Understanding Sedation Dentistry
What is Sedation Dentistry?
Sedation Dentistry can be defined as a dental care and procedures that are accompanied by techniques that induce a minimally depressed level of consciousness that retains the patient’s ability to independently and continuously maintain an airway and respond appropriately to physical stimulation and verbal command and that is produced by pharmacological or non-pharmacologic methods or a combination thereof.
Is There Something Stronger?
If sedation dentistry produces a minimally depressed level of consciousness, is there something that pits one completely out just like in many medical surgeries?
Yes, just as in medical surgeries, this is called General Anesthesia, where a patient is completely unconscious, asleep, and unable to respond and this is not categorized as Sedation Dentistry. General anesthesia differentiates itself from local anesthesia in that it numbs the body and puts the mind to sleep. Most commonly given by means of an injection or as an inhalant, general anesthesia describes a mixture of potent drugs that are used to induce a sleep-like state in those to whom it’s given.
Though the majority of dental procedures can be performed without its use, general anesthesia has been an important part of the world of dentistry for a very long time. However, the general anesthesia that is used in dentistry is typically less invasive than its use in the rest of the medical world. Unlike with other types of surgery, oral surgery does not typically require the use of paralytic drugs and consequently can be administered without the additional use of a breathing tube.
If you are considering general anesthesia, keep in mind that its effects may take several hours to wear off. Dentists typically require a patient to arrange for a ride home and a few hours of aftercare following procedures in which general anesthesia is used.
Now, back to Sedation Dentistry…
Types of Sedation Dentistry
The 3 forms of Sedation Dentistry are:
- Inhalation Sedation (also known as “laughing gas”, “happy gas”, nitrous oxide)
- Oral Sedation (anti-anxiety pills or a liquid)
- IV (Intravenous) Sedation (drugs administered into the blood-stream through a vein).
Inhalation sedation is also known as laughing gas, relative analgesia, RA, happy gas, gas and air, nitrous, nitrous oxide, and N2O-O2. It has more names than any other sedation technique.
Nitrous oxide (N2O) is simply a gas which you can breathe in. It has no color, smell, and doesn’t irritate.
Nitrous oxide kills pain and induces a pleasurable feeling. After 5 minutes or so of breathing in the gas, you should feel a euphoric feeling spread throughout your body. It really kind of feels like a ‘happy drunk’ feeling. People often feel a bit light headed and they frequently get the giggles, ergo the name “laughing gas.”
Different levels of sedation can actually be achieved with nitrous oxide depending upon the length of time administered and the concentration.
Advantages of Inhalation Sedation
- Nitrous oxide works very rapidly – the effects develop after only 2 or 3 minutes.
- The depth of sedation can be altered from moment to moment, allowing the person who administers the gas to increase or decrease the depth of sedation.
- Gas can be given for the exact time span it’s needed. It can also be switched off when not needed and then switched on again. Other sedation techniques have a fixed duration of action because the effects of pills or intravenous drugs last for a specific time period.
- There’s no “hangover” effect – the gas is eliminated from the body within 3 to 5 minutes after the gas supply is stopped. You can safely drive home and don’t need an escort.
- No injection is required so this can be helpful with cases of severe needle phobia. Getting laughing gas first can help you feel relaxed enough to allow the needle required for IV sedation to be inserted in your arm or hand. The very deep state of sedation achievable through IV sedation will then allow you to accept local anaesthetic.
- Inhalation sedation is very safe. It has very few side effects and the drugs used have no ill effects on the major organs of the body.
Disadvantages of Inhalation Sedation
- Occasionally, a person will not be able to achieve a good level of sedation.
- Sometimes people are uncomfortable with the effect of nitrous oxide and sometimes it makes people nauseous. However, for the latter, it is often helpful to simply eat something beforehand. The idea is not to have an empty stomach but also not to be too full.