While most dental procedures can be safely and relatively painlessly performed under local anaesthetic (eg: a simple numbing injection), sometimes the dentist or patient may prefer some additional ‘relaxation therapy’, sedation or sleep dentistry to help facilitate treatment.
Sleep dentistry has been used for many years and when used appropriately can be a safe and effective way to make dental treatment faster and easier.
Sleep dentistry can include the use of
- Oral Drugs
These include drugs such as diazepam (known often as ‘Valium’), and Temazepam (a newer, progressively more popular valium-like drug).This is a popular, inexpensive and safe way to ‘calm the nerves’ enough to facilitate dental treatment. These drugs may be taken the night before a procedure and/or one hour prior to a dental procedure, depending on the degree of sedation desired.Different patients are affected my oral sedation differently. Patients must be aware that prior to taking any form of oral sedative drug, the dental staff need to review their medical and medication history prior to administering any drugs to ensure that these drugs to not adversely react with any other mediations they may be taking.
On the day of the appointment, a responsible adult escort is required to attend the session with the patient and remain with the patient for the rest of the day. Patients should also avoid alcohol, driving, operating heavy machinery, signing important documents or making important decision for 24hrs after administration of the oral sedative.While these drugs are considered acceptable for single doses in pregnant patients (eg: for an emergency situation), repeated administration is best avoided where possible.
- Inhalational sedation
Often referred to as ‘laughing gas’, this form of sedation has been very popular and safely used for many years. A mixture of oxygen and nitrous oxide is administered to the patient via a nose-piece. The dose can be increased on decreased depending on the level of sedation a patient desires.
The effects can be initiated and reversed very quickly, making it very easy to deepen or reduce the level of sedation to the level that a patient is comfortable with.The effect of the gas dissipates within minutes after the flow is stopped. However, in the interests of maximizing patient safety, a 30min or more ‘resting period’ is required by the dental team before the patient is allowed to leave. Usually this is spent in the waiting room, with a cup of tea/coffee (numbness permitting!). Unlike oral sedation, no escort is required to help a healthy adult patient home.
We still recommend that a patient avoid driving home if possible and abstain from alcohol, operating heavy machinery, signing important documents or making important decision for 24hrs after administration of the inhalational sedative.Inhalational sedation may be ineffective or inappropriate for patients with severe respiratory disease, enlarged tonsils or airway obstructions.
Very young children or patients with moderate-severe learning difficulties or psychiatric disorders may find the nose-piece distressing and may benefit from a different type of sedation.
- Intra-venous sedation and General Anesthesia
When increasing levels of sedation are desired, the dental team can arrange for a specialist anesthetist to attend the surgery to administer sedative drugs direct to the patient bloodstream (known as intra-venous or IV sedation).
This provides the patient with a level of sedation where essentially the patient responds to instructions (such as open wide etc) and is vaguely aware of the procedures being carried out, but has no memory of the procedure afterwards.
In other circumstances a patient may elect to have their treatment carried out in hospital under general anesthesia, where the patient is sedated to the point of unconsciousness and have no awareness of treatment being carried out at all.
If you would prefer sedation dentistry to help with nerves and an intense procedure. Be ensured that Mount Pleasant Dentists are using well research techniques and are gentle dentists. Contact Mount Pleasant Dentists today for more information.
Girdler, Hill and Wilson (2009) ‘Clinical Sedation in Dentistry’, Wiley-Blackwell UK.