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There are a few types of medical anxiety control in Dentistry which range from you being fully awake to fully unconscious. Your dentist will discuss the various options with you and between you, you will decide on the most appropriate method. the different types are 1. Inhalation sedation (often called laughing gas or nitrous oxide sedation) 2. Intravenous sedation (often called IV sedation) 3. General anaesthetic - this is when you are put to sleep in a hospital setting but the other options are safer and so this is a last resort once all other options have been exhausted below is a brief outline of both and what to expect to give you a better understanding of what would be most suitable for yourself. Most importantly realise that your dentist is only thinking of you when they suggest a lighter form of sedation over general anaesthetic as it is safer and can be carried out in their practice and so treatment will be carried out sooner. See here for our latest Anxiety Management article |
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Inhalation Sedation (Laughing gas) Inhalation sedation is where a nose piece is placed over your nose and you breathe in and out a mixture of oxygen and nitrous oxide (see image). This is very safe and is used for mildly anxious patients or patients with severe gag reflexes as it eliminates the gag reflex completely! You remain fully conscious but mild anxiety is relieved and you will feel much more relaxed. The strength of the gas is turned up depending on how well you respond to it and this will be determined by your dentist. This works very well for children and adults with mild to moderate anxiety for simpler treatments. You will recover almost immediately and generally will not require an escort (as you would with IV sedation). So you can come in to the practice, have the treatment and in 5-10 minutes be up and go home on your own. This is unsuitable for children under 4, people with moderate to severe anxiety and people that can't breathe easily through their nose. for more information on inhalation sedation click below.
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Patient wearing inhalation sedation/RA/laughing gas nosepiece for dental treatment
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Intravenous Sedation (IV sedation)This is the type of sedation where you get a cannula (small needle followed by a very fine flexible plastic tube) inserted into usually the back of your hand or your arm and then you are given a medication (usually midazolam) which brings about a much greater degree of sedation and relaxation than the inhalation sedation does.
Not all dentists offer this sort of sedation as they require further training and mentored experience in order to carry it out safely in dental practice. This type of sedation is for moderate to severely anxious patients or for more complicated or lengthy procedures such as multiple implants or root treatments. You require an escort to remain with you during treatment and for 24 hours afterwards and you will generally have no memory of some or all of the treatment when you recover. You will need to have your blood pressure and BMI assessed prior to treatment and there are a number of patients who should not have IV sedation for treatment in dental practice including pregnant women, people with heart problems, some other medical problems and people who are markedly overweight as it may not be safe so ensure your dentist is aware of your full medical history including all medications. Patients with these conditions may be treated but this will need to take place in a dental hospital setting rather than in your normal dental practice but your dentist will advise you and refer you if necessary. For more information click to the right.... |
Cannula being inserted into vein in arm as would be done during IV sedation - click image to watch video
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General Anaesthesia (GA)
General anaesthesia is the last resort for anxious patients or very young patients requiring a lot of dental work. This is where medications are used to render you completely unconscious, this has its obvious complications, requires admission into hospital and should be avoided where possible. This is why your dentist will most likely suggest one of the alternatives above if you ask them to be put to sleep; especially for fairly straightforward or routine procedures.
All this monitoring is required so General Anaesthesia is only carried out in Hospitals. It is not feasible to do safely in dental practice