Sedation in Dentistry : 4 Different Types And Harmful Risks

Last Updated on: 10th June 2024, 02:47 pm

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Q.F. Nayibe Cubillos Morales

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Dr. Gustavo Assatourians D.D.S

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Sedation in dentistry was first used in 1844 by the American dentist Horace Wells, who discovered the anesthetic effect of nitrous oxide, also known as “laughing gas”, and administered it to perform a dental extraction.

Aversion and even fear in the face of a dental process have accompanied humanity for years, but a solution was found with sedation in dentistry.

sedation in dentistry

Currently, sedation dentistry is used for different treatments. promoting calm and reducing anxiety levels, they facilitate dental interventions. In other words, it is a relevant therapeutic alternative for those who manifest odontophobia.

Extractions, root canals, and implant placements are procedures in which sedation is regularly used, although it may be appropriate for any dental intervention.

 

Are Anesthesia and Sedation the Same?

It is often assumed that anesthesia and sedation are two terms for the same procedure, but they are two different techniques.

Anesthesia

1. Anesthesia eliminates sensitivity and leads to a state of total unconsciousness and numbness. There are two levels:

 General anesthesia is administered for complex surgical interventions and in some dental interventions.
 Local anesthesia, which eliminates sensitivity in a certain sector of the body. This one is frequently used in dental procedures.

2. Sedation calms and facilitates the management of the person’s mood, generating changes in the level of consciousness, from slight drowsiness to a deeper level, in which there is no reaction to strong or painful stimuli.

They are complementary techniques. That is, the dentist can initially administer a medication to calm the patient down, reduce his level of anxiety, and then apply the dose of local anesthesia required for the procedure.

 

What are the Advantages of Sedation in Dentistry?

Fears generate anguish and stress, making it increasingly common for oral health professionals to resort to sedation to facilitate dental treatments. The benefits of sedation vary. It facilitates the work of the dentist while allowing the patient to receive the treatment he requires, under better conditions and a favorable prognosis.

dentist holding injection

Sedation facilitates the tranquility and comfort of the person during the dental intervention, which has a direct impact on the success of the procedure and the subsequent results for the person’s oral health.

From the dentist’s perspective, the required procedure can be performed, avoiding the inconvenience related to the fearful emotional condition of the patient. In short, it increases the possibilities of patient cooperation.

 

Who is a Suitable Candidate for Dental Sedation?

Aversion to dental procedures is common. People who regularly require help to facilitate their dental treatments present some of the following situations:

 Anxiety or fear when visiting the dentist

 Difficulty controlling movements

 Less sensitive to local anesthesia

 Fear of needles (aichmophobia)

Gagging reflex, as a consequence of high sensitivity in the mouth

 Special requirements due to physical, cognitive, or behavioral conditions

However, a large number of people do not fit into this list but prefer sedation for dental processes for comfort.

 

Types of Dental Sedation

There are different sedation options available to facilitate dental treatments for those visiting the dentist and who find that it is not a pleasant experience.

injection and tube

The sedation alternative is determined according to the dental condition and needs of the patient. The level of anxiety, the time required for the dental procedure, and the person’s medical history are some of the factors that influence this decision.

These are the most frequent types of sedation:

1. Minimal inhaled sedation: nitrous oxide (laughing gas) inhalation sucked through a mask. The calming effects are registered in the following five minutes. The dentist controls the dose administered and adjusts it during the procedure. In the end, pure oxygen is supplied to remove the nitrous oxide from the body.

2. Oral sedation: the level can go from minimal to moderate. Generally, it is administered through a pill taken one hour before the dental procedure. It produces drowsiness, even though the person is awake. If a higher dose is administered, it is considered as moderate sedation.

If this is the sedation option chosen for the dental treatment, it is suggested that the patient be accompanied, since side effects on motor skills can be expected.

3. Intravenous (IV) sedation: this is the deepest form of sedation. The medication is received intravenously and takes effect in less time. It facilitates the control of the nervous and motor systems. In addition, it allows the dentist to adjust the level during the intervention and use even reversal medications.

Note: Heart rate, blood pressure, and oxygen levels must be monitored during the intervention.

4. Deep sedation and general anesthesia: Medications can cause unconsciousness, that is, the person falls asleep and needs time to wake up.

General anesthesia is the alternative to treat young children and adults with special needs. This type of unconscious sedation requires training and experience on the part of the health professional. In such cases, the dentist usually works with an anesthesiologist.

 

Preparation Before Sedation

In the consultation prior to the dental intervention, the professional informs the patient about the sedation alternatives. Their medical history including medications for ongoing conditions is also discussed.

injecting anesthesia

After gathering this vital information, sedation recommendations can be made.

Steps are required before sedation for a dentistry procedure:

 Review the patient’s medical history to determine if sedation is appropriate.

 Inform the dentist about medications being taken.

 The dentist will provide instructions on fasting prior to sedation.

 Fill out an informed consent form, a document that mentions possible risks.

 The dose should be in accordance with the age and health condition of the patient.

 Monitor vital signs during the intervention, in accordance with the guidelines of the American Dental Association.

If you are taking an anticoagulant, it is necessary to inform the dentist.

 

Aftercare

It is recommended to attend the dental consultation in the company of another person, who can assist you if the need arises. The sedation effect wears off approximately two hours after the end of the procedure. During this time, it is normal to feel drowsy or have decreased reflexes.

 

Risks and Side Effects

A the end of dental treatment, you may experience:

 Drowsiness

 Dry mouth (xerostomia)

 Headache

 Fever and snoring in children

 Nausea and vomiting

 Hypoxia/apnea, due to the lack of oxygen in the cells and difficulty breathing

 Bruises, if the sedation was intravenous

Determining the side effects of sedatives can be complex and rarely cause an allergic reaction.

 

Use in Children and Pregnant Women

Sedation is generally safe in children; however, some parents may not feel comfortable giving these substances to their children. Side effects can appear such as:

 Irritability

 Snoring or different sounds

 Fever

 Nausea and vomiting

Some children take more time to wake up so the effect of the sedative is prolonged. If it occurs, the child must remain under observation. Some side effects are possible but go away in a day or two

Sedation dentistry is not recommended for pregnant women because some sedative medications can affect the normal development of the baby. Only in exceptional cases is it possible to consider the use of nitrous oxide, during the second trimester of pregnancy. As a general rule, dentists prefer to use sedation, even after pregnancy.

 

Against Odontophobia, the Remedy is Sedation

For those who fear the dentist, a condition called odontophobia, sedation procedures are an alternative to avoid major effects on oral health.

Anxiety, fear, and other reactions that may occur during dental interventions can be controlled through sedation. I the required dental procedure for the benefit of the person’s oral health, optimizing intervention time.

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References

1. Agarwal Rita (May 28, 2019) Anesthesia or sedation for your child’s dental treatment? /https://www.healthychildren.org/Spanish/healthy-living/oral-health/Paginas/Anesthesia-or-Sedation-for-Your-Childs-Dental-Work.aspx

2. Cleveland Clinic (Enero 12 de 2022) Sedation Dentistry / https://my.clevelandclinic.org/health/treatments/22275-sedation-dentistry

3. Fiorillo Luca (December de 2019) Conscious Sedation in Dentistry /https://pubmed.ncbi.nlm.nih.gov/31817931/

4. Guerrero Ortiz F, Sanchis Fores C, Onrubia Fuertes X, Aspiazu Hinostroza K (December 2020) Conscious, inhalational, and pharmacological sedation, its effectiveness in redirecting the behavior of pediatric patients in the dental office: an observational cross-sectional study – Magazine Advances in Odontostomatology Vol. 36 No. 4 / https://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0213-12852020000400002

5. Kapur Arpita, Kapur Viany (December 2018) Conscious Sedation in Dentistry /https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6327823/

6. Ortega Carolina, Diaz Omar, Molano Alberto, Barrientos Silvia (s.f) Sedoanalgesia in dental treatments: a descriptive study / https://repository.javeriana.edu.co/bitstream/handle/10554/46143/SEDOANALGESIA%20EN%20TRATAMIENTOS%20ODONTOL%C3%93GICOS-%20UN%20ESTUDIO%20DESCRIPTIVO.pdf?sequence=2&isAllowed=y

6. Salazar Alejandro (1999) General anesthesia and sedation in dentistry / https://www.actaodontologica.com/ediciones/1999/2/art-13/

7. Watson Stephanie (Enero 24 de 2022) Sedation Dentistry: Can You Really Relax in the Dentist’s Chair? / https://www.webmd.com/oral-health/sedation-dentistry-can-you-really-relax-in-the-dentists-chair

 

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