dental circles. Its common use in the dental world, can be traced back to Gardner Colton, the man who had originally administered the gas to Wells, and American T.W. Evans who was practicing dentistry in Paris around 1862.
Beginning of Modern Dental Sedation
Since the adoption of nitrous oxide in the mid-1800s, dental anesthesia and sedation have come a long way. Throughout the 1800s, many different substances were created and used by dentists to provide general and local anesthesia for their patients. These drugs were designed to render the patient unconscious or numb localized pain so that the dentist could perform the necessary procedure.
Starting in the 1900s, however, dentists began experimenting with sedation that was administered via intravenous delivery of barbiturates. Barbiturates are a general classification of drugs that suppress the nervous system, resulting in less perceived pain. Nitrous oxide and newer, safer barbiturates are still used today to provide safe and effective sedation that helps patients receive the dental care they need.
Benefits of Sedation Dentistry
While sedation dentistry has traditionally been used for painful procedures, the dental industry has begun to use it to help those who experience fear and anxiety about any type dental procedures. As such, the use of sedation dentistry has risen dramatically. Let’s look at three of the benefits that these people experience from being sedated when they need to see the dentist.
- Less Fear, Anxiety, and Stress – Sedation dentistry is often ideal if you experience high levels of fear, anxiety, or stress when you visit the dentist. This phobic reaction has even been known to prevent patients from seeking routine dental care that can prevent bigger problems in the future. The sedatives administered by a trained professional can calm you down and put you in a relaxed state that allows the dentist to perform any type of procedure from routine cleanings to impacted extractions.
- More Work in Fewer Visits – When a lot of dental work needs to be completed, the procedure can take a long time. The solution for many people is to make multiple visits to the dentist to have all of the work completed in relatively short blocks of time. For those with dental fears or who simply don not want to stretch out their care, sedation dentistry can allow your dentist to perform more work in fewer visits. As a bonus, you may not remember the procedure or feel like it only took a short time.
- Improved Routine Care – When sedation dentistry is used to help people with dental phobias relax, they are more likely to return for routine dental visits that are critical in the prevention of serious dental problems.
Who Should Use Sedation Dentistry?
There is one question that almost everyone has asked themselves: Is sedation dentistry right for me? The answer to that question is different for everybody, and they should have an in depth conversation about it with the trained professionals at their dental office. However, there are many types of people who should consider using sedation dentistry as part of their care. Below is a partial list of the types of people who could benefit from dental sedation.
Dental Sedation Is Perfect for People Who Have…
- High levels of fear, anxiety, or stress associated with the dentist
- A history of traumatic dental experiences
- Difficulty with local anesthetics
- Overly sensitive teeth
- A strong gag reflex
- Limited time in which to complete dental care
- Complex dental problems that require a lot of work
Dental Sedation May Also be Right For People Who…
- Are afraid of needles or shots
- Hate the sounds, smells, and/or tastes associated with dental care
- Are afraid of the dentist or embarrassed about their teeth
Finding the Right Sedation Dentistry Office
The American Dental Association — and most state dental boards and colleges — require dentists who perform sedation dentistry to have specialized training in the techniques, equipment, medications, and medical history analysis that are vital to successful sedation dentistry. These requirements are to ensure that those who practice dental sedation are correctly trained and have the appropriate skills necessary to help you get the care you need.
Do you feel like sedation dentistry is right for you, but don’t know where to start? That’s okay. You’ll want to begin by finding a dentist near you who has received the specialized training necessary to care for you. SedationCare.com is a great place to start. Their website offers a great deal of information for those who have questions about sedation care and they provide a tool you can use to find properly trained dentists in your area. For example, Dr. Chris Hansen at Comfort Care Dental in Idaho Falls, Idaho is on their list of local sedation dentists.
After you find a local office that is able to provide you with sedation dental care, don’t be afraid to ask questions. Ask them about their education, their sedation options, and any other questions you may have. Yes, sedation is designed to make you feel less anxious and more relaxed in the dentist’s chair, but it all begins with finding a dentist you can trust.
When you’re ready to begin your sedation dentistry procedures, make sure that you carefully review the informed consent form your dentist will provide you with. This form should provide you with specific details about your upcoming procedure, the equipment and medications that are to be used, and the advantages and any risks that are associated with your treatment.
If you have additional questions, don’t hesitate to ask. Your sedation dentist should be willing to spend some time with you discussing any aspect of your care. You may also want to acquire pre-procedure and post-procedure instructions ahead of time so that you can prepare properly.
Yes, you can receive quality dental care even if you are afraid. Just take the time to find the sedation dentistry office that is right for you.