Some patients have so much anxiety that they completely avoid dental treatment which often leads to loss of teeth due periodontal disease (gum disease). For patients who have high levels of anxiety there is good news. Different forms of sedation have become available. Depending on the level and severity of anxiety, sedation can range from anxiolysis (light) and conscious to deep and unconsciousness.
Degrees of Sedation
For many, the only dental sedation they require as a patient is some mind-numbing afternoon television show on a tv screen hanging above the dentist chair they’re sitting in. For others, the sedation level required to get through a basic dental procedure may be total unconsciousness. Dr. Coello is experienced with all levels of dental fears and is there to work with you to achieve the level of comfort that will allow the required dental procedures to be accomplished in a safe, timely and, most importantly, stress-free manner.
There are a variety of sedation levels and techniques available, all dependent on the individual’s personal level of fear or anxiety when faced with dental procedures. These dental procedure sedation levels and techniques include:
Anxiolysis – The lowest level of sedation, designed to eliminate anxiety or slight nervousness. The patient is completely alert and awake at this level. Usually administered by nitrous oxide, anti-anxiety medication, or a light dosage of oral conscious sedation.
Mild Conscious Sedation – With a very mild form of oral conscious sedation, a patient can take care of many cosmetic or restorative dental procedures in just one visit. With mild conscious sedation, patients generally do not have amnesia and remember treatment, but are still rested and do not feel any discomfort. Mild conscious sedation is usually administered through oral conscious sedation, a small pill taken before treatment.
Conscious Sedation – The most commonly performed level of sedation in dentistry. A perfect level of sedation meant to complete just about any cosmetic, restorative, implant or complicated dental procedure. Patients will be conscious, but will feel as though they have been asleep and will awaken with little to no memory of the experience. Conscious sedation is delivered either through oral or IV sedation.
Deep Sedation – For very nervous patients, a higher level of conscious sedation, called deep sedation, may be used. With deep sedation, a patient will not be able to respond to commands and may need an extra level of monitoring, particularly with breathing. Deep sedation is usually administered through IV, as oral sedation may not be enough to sedate very anxious patients.
General Anesthesia – The highest form of sedation, where a patient is completely put to sleep and fully monitored to ensure safety. The same level of sedation as used in hospitals, general anesthesia is reserved for very complicated dental procedures that could not be completed otherwise.
Although you may feel alert after treatment under sedation, it is imperative that an adult accompanies you upon leaving our office and continues monitoring you until the medication has completely worn off. Do not drive, operate hazardous devices, or make any important decisions (financial or otherwise) for 24 hours after taking sedation dentistry medication. You should not go up or down stairs unattended. Contact us if you have any questions, concerns or difficulties. If you feel your symptoms warrant a physician and you are unable to reach us, go to your nearest emergency room immediately.
Methods of Sedation
One of the most popular and trusted forms of sedation, nitrous oxide has been used by dentists for decades to provide quick comfort to patients. Often called laughing gas by many patients, nitrous oxide creates a soothing calming effect and increases euphoria, hence the “laughing” part of the nickname.
Oral Conscious Sedation
It’s amazing what a tiny pill can do. By taking oral conscious sedation in pill form, usually an hour before treatment begins, a patient can receive the desired level of sedation needed to relax, from light to moderate. Oral sedation is enough to rest and even create amnesia, but will not render a patient unconscious. For added safety, vital signs are monitored when a patient is under oral conscious sedation.
IV Conscious Sedation
There are many advantages to using IV conscious sedation. IV sedation is safe, easy, and effective. It allows your Dentist to easily perform a variety of procedures while still being able to keep a patient alert, responding to commands. In some cases, IV sedation can be used to sedate patients to where they are conscious but not able to respond to commands. The result is great amnesia, with patients unable to remember the entire treatment. Patients should usually have someone with them to drive them home, as they may not be able to operate a vehicle immediately after their visit.
While nitrous oxide, oral sedation, and IV sedation are designed to keep patients awake, general anesthesia makes the patient sleep through their entire treatment. Because the effects require constant monitoring of vital signs and breathing, general anesthesia is usually reserved for dentistry done in a hospital setting or very complicated procedures, such as oral surgery.
Acupuncture needles stimulate the nervous system, changing the way we process pain signals and releasing natural painkillers such as endorphins and serotonin in the nervous system. Each patient responds to acupuncture differently. Some people notice an immediate improvement, while others need several treatments to experience the full effect. Some may not respond at all.
Acupuncture involves stimulation of the body at certain points. During a treatment, thin steel needles are inserted into the skin, then manipulated gently by hand or with light electrical stimulation. The same points may also be pressed (acupressure) or warmed (moxibustion). Treatment is short and may be performed during dental treatment.