A significant number of people are fearful of oral surgery procedures. Therefore, we provide a variety of options to assist our patients with their anxiety and improve their comfort during procedures.
What kinds of techniques are available?
The most popular sedative techniques are nitrous oxide, oral conscious sedation, and IV sedation. Different levels of sedation (mild, moderate and deep) can be utilized depending on individual needs. Before administering any sedation, a physical examination, review of the patient's medical history and current medications must be performed.
Here is an overview of the techniques we provide:
Nitrous oxide, or “laughing gas,” is used as a mild sedative. It is delivered through a nose hood, and is administered throughout the entire procedure. Nitrous oxide elevates the general mood and can evoke a general sense of well-being. Most importantly, it relieves anxiety and reduces pain during the procedure. In addition, some tingling and numbness may be felt. There are few side effects associated with nitrous oxide, and it has been safely used in dentistry for many years.
Intravenous sedation is a moderate type of sedation. Patients who have previously experienced IV sedation often report feeling like they slept through the entire procedure. Generally, IV sedation is used for shorter treatments. It is administered via direct injection into the bloodstream, which means the effects are immediate. Sometimes patients feel groggy and sleepy when the IV sedatives are withdrawn. This is why it is important to bring a designated driver for the drive home.
Oral Conscious Sedation
Oral conscious sedation is an excellent choice for people who fear needles. However, a consult and the completion of the surgical consent form must be completed on a separate visit prior to the medication administration. Oral medication is provided prior to treatment in order to induce a moderate state of sedation. Though oral sedatives do not cause sleep, they usually dull the senses. This means that most patients cannot remember anything associated with the procedure. Usually, a dose of medication is taken prior to the appointment and the patient is brought to the office by a designated driver. Nitrous oxide or IV anesthesia can then be provided as needed to make the patient even more comfortable.
What types of drugs are used in IV sedation?
Each medication has a different half-life, meaning that the effects last for varying amounts of time. The estimated length of the procedure determines which type of drug is going to be most effective.
Here are some of the most common drugs used :
Valium® – This sedative has amnesic properties and a long half-life. It is usually used for time-consuming, complex procedures.
Halcion® – Usually used to treat insomnia, Halcion is an effective sedative with amnesic properties. A short half-life makes this sedative useful for shorter procedures.
Ativan® – This sedative is best known for reducing anxiety. It has amnesic properties and a medium half-life. Ativan is typically used for treatments shorter than two hours.
Versed® – This sedative has the shortest half-life and is therefore most commonly used. It alleviates anxiety and provides excellent amnesia (inability to remember events during the procedure).
Fentanyl - This narcotic provides excellent pain relief in conjunction with the injection of local anesthesia during the procedure.
Propofol - This medication produces a very short acting level of deep sleep and is easily titrated to keep patients comfortable during the surgery and allows them to awaken quickly once the procedure is completed.
If you have questions or concerns, please feel free to ask us.