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If the thought of having your teeth cleaned, or even the very thought of stepping into a dentist’s office grips you with fear, you’re not alone. Some people are so afraid of dentistry that they would rather live with toothache pain than to seek treatment. Putting your health at risk is never a good idea. For those people who suffer from dental fear, sedation dentistry may ease anxiety and make for a more pleasant appointment.
Oral conscious sedation is a type of sedation dentistry that uses medication in pill form in order to reach a level of relaxation so that a patient can calmly receive the dental work they need. The process is quite simple and comfortable for the patient. The pill is given to the patient a half hour to an hour before the dental procedure. The pill given is a type of Benzodiazepine (i.e. Valium or Halcion), which reduces activity in the part of the brain that controls fear and anxiety. This keeps the patient calm and worry-free, allowing dental treatments or somewhat invasive procedures to be performed without stress on the patient. If needed, nitrous oxide will be given to help with relaxation. Some patients, may fall asleep during the dental visit. At times, the medication will cause an amnesic effect, so you’ll have few memories of being in the dentist’s chair. Even though your oral procedure could take hours, it will feel like minutes.
With this type of sedation, you breathe in nitrous oxide, also known as laughing gas, through a mask placed over your nose. The gas helps to relax you, yet you are still coherent enough to respond to the doctor’s commands. Light sedation like nitrous oxide is used and for those with minor fear.
It’s quite common for people to feel nervous before a surgery or medical procedure. It seems to be even more common for people to fear a dental visit since dental work has traditionally been done with the patient wide awake and very aware of the work being done on their teeth. The pain associated with most procedures is what induces fear and anxiety, which results in so many people completely ignoring their oral health. And while Novocain lessens the pain, it does nothing to help with the fear and dread a lot of people have regarding dental appointments. Dental fear and low pain tolerance are associated with increased levels of cavities since many people would rather live with the cavity than step foot inside a dental office. This fear of the dentist and the inability to endure pain, can result in patients delaying a much needed trip to the dentist, or even avoiding the dentist’s office altogether. Neglecting your oral health can lead to cavities, tooth loss, gum disease, and overall health problems. However, with oral conscious sedation, your dental anxiety can be overcome.
Pain sensitivity is another reason for conscious sedation. The sedative keeps you relaxed during your treatment or surgery so that your jaw is not as tense. This means the post-treatment soreness is less than what it would be if no sedative was used at all.
Being a busy person is another reason people choose moderate sedation. If you need extensive work, it may be more convenient for you to have it done all at once. Some busy patients may choose to break up a procedure into more than one visit since certain procedures seem to take up a great part of the day. However, breaking up a treatment into more than one visit takes up more time. Being able to relax during a very long procedure will assist with it feeling like it has gone by quickly.
The dentist will prescribe the pill for you. All you have to do is take the pill about an hour before your appointment, and you’ll be feeling relaxed by the time you arrive. The nitrous oxide will be given right before the procedure. Most states require board-certification, which involves additional training in dosage, monitoring and safety, along with continuous education.
If you have a fear of needles, the pill is the best way to go. Rather than inserting a needle into a vein for IV sedation, with oral sedation, you can take the sedative by mouth before the appointment without having to worry about needles. Keep in mind that a treatment such as a filling will require analgesia like Novocain. The numbing would be given after the medication has taken affect and you have relaxed.
The cost of full anesthesia can cost hundreds of dollars while a pill can cost comparatively little.
The strong dosage of Benzodiazepine can cause a sort of amnesia or little to no memory of the procedure. This is one of the best side effects for someone suffering from dental fear. If you have no recall of the dental visit, it will make it easier for you to decide to return for another appointment.
The oral sedatives are all regulated by the FDA, so it’s extremely unlikely that there will be any dangerous side effects.
Although you may feel drowsy with pill sedation, you’ll still be awake and responsive. Since you’re awake during the procedure, you’ll be able to listen and respond to your dentist’s instructions.
The disadvantages of oral sedation are few. The most common disadvantage is that it takes longer for it to become effective. IV anesthesia and nitrous oxide act faster. The second most common disadvantage is the drowsiness that you will experience. You will need to take the pill before arriving at your appointment, which means you may arrive groggy and need assistance. It’s also possible that someone will need to stay with you for a while after you have returned home.
If you are fearful of dental treatments or are very anxious around dental instruments, you would be good candidate for oral sedation. If you don’t respond well to local anesthetics, you should consider this type of sedation as well. Also, if you have neck or back issues and may become quite uncomfortable in the dental chair, considering this technique will help you be more relaxed.
Most dentists can give minimal sedation like nitrous oxide and moderate sedation like valium, ketamine, or midazolam in pill form. The number of dentists who have completed the Commission on Dental Accreditation program on deep sedation and general anesthesia is small. Only those who have completed this program are allowed to use the deep sedation techniques. Those who have completed it are normally maxillofacial surgeons and dentist anesthesiologists. Each state has a dental board which regulates the conscious sedation techniques, the permits, and the minimal continuing education requirement.
When getting anesthesia, there is always a risk, but it is usually safe when administered by an experienced dental professional. Keep in mind, certain people such as those who are obese or have obstructive sleep disorder, should talk to their doctor before participating in conscious sedation. These people are more likely to suffer from complications. Vital signs will be monitored during the procedure and oxygen will be available. Your blood pressure will likely be checked since feelings of stress and fear will raise a person’s blood pressure. But conscious sedation is considered quite safe. It is effective for both pediatric patients and fearful patients with a low tolerance for pain. In fact, the use of conscious sedation with nitrous oxide has resulted in 86.3% of dental treatments being successfully completed. When you consider all the factors, oral conscious sedation is the way to go.
Make sure before the procedure, you and your doctor go over your medical history and determine if you are a good candidate for oral conscious sedation. Any medications you’re on should be discussed. It’s also a good idea to find out how much training the anesthetist has had and how often they have performed oral sedation dentistry. You should be able to get specific information from your dentist’s office or from their website. And always ask questions if you are unclear about anything.
Dental offices and their staffs feel quite confident that your stress and fear can be managed with oral sedation, nitrous oxide, or with the combination of the two. If you’re concerned about going to see the dentist and you’re putting off much needed dental care, sedation dentistry can help you conquer your anxiety. Contact your local dentist’s office today to discuss your options and the treatment you have been delaying.
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