Sedation Dentistry Peterborough ON

What Is Sedation?

Sedation is a process used to establish a relaxed, easy and calm state through the use of sedatives. Sedative drugs (tranquillizers, depressants, anti-anxiety medications, nitrous oxide, etc.) can be administered in a variety of ways. In the past, intravenous (IV) sedation – sedatives delivered via injection into the blood vessels of the hand or arm – was predominantly used to sedate a dental patient. Today, however, sedation dentistry has evolved to be even more conducive to a relaxing experience and patients have alternatives to the traditional modalities of inhalation (nitrous oxide or “laughing gas”) and IV sedation. Oral sedation dentistry is now the most common technique used in the United States and Canada to quell patient fears. The technique is easy and requires no needles. Best of all, the medications create such a comfortable experience that most patients do not remember the visit; it is as if they slept through the treatment. In reality, oral sedation dentistry maintains a level of consciousness in the patient for safety and cooperation. Note that sedation is different from anesthetic injections. Although some forms of sedation (such as nitrous oxide gas) may raise your threshold for pain, most dental treatments still require a local anesthetic injected in the mouth, even when sedation dentistry techniques are performed. However, the will occur after you are already sedated and comfortable, so most likely you won’t be bothered by or remember the sensation of having the injection.

Benefits

One of the major benefits of sedation dentistry is that people often feel like their dental procedure lasts only a few minutes, when in fact it might have taken hours to perform. Therefore, complex dental procedures such as smile makeovers, root canal treatment or extractions. Sedation dentistry has become very popular because it offers several benefits for both the patient and the dentist. For some patient groups, the use of sedation dentistry is actually the only way that they can get the dental care they need and improve their dental health. Also, because sedation dentistry addresses some of the fears that keep people from going to the dentist on a regular basis, sedation dentistry patients are more likely to receive recommended routine care. As a result, they are less likely to neglect their oral health or allow oral health problems to build to the point when drastic dental treatments become necessary.

Sleep Dentistry or Sedation Dentistry?

Sedation dentistry has occasionally been dubbed sleep dentistry, but this term is misleading. In actual fact, you do not sleep during the procedure but because of the effects produced by the sedative, you may feel sleepy.

Sedation dentistry enables you to be kept awake throughout the entire procedure, but you will feel relaxed and likely won’t remember much about your treatment. The use of general anesthesia is not considered sedation dentistry. “Conscious sedation is a combination of medicines to help you relax (a sedative) and to block pain (an anesthetic) during a medical or dental procedure. You will stay awake but may not be able to speak. Conscious sedation lets you recover quickly and return to your everyday activities after your procedure within a reasonable time.” It is important to remember that with conscious sedation you will receive a local anaesthetic (freezing) as well for pain management.

Sedation Levels & Definitions

Sedation by pharmacological methods may be obtained by two general routes. The oral route involves absorption of medication across digestive system. This route includes medications that are swallowed, absorbed through the mucosa of the oral cavity. The parenteral route involves the administration of sedative drugs other than absorption across digestive system. These methods include intravenous, inhalation, intramuscular, and submucosal administration, among others.

The sedative methods used for sedation dentistry vary in strength and purpose. Your dentist will select the sedation dentistry option that is best for you based on the treatments performed, how long these procedures will take and your level of anxiety. Although your dentist will ultimately determine what sedatives will be used, you can request stronger sedatives if you suffer from severe anxiety.

Levels of sedation range from mild, to moderate, to deep and are achieved through different types of sedatives. According to the Academy of General Dentistry, sedation is safe, but it is important for patients to talk to their dentist about what is involved and expected before the procedure. In order to ensure that the appropriate sedatives are used, your sedation dentist will require a medical history and list of all medications you are taking – including over the counter products and herbal supplements. Sedation dentistry refers to the use of pharmacological agents to calm and relax a patient prior to and during a dental appointment. The pharmacological agents usually belong to a class of drugs called sedatives, which exert their action by depressing the central nervous system, specifically those areas concerned with conscious awareness. Sedation includes a continuum of states of consciousness ranging from minimal sedation (anxiolysis) to general anesthesia.  There are different degrees of central nervous system depression, each corresponding to a level of relaxation which ranges from minimal, moderate, to deep sedation

· Minimal sedation:  Also known as anxiolysis. Anxiolysis is defined by minimal or mild sedation and is associated with relieving anxiety. Inhalation analgesia (also known as nitrous oxide or “laughing gas”) is one of the more commonly requested types of anesthesia from people who have anxieties about their procedure. It is administered via a small nose-hood placed over the nose through which nitrous oxide is delivered prior to and throughout treatment. In addition to some tingling and numbness, nitrous oxide typically evokes an overall feeling of well-being. Pills can also be used to create a feeling of anxiolysis. It is important for you to be open and honest with your dentist about any past drug use or current medical conditions so that an appropriate medication may be selected.

·Moderate sedation:  depressed level of consciousness, meaning you can breathe independently, retain your reflexes and respond to verbal/physical stimulation. Oral sedation or oral conscious sedation in conjunction with nitrous oxide (laughing gas) produces moderate sedation, which the patient responds purposefully to verbal command, either alone or accompanied by light tactile stimulation. Spontaneous ventilation (breathing) is adequate.  Intravenous sedation can also make people feel as if they are actually asleep, much like oral sedation. The difference between oral and intravenous sedation is the route of administration. Administered via injection, intravenous sedation has an almost instantaneous effect and is best used for shorter dental procedures. Amnesia is a common side effect of intravenous sedation and oral sedation, often leading people to believe that their procedure lasted mere minutes.

·Deep sedation/analgesia:  involves depressed consciousness in which a patient may not breath independently, loses some of his/her reflexes and is unable to respond to verbal/physical stimulation. This level of sedation is typically achieved with IV sedation or general anesthesia medications, the effects of which may linger for hours after the procedure is completed. Independent ventilatory (breathing) function may be impaired. The patient may require assistance to maintain airway. 

·General anesthesia:  A drug-induced loss of consciousness during which the patient is not arousable, even to painful stimuli.  The ability to maintain independent ventilatory function is often impaired.  Assistance is often required in maintaining a patent airway.  Positive pressure ventilation may be required due to depressed spontaneous ventilation (breathing), which will require intubation.  Cardiovascular function may be impaired.

Patients receiving sedation dentistry treatments must be accompanied by a responsible driver/caregiver who will drive them home. After the appointment this individual should stay with the patient until the effects of the sedation have worn off.

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