Which Oral Sedation Medication Is Right For You?
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Oral sedation dentistry is a medical procedure involving the administration of sedative drugs via an oral route, generally to facilitate a dental procedure and reduce patients’ anxiety related to the experience. Oral sedation is one of the available methods of conscious sedation dentistry, along with inhalation sedation (e.g., nitrous oxide) and conscious intravenous sedation. Benzodiazepines are commonly used, specifically triazolam. Triazolam is commonly selected for its rapid onset and limited duration of effect.
An initial dose is usually taken approximately one hour before the dental appointment. Treatment may include additional dosing on the night proceeding the procedure, to mitigate anxiety-related insomnia. The procedure is generally recognized as safe, with the effective dosages being below levels sufficient to impair breathing.
Dental patients with generalized anxiety, belonephobia (fear of needles and sharp instruments), prior dental trauma, or generalized fear of the dentist can take oral medication in order to reduce their anxieties. A variety of single and incremental dose protocols are used to medicate the patient as early as the day before treatment. Medication additionally helps reduce memory or the sights and smells of the dental office to avoid recall of any trauma. The sedative effect allows more dentistry to be completed in fewer appointments as well as allowing complex procedures to be performed in less time.
What Types Of Sedation Are Used In Dentistry?
The following types of sedation are used in dentistry:
You breathe nitrous oxide — otherwise known as “laughing gas” — combined with oxygen through a mask that’s placed over your nose. The gas helps you relax. Your dentist can control the amount of sedation you receive, and the gas tends to wear off quickly. This is the only form of sedation where you may be able to drive yourself home after the procedure.
Depending on the total dose given, oral sedation can range from minimal to moderate. For minimal sedation, you take a pill. Typically, the pill is Halcion, which is a member of the same drug family as Valium, and it’s usually taken about an hour before the procedure. The pill will make you drowsy, although you’ll still be awake. A larger dose may be given to produce moderate sedation. This is the type of anesthesia most commonly associated with sedation dentistry. Some people become groggy enough from moderate oral sedation to actually fall asleep during the procedure. They usually can, though, be awakened with a gentle shake.
You receive the sedative drug through a vein, so it goes to work more quickly. This method allows the dentist to continually adjust the level of sedation.
You will get medications that will make you either almost unconscious or totally unconscious — deeply asleep — during the procedure. While you are under general anesthesia, you cannot easily be awakened until the effects of the anesthesia wear off or are reversed with medication.
Regardless of which type of sedation you receive, you’ll also typically need a local anesthetic — numbing medication at the site where the dentist is working in the mouth — to relieve pain if the procedure causes any discomfort.
Sedation is most appropriate for people with a real fear or anxiety that is preventing them from going to the dentist.
Sedation dentistry may also be appropriate for people who:
- have a low pain threshold
- can’t sit still in the dentist’s chair
- have very sensitive teeth
- have a bad gag reflex
- need a large amount of dental work completed
Sometimes, children are given sedation if they are terrified of going to the dentist or refuse to cooperate during the visit. Nitrous oxide tends to be safe in children, and just about any dentist can administer it. A smaller percentage of pediatric dentists are trained to give children oral sedation. Oral sedation can be safe when kept within the recommended dose for the child’s age and weight.
Most dentists can administer minimal sedation (such as nitrous oxide or pills). An increasing number of dentists can give moderate sedation. However, only a small percentage of dentists who have completed the Commission on Dental Accreditation (CODA) program in deep sedation and general anesthesia can use these more complex techniques. These dentists are typically oral and maxillofacial surgeons and dentist anesthesiologists. Some dentists use a dentist anesthesiologist, who is specially trained to give all levels of sedation and anesthesia to both children and adults.
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Article compiled by Apple Tree Dental
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