Many people suffer an intense, deep fear of having dental work done and they may go to extreme lengths to avoid it. Only the most severe pain of a dental abscess or other emergency will drive them to finally seek care. About 10% to 15% of Americans suffer this type of fear, which has been diagnosed as “Dental Phobia”. For these dental patients, some form of sedation is a blessing which helps them get through most dental procedures.

Dental Sedation Is Beneficial For The Patient Who:

• Suffers from severe dental phobia
• Has a high level of anxiety or fear about dental procedures
• Is a patient with special needs, such as autism, which can make dental treatment quite difficult for both the patient and the dentist
• Have an uncontrollable or severe gag reflex
• Have a high tolerance for local anesthetics and “do not get numb”
• Patients who have adverse reactions to local anesthetics
• Patients who require extensive dental work and must have it completed within a limited number of visits.
• Patients with certain medical conditions, such as cerebral palsy, which makes dental procedures difficult, uncomfortable or unsafe.

Patients should be encouraged to let their dentist know their level of fear and anxiety. The first visit is a good time to share this anxiety so an appropriate plan of treatment can be developed. It will take the patient’s fears into consideration as well as the type and amount of dental work that must be done. Adequate sedation must be planned for the patient that may need some lengthy dental procedures.

Types Of Dental Sedation

Oral Sedation
Medication such as Valium, Xanax, or Halcion is given to the patient the night before the appointment with a second dose about one hour before seeing the dentist. This helps relaxation and the patient remains awake and able to follow instructions. A local anesthetic is given so there is no pain at the site for the dental work.

Nitrous Oxide – “Laughing Gas”
This gas reduces anxiety and helps the patient become calm and relaxed. This is most effective when given to patients who have mild anxiety but will be having a relatively short, uncomplicated dental procedure. Gas is administered with a mask and local anesthesia is also used.

Intravenous Conscious Sedation
A medication is injected into a vein to produce a lowered state of consciousness. The patient can not smell, feel, or taste. Because there are different levels of sedation, a local anesthetic may be used in conjunction..  The patient’s blood pressure, pulse and heart rate are monitored as well as respiration rate. The level of oxygen in the patient’s blood is also observed closely. Sedation dentist are specially trained in dental anesthesia.

Deep Intravenous Sedation
This is a state that is between IV Conscious Sedation and Unconscious Dental Sedation. The patient is not able to respond to questions or follow simple instructions. These patients must be monitored closely and the blood pressure, heart and pulse rate are watched closely as well as their respiratory status. Advanced training is required to administer this type of dental anesthesia.

When the dental procedures are completed patients are observed closely until they are fully awake and their vital signs are stable. Dental sedation provides a way for patients with a high level of fear, as well as other problems, to have dental procedures carried out with relative ease.

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