Do you have dentist phobia? Are you afraid of having your implants inserted? If the answer to these questions is ‘yes,’ you should consider sedation.
The primary purpose of sedation is to reduce discomfort, pain, and anxiety during dental surgical processes. Specific medications may accomplish sedation.
There are four types of sedation that your dentist can administer to you. These types include oral sedation, inhalation, intramuscular sedation, and intravenous sedation. In this article, we will focus majorly on oral sedation and intravenous sedation.
If you believe that you can benefit from sedation dentistry, we invite you to contact us at Encino Dental Implant. We will explain to you all the available options, and how best to overcome anxiety and reduce pain and discomfort during dental surgical procedures. We provide free consultations on what to expect. Our main goal is to help Encino residents obtain beautiful and healthy smiles.
Definition of Sedation
The main goal of a medical practitioner is to provide comfort to his/her patients. When a patient presents himself/herself at a clinic, a medical professional should provide treatment to cure the illness, as well as reduce the patient’s pain and anxiety.
Generally, sedation can be defined as the act of depressing the patient’s awareness about his/her environment and reducing his/her response level to external stimuli. Sedation is mainly used in surgical procedures, such as reconstructive surgery, vasectomy, endoscopy, as well as in dentistry.
Before a doctor can sedate you, he/she will first screen you to identify any health concerns. For instance, he/she may check whether you are allergic to particular drugs or substances or if you are under any current form of medications.
The medicines that are usually used during sedation are referred to as 'sedatives.' These sedatives can make you feel relaxed and drowsy very quickly. You can also fall into a deep sleep and wake up only when the effect of the sedative wears off.
Difference Between General Anesthesia and Sedation
Some people confuse general anesthesia and sedation and even think that they are the same. Both of these procedures apply to dentistry. Below, we list for you the significant differences between general anesthesia and sedation:
- Sedation is mainly used in minor surgical procedures while most major surgeries require general anesthesia
- When you are sedated, you may remain responsive unlike in general anesthesia where you will be unconscious
- In sedation, you will be able to remember some parts of the procedure whereas in general anesthesia you won’t recall anything
- Sedatives can be administered orally, via intravenous injection, a muscle shot, or inhalation while anesthetics are mainly given in the form of an injection into your arm
- General anesthesia works faster than sedation; a patient who has been administered anesthetics can become unconscious immediately, while sedatives take around 30 – 60 minutes for them to take effect
- Sedatives wear off quickly while anesthetics take time to wear off completely
Stages of Sedation
Sedation is procedurally done. It involves the following three stages:
- Anxiolysis/Minimal – You are relaxed but fully responsive and conscious
- Moderate – You are sleepy, and you may become unconscious, but still responsive
- Deep – You have fallen asleep, and you are mostly unresponsive
General Procedures for Sedation
The procedures used during sedation may differ, depending on the type of sedation that is being conducted. But, here is what you should typically expect during sedation:
- You will sit down or lie down
- The doctor will administer to you the sedative
- You will wait until the administered medication takes effect
- Your doctor will monitor your blood pressure and breathing
- He/she will begin the implant insertion process after the sedative has taken effect
If your doctor notices that your breath has become too shallow, he/she may require you to put on an oxygen mask. This mask will help you maintain your breathing and blood pressure levels.
Generally, you must personally request for sedation before the dentist administers it to you. This is because most dentists prefer local anesthesia to sedation in almost all surgical processes, including implant insertion. In some situations, your dentist may advise you to opt for sedation instead of anesthesia if he/she believes that you may develop some complications as a side effect of the anesthetic agents.
Types of Sedation
Four categories make up the sedation process. The four are used based on a dentist’s assessment of the sedation type that is most suitable for you. The sedation categories include:
- Intravenous (IV)
In inhalation, you will put on a mask full of nitrous oxide. Automatically, you will inhale it, and it will start taking effect on your body system. During intramuscular sedation, your dentist gives you a shot of a sedative like a benzodiazepine on your butt or upper arm. Let us now focus majorly on oral sedation and intravenous sedation:
During oral sedation, your dentist will administer a pill, which you will have to take via your mouth. In most instances, this pill is tiny and blue.
When this pill takes effect, you will become sleepy and slightly unconscious, but you will remain responsive. Then, your dentist will insert the implant. You will wake up when the procedure ends, feeling refreshed, and with a healthy and beautiful smile. Below, we discuss comprehensively oral sedation, and in particular: who qualifies for it, how it works, why you should choose it, whether it is suitable for children, the medications used, and its pros and cons.
Why Should You Choose Oral Sedation?
You should choose oral sedation if you have dental phobia. For instance, you may fear the instruments dentists use, or suffer from general anxiety while at a dental office.
Often, most patients would like to have oral sedation before implant insertion. This is because the implant insertion process is generally invasive. Of course, you may be terrified of the dentist, but this should not keep you from obtaining a beautiful smile.
Do You Qualify for Oral Sedation?
Although oral sedation is a highly effective method to reduce anxiety while at a dental office, not everyone qualifies for it, around 25% of patients are generally unresponsive to oral sedation medication. These patients will typically feel nothing when they take the prescription pill.
There is no precise method of predicting whether or not you will be responsive to the sedative pill. But, some individuals may not qualify for oral sedation because of their medical history. Your dentist will not put you on oral sedation if you have conditions such as chronic bronchitis, impaired liver and kidney function, glaucoma, heart failure, respiratory diseases, depression, and bipolar disorder. Moreover, you should not undergo oral sedation if you are pregnant, under prescription for other medicines that can counteract the sedative pill, or allergic to benzos.
How Does Oral Sedation Work?
First, you will have to let your dentist know that you are interested in sedation. Next, your dentist will check your medical history and blood pressure levels, as well as make you go through specific diagnostic tests.
Then, he/she will explain to you the various types of sedation available and their pros and cons. Your dentist will also recommend the best sedation method for your situation. If you opt for oral sedation, he/she will prescribe for you two pills.
You will have to take one pill before bed on the night before the day you intend to have your implants inserted. You will receive the second pill within 60 minutes before the implant insertion procedure. After you've taken this pill, you will feel drowsy, and you may even fall into a deep sleep. The dentist will perform the insertion procedure after the medicine has taken effect. This way, you will feel no pain, and you will be completely relaxed throughout the procedure.
Medications Used During Oral Sedation
The primary drugs used during oral sedation are benzos. Benzos are quite common in the United States, and you may probably know them as Ativan, Valium, or Xanax. These medications will relax some parts of your brain, especially the parts which bring about fear and anxiety.
Benzos can be divided into two categories: anti-anxiety medicines and sedative-hypnotics. Sedative hypnotics can result in significant drowsiness or unconsciousness. If you take them, you will remember close to nothing about the procedure.
On the other hand, anti-anxiety medicines will only relieve your anxiety. They can make you fall asleep, but you will remain conscious and responsive to what happens around you.
In reality, these two types can be used to induce any stage of sedation, whether it is minimal, deep, or moderate. The stage of sedation you will be in generally depends on how much dosage you take and how your body system reacts after taking the drugs.
Benzos do not have any adverse side effects. This is why many dentists highly recommend them. However, make sure you follow the doctor's prescription. Do not overdose or underdose, or mix them with alcoholic substances.
Advantages of Oral Sedation
The following are the advantages of oral sedation:
- Easy and quick to administer - The doctor will give you a pill that you will take orally. This pill will start functioning within 30 – 60 minutes, and you will feel relaxed by the time your dentist begins the procedure.
- No needles - If you don’t like injections, then you should opt for oral sedation. In oral sedation, you don’t have to fear feeling pain when being injected.
- Amnesia - You will not remember anything about the procedure. Occasionally, you may recall very little of what transpired.
- Safe - Oral sedation has minimal side effects.
- Responsive - Although you will fall asleep after sedation, you will remain conscious. This means that you can even listen and react to whatever is going on around you.
Disadvantages of Oral Sedation
The cons of oral sedation include:
- It does not take effect immediately - Unlike intravenous sedation and inhalation, oral sedation isn’t immediately effective. This is why your dentist will give you the pill in at least an hour before he/she starts the implant insertion procedure.
- It isn’t easy to change the sedation level - Because the pill doesn’t take effect immediately, it may not be easy for you to move from a lower sedation level to a higher sedation level. For instance, it can be hard for you to move from minimal sedation to mild sedation, or from moderate sedation to deep sedation.
- Inability to drive - It may take some time for the sedative drug to wear off completely. This means that you can’t drive yourself home after the procedure, and you will need to bring a friend or family member along so that he/she can ensure you reach your destination safely.
Oral Sedation for Children
As a parent, you may be apprehensive about your child undergoing oral sedation. But still, you would want them to have a healthy and beautiful smile without them experiencing unnecessary pain and discomfort.
Generally, oral sedation for children has minimal risks. Therefore, you shouldn't worry about taking your child to the dentist to have his/her implants inserted. We recommend oral sedation for children who will undergo any form of dental surgery, for them not to be traumatized after the procedure and to help them overcome fear and anxiety. Unlike intravenous sedation or anesthesia, oral sedation has fewer adverse effects and is less complicated.
The dentist will administer your child an oral medication. This medicine will make him/her fall asleep, but he/she will remain conscious. Your child will remain asleep throughout the procedure. When your child wakes up, he/she will not recall anything or remember very little about the procedure.
Generally, oral sedation for children works as a magical memory eraser. It is an excellent method to enable your child to obtain a beautiful smile without him/her suffering emotional distress.
You will be able to go back home with your child after the procedure. Sometimes, you may hear your child talking about the procedure. Often, he/she may be incoherent and unaware of what he/she is saying. Even though your child says what they witnessed or what happened, this does not mean that the oral medication did not work.
Ensure you monitor your child after the sedation and implant insertion process. Do not permit your child to eat overly hard foods for 24 to 48 hours after he/she has had the implants inserted. This is because his/her mouth might still be numb. Serve him/her soft foods only.
Moreover, you should exercise reasonable caution if your child decides to play after sedation. Don't allow him/her to trip hazards or run up and downstairs. These activities could be risky because the effects of the sedative might not have worn off completely.
If you aren’t responsive to oral sedation or inhalation, then you should consider intravenous sedation, instead of giving up your quest for finding a beautiful smile. In intravenous sedation, your dentist will administer anti-anxiety medicines. These medicines will be delivered in the form of an injection into your circulatory system.
Some people may refer to intravenous sedation as ‘twilight’ or ‘sleep’ dentistry. Don’t let these terms misguide you into believing that you will remain completely unconscious during the implant insertion procedure. On the contrary, you will stay awake and responsive to the dentist. However, you may not be able to remember anything about the procedure once the medicine wears off.
You shouldn’t visit the dentist alone if you intend to go through intravenous sedation. Bring along a friend with you, who will ensure you reach home safely after the implant insertion procedure. Your friend will also shield you from indulging in any activities that can be hazardous to you until the sedative drug wears off. Though intravenous sedation is highly effective, you shouldn’t take it lightly. Let’s discuss more comprehensively about intravenous sedation.
How to Prepare for IV Sedation
You may have to adjust some of your activities and habits before going for intravenous sedation. According to the American Society of Dentist Anesthesiologists, you shouldn’t eat or drink anything for eight hours before the sedation procedure. You should also stop smoking to ensure you heal faster.
Make sure you come with a friend when visiting the dentist. Moreover, free up your schedule beforehand to allow you sufficient time to rest after the procedure.
Take note that you should inform your doctor of your medical history and any allergies before the sedation process during the consultation. Your doctor will also advise you on any other necessary steps or precautions you should take before undergoing IV sedation.
What Happens during IV Sedation?
The dentist will inject you with a small needle on your arm or hand, into one of your veins. This needle is attached to a tube containing a liquid sedative, which will be delivered into your bloodstream. The dentist may apply some cream onto the skin before the injection if you are afraid of needles.
When the sedative starts taking effect, you will feel lightheaded and dreamy. Though you may feel relaxed, you won’t fall asleep. If your dentist talks to you, you will probably answer him/her.
Your dentist will monitor your heart rate and rhythm, oxygen levels, and blood pressure as the sedative takes effect. Once your doctor is satisfied that you are fully relaxed, he/she will initiate the implant insertion process.
Do you qualify for IV Sedation?
IV sedation may not be a perfect choice for some individuals. Generally, if you have conditions such as CNS depression and glaucoma, you cannot undergo IV sedation. Also, you should not undergo IV sedation if you are pregnant, intoxicated, or allergic to benzos. Individuals who are of advanced age or those who have psychosis, sleep apnea, liver, lung, or kidney problems are customarily discouraged from undergoing IV sedation. However, they may still qualify for it.
Popular Medications for IV Sedation
Just like in oral sedation, benzos are typically used for IV sedation. The most popular types of benzos utilized during intravenous sedation include Diazepam and Midazolam. These medicines are offered in a different amount of dosage, to what is administered in oral sedation. They will make you feel relaxed and enter into a trance-like state.
Sometimes, you may receive painkillers, such as opioids, in addition to benzos. The primary purpose of these painkillers is to eliminate or reduce pain during the surgical process. Both opioids and benzos have minimal side effects that are not prejudicial to your overall health and wellbeing.
Advantages of Intravenous Sedation
The following are the advantages of IV sedation:
- It is safe
- It wears off quickly
- It takes effect quickly
- You will remain responsive during the procedure
- You will have little or no memory about the procedure
Disadvantages of Intravenous Sedation
Here are the cons of intravenous sedation:
- You may feel slight pain and anxiety when receiving the injection
- You won’t be able to drive yourself home or engage in vigorous activities immediately after the procedure
Is Intravenous Sedation Safe for Children?
Yes, IV sedation is safe for children. All you need to do is to prepare your child for the procedure emotionally. Also, you should dress him/her in loose clothing before going for the procedure. Make sure he/she eats only soft foods for two days after the procedure. Generally, both IV and oral sedation are fuss-free and safe processes to ensure your child has a comfortable, pleasant, and relaxing experience while at the dental office.
Find a Highly Qualified Sedation Dentist Near Me
At Encino Dental Implant, we recommend IV and oral sedation as highly effective methods to eliminate anxiety and fear while at a dental office. Although not everyone may qualify for them, they have helped numerous patients.
Don’t avoid having an implant inserted just because you are scared. Get in touch with us instead. We will help you obtain a beautiful and healthy smile, and at the same time, eliminate your fear and anxiety. Call us today at 818-810-7535.