Hi, this is Dr. Chan at Crown Dentistry. We've been getting a lot of questions about sedation dentistry. Today I hope to answer some of your questions on that topic and I hope that we can talk about what it is, when it should be used, and how it can help you as a patient.
What is sedation?
Sedation dentistry is what we do when we want to have a patient not be as aware when we're working on them. That can be because a patient is nervous or scared about treatment. It could be that they have a hard time sitting still or keeping their mouth open. It also could be that we just want to get a lot of work done in their mouth and they want to be more comfortable when that's taking place. Either way, these are all situations where sedation dentistry can be a huge help for our patients.
What different types of sedation are commonly used in dentistry?
There are different levels of sedation that we use in our dental practice. The first one, the first level of sedation, is nitrous oxide, commonly known as laughing gas. That's basically done when a patient just wants a little something to help them relax, but they still want to have complete control over what's going on and the situation. That involves attaching our patient to a nitrous oxide dispenser, and they'll generally breathe in the gas through a nasal hood or mask, and that happens when we're working on them. The second level is oral conscious sedation. We will also sometimes use nitrous oxide in conjunction with this treatment. Oral conscious sedation involves the administering of pills or medication that the patient will take the night before the appointment, the morning of the appointment, and then during the appointment when the patient is here in our office and getting treatment done. We will give them more medication depending on the situation and whether or not they need to be more sedated for their procedure. Another level of sedation above conscious sedation is IV sedation. And in these cases, the patient is hooked up to an intravenous tube in their arm, and that is directly connected to a medication source. And in this case, the medication is administered to the patient through their blood vessels. Directly into their circulatory system.
Is there a difference between sedation dentistry and general anesthesia?
The biggest difference between sedation dentistry and general anesthesia is—well, we mentioned earlier what sedation dentistry is and the different levels that can be achieved with it. General anesthesia is what a patient is given if they're going into some sort of deeper surgery. A lot of times, this happens in a hospital or sometimes in certain offices, like an oral surgeon’s office. For example, some people undergo general anesthesia to have their wisdom teeth taken out. But the biggest difference is that with sedation dentistry, the patient is still breathing on their own. With general anesthesia, a lot of times the patient is intubated, and an anesthesiologist is brought in to monitor how the patient is breathing.
Who's a good candidate for sedation dentistry?
For the most part, we like to do sedation dentistry on healthier patients, meaning there aren't too many medical complications. They're not taking too many medications to manage their medical conditions. Usually if a patient has one or two medical conditions that are being monitored by their physician or through different kinds of medication, we can usually still work with that and offer them sedation dentistry as an option.
What drugs are typically used for oral sedation?
So for oral conscious sedation, there are several main drugs that we use in order to keep our patients comfortable. As I mentioned earlier, nitrous oxide or laughing gas is used as just kind of a base substance to help our patients relax. In addition to that, we usually give our patients a combination of Valium and triazolam. Sometimes Adavan and or hydroxazine are also used. A lot of this just depends on other medications a patient's taking or how they tend to react to certain medications. Some patients tend to react better to certain kinds of sedation medication than others and so we try to use whatever works best for the individual patient.
What drugs are typically used for IV sedation?
For IV sedation, sometimes they will use medications that are a little bit stronger. Propal sometimes even morphine mazzelam and so again a lot of these depend on just whatever is needed for the particular situation.
Would you say that sedation benefits patients who are super anxious or fearful of the dentist?
In our practice, I have used sedation dentistry multiple times to great success in order to help patients who are super anxious and fearful get the work done that they need to get done to make their mouth happy and healthy.
What about children? Is this safe to use for kids?
So sedation dentistry can be used on children, specifically meaning our patients who are under 18.At Crown Dentistry we do not sedate children. We do work with pediatric specialists who can sedate our patients who are under 18 and we do refer them to those specialists if they happen to need that.
What exactly is the difference between a regular dental and a pediatric specialist when it comes to sedation?
Sedation for children, well, actually sedation at any age requires extra training and certification. At Crown Dentistry, we are certified to offer oral conscious sedation and nitrous oxide for patients who are 18 and over. Patients who require sedation, pediatric sedation, need to go to a dentist who is certified and trained for pediatric sedation.
Are there risks or other side effects associated with sedation dentistry?
One of the biggest things about sedation dentistry is making sure that our patients are sedated enough for the procedure, but not too heavily sedated. I mean, after all, we want to make sure our patients are able to come out of sedation before they leave our office. So, it's a question of simply monitoring and keeping a close eye on our patients vital signs the whole time they're in our office. When we have our patients here for sedation, we have them hooked up to a blood pressure monitor as well as a pulse oximeter. What that does is their blood pressure is being measured every 10 minutes, and they also have a pulse oximeter, which means that it measures the amount of oxygen that's in their bloodstream at all times. We want to make sure that whenever we're working on our patients that they're getting enough oxygen, that their blood pressure is staying in a healthy range, and that they aren't being either too heavily sedated or too lightly sedated. We're looking for that sweet spot of sedation when we're working on our patients. And that just involves giving our patients enough sedation medication but not too much.
If laughing gas or nitrous oxide won't put me to sleep, how will it make me feel?
So laughing gas or nitrous oxide is a really good option for patients who are maybe a little bit anxious, and they are still able to have work done, but they just maybe want to take the edge off of just some of the anxiety of coming to the dentist. We just have our patients get hooked up to the nitrous oxide machine, and they're just able to breathe that laughing gas a little bit before their procedure, during their procedure, and after their procedure.
How long does it take for sedation to wear off after the dental procedure?
So, our patients report that the effects of the sedation wear off anywhere from a couple of hours to maybe half a day after their procedure is done. A lot of it depends on how much sedation medication was given to the patient, and that is usually dictated by how much work we have to have done or how much work the patient needs. Obviously the more medication we give the patient, the longer we can keep them sedated. Sometimes more time is needed to complete everything that we need to do. At times, we aren't able to complete everything in one sedation appointment. That's expected and normal and sometimes people need more than one sedation appointment.
What type of procedures can I use sedation on? Can I use it for cleanings, or is it just for more serious procedures?
If a patient desires, we can sedate them for any procedure that we do here in the office. We do have patients in our practice that we sedate for cleanings. We do have patients that we sedate for crowns, fillings, extractions, root canals, and implants. We do our best to try and tailor our treatment to make it as comfortable and pleasant as possible for our patients.
How do I prepare for a dental appointment with sedation?
So if you decide to undergo sedation uh before any of our dental procedures that you might need, we always have a consultation beforehand where we will take your vital signs and take some records of your height, your weight, what kind of habits you have on a regular basis at home. will also give you instructions on when to take medication the night before the appointment and the morning of as well as dos and don'ts in order to make the sedation appointment as successful as possible. We'll over just give you an overview of everything that will be done dWe’ll just go over and give you an overview of everything that will be done during the sedation appointment, because for the most part, when you’re sedated, you might not remember what’s going on. And honestly, that’s one of the major selling points for sedation, because a lot of times when people have sedation done, they don’t want to know what’s going on. So, we try to give them as much information as possible beforehand so that they feel safe and secure about getting sedated here in our office
What should I do if I have concerns about the safety of sedation dentistry?
If you have any questions about whether sedation's right for you or if it's safe enough for you, please don't hesitate to call our office and speak with me or any of our knowledgeable staff. Our phone number is (916) 848-2145 or you can go to our website. There's a lot of information there. www.crowndentistry.net.
Thanks so much.
No Fear, No Excuses!
We take patient comfort very seriously. Our fun, relaxed team of dental professionals is committed to helping patients overcome their dental phobias. From creating a comfortable environment to offering different options for anxiety relief, we’ll walk you through any dental fear, no matter how severe.
Oral Conscious Sedation
Dr. Christopher Chan is DOCs certified to provide in-office oral conscious sedation to his patients. Oral conscious sedation is a simple, straightforward way of helping patients experience the benefits of sedation treatments without the deeper levels or sedation medications used in a hospital. Instead, a dose of prescription strength sedative is taken approximately one hour prior to the appointment, helping the patient feel as if they are in a dream-like state through their appointment. Patients may be given incremental dosages of the same medication throughout the procedure as needed. Patients will be able to respond to Dr. Chris to answer questions, but most of them won’t remember much about their visit. One of the biggest benefits of choosing oral conscious sedation is that patients can have most (or all) of their treatment completed during a single dental visit. It is also a great benefit for patients who are nervous about dental visits, those who have trouble sitting comfortably for longer periods of time, people with a strong gag reflex or who have trouble getting numb, and those who need major work completed.
For more information, check out our blog on Oral Conscious Sedation.
Nitrous Oxide
Laughing gas (nitrous oxide) is easy to use at literally any dental visit, even cleanings! Just a small amount of nitrous is needed to create a relaxed, calm sensation in our patients. The effects do not linger, and are completely reversed once it is turned off after the completion of their treatment. That means it’s fine to go back to school or work right away.