Sedation (Sleep) Dentistry

Sedation dentistry uses medication to help patients relax during dental procedures. It is sometimes referred to as ‘sleep dentistry’ although this is not entirely accurate. Patients still remain awake during sedation dentistry but often don’t remember what happened and will feel like they have had a good sleep. It can be used for everything from invasive procedures to simple tooth cleaning.

Light sedation techniques using inhaled nitrous oxide are very safe and suitable for most patients. Their effects also wear off quickly meaning you can drive yourself home after the procedure. More moderate sedation procedures involving taking oral medications or those in which sedative drugs are given through a vein, require a detailed medical examination with the sedationist to exclude any pre-existing or undiagnosed medical conditions that may complicate the sedation or recovery. Patients with certain pre-existing medical conditions may not be suitable for treatment in the dental clinic under intravenous sedation. In this circumstance it will likely be advised that they receive treatment with a general anaesthetic under the care of a medical anaesthetist in a hospital setting.

Inhalation sedation uses nitrous oxide (also known as “happy” or “laughing” gas) as a safe and effective sedative agent that is mixed with oxygen and inhaled through a small mask that fits over your nose to help you relax whilst undergoing dental treatment. It is one option that we can offer here at Claremont Dental to help make you more comfortable during certain procedures. It is not intended to put you to sleep and you will be able to hear and respond to any requests or directions the dentist may have. What’s better, the effects following completion of the treatment wear off within a few minutes and you can leave the practice soon after with no further ill effects.

Your dentist will ask you to breathe normally through your nose and within a few short minutes you should start to feel the effects of the nitrous oxide. Some people may feel a little light-headed with tingling in the arms and legs, but ultimately, you should feel relaxed, calm and comfortable.

As it is fast, safe and quickly reversible, it is often the preferred sedation technique with children, in emergency situations and for quick, basic dental procedures.

In oral sedation the sedative is either taken in tablet or liquid form.

A tablet taken one-hour prior to the dental visit can take the edge off any anxiety. Some people may also find it beneficial to take a tablet the night before their appointment to help them sleep.

Liquid sedation is a safe, commonly used oral sedative. As it is a liquid and can be mixed with orange juice to drink at your appointment, the sedative will usually take effect within about 20 minutes.

Intravenous (IV) conscious sedation is when a sedative/anti-anxiety drug is administered into the blood system during dental treatment to induce a state of deep calm, relaxation and loss of any anxiety relating to the treatment. It is often termed under the category ‘sleep dentistry’ or ‘twilight sedation’, which is in fact confusing as it suggests that IV sedation involves being put to sleep. This is not the case, and in reality, you remain conscious during an IV sedation and are able to understand and respond to requests from your dentist. However, you may not remember much (or anything at all) about what went on because of two things:

• IV sedation induces a state of deep relaxation and a feeling of not being concerned by what’s going on.
• The drugs used for IV sedation produce either partial or full memory loss (amnesia) for the period of time when the drugs first act until they wear off. As a result, time will appear to pass very quickly, and you will not recall much of what happened. Many people remember nothing at all, so it has seemed like they were ‘asleep’ during the procedure.

This type of sedation may be of great value in enabling the treatment of a particularly anxious patient or one with a dental phobia.

Prices depend on the type of sedation used and the length of time taken for the procedure. This includes the time needed for the patient to safely recover before they can be discharged. Inhalation sedation with nitrous oxide generally starts from under $100, whereas longer procedures using intravenous sedation start from $600.

Children can be sedated if they are extremely anxious before or during their dentist visit. While nitrous oxide tends to be safe in children, deeper intravenous sedation techniques are reserved for older teenagers and can be a great way to facilitate removal of wisdom teeth and avoiding going under a general anaesthesia.

In-house dental sedation can be very safe for adults, but it is imperative that a thorough medical assessment is undertaken beforehand. The elderly are more likely to have existing or even undiagnosed medical conditions, which can compromise safety during sedation. As you age you become more sensitive to the effects of sedative drugs and they may take longer to wear off. As a general rule, sedation can be safe and work extremely well for those under 70 years of age.

What we can offer our nervous patients:

• Realistic treatment plans with time/action calendars based upon individual patient needs
• A wonderfully caring support team to look after you emotionally before and after each appointment
• Extra time devoted to all patients who need it
• Numbing gel
• Pain control with gentle dental anaesthesia during visits
• A relaxed environment with audio and visual aids to further the sense of calm and reduce anxiety.