There is no real mystery to how sedation dentistry works. It is not quite the same as anesthetic injections. It involves three different degrees of depressing the central nervous system and can range from minimal to moderate to deep sedation.
When sedation dentists administer minimal sedation, the patient has reduced anxiety, but can still respond verbally and physically to his surroundings. In moderate sedation, the patient is even more relaxed, but will respond only to a larger stimulus in his environment. In deep sedation, the patient usually does not who any signs of consciousness and is not responsive to anything going on in his local environment. Oral sedation dentistry offers the flexibility of all three sedation states, depending on the level of anxiety of the patient.
What usually happens is a dentist will give a patient a prescription for a sedative to be taken the night before the procedure is scheduled. The sedative serves two purposes: 1) It helps the patient to get a good sleep during the night, and 2) it ensures the patient will wake up relaxed for the procedure. This is considered a no-needle approach. The patient can either take whole pills or allow the dentist to give the pills to him sublingually (under the tongue). Drugs taken sublingually in sedative dentistry get to the bloodstream much quicker.
Dentists who administer the meds used during conscious sedation dentistry have usually already measured the safety of these drugs on the therapeutic index. The larger the med measures on the scale, the safer it is. Because some of the meds make you remember little after you take them, they are sometimes lumped into a category called “comfort dentistry” or “relaxation dentistry.” The terms are meant to describe how patients feel after taking the meds: free of fear and quite relaxed.
Sedation in dentistry requires that a dentist knows which drug is appropriate for weight, height and level of anxiety. Some of the drugs a patient will take are given after he arrives for the procedure and after he has taken the sedative pill the night before. Those drugs might include laughing gas (also call nitrous oxide), valium, Ativan, Sonata and a few others. They take a while to wear off after the procedure, so the patient may need someone to drive him home. The patient may also experience an amnesic side effect and not remember much, but memory does return.
Sedation dentistry has become a safe, viable alternative to patients who cannot overcome the fears they have of dental procedures. Even IV sedation dentistry (meds injected directly into the bloodstream) offers hope for extreme cases of anxiety. The entire process seems to rest squarely on a single belief: fear and anxiety are conquerable. After the fear is gone, pretty smiles are more than possible.