What Types of Sedation Are Used in Dentistry?

If the mere mention of the word "dentist" sets your teeth on edge, rest assured that you have plenty of company. Roughly 25 percent of all American adults put off regular visits to the dentist for fear of the pain that such a visit might entail, delegates to the American Dental Association's 2003 national convention were told. Recognizing this fact of life, dentists are increasing their use of various forms of sedation to relax anxious patients.

History

• Although this deep fear of dentists has given birth to a new area of dental practice, called sedation dentistry, the use of sedatives is nothing new in this field. The first use of sedation and general anesthesia in American dentistry can be traced back to the 1840s when nitrous oxide was introduced by Connecticut dentist Horace Wells. Because a number of the procedures that dentists routinely perform can be quite painful, sedation has been utilized for more than 160 years to reduce patient anxiety. Because sedation does not eliminate pain, it is usually used in conjunction with a local anesthetic, such as lidocaine.

Significance

• In a presentation to the 144th annual ADA meeting in San Francisco, dentists Shirley Brown and Michael Unthank, along with management consultant Risa Simon, said that the fear of pain associated with dentists is widespread. They cited a national survey that showed a quarter of all American adults had not visited a dentist in at least five years because of such fears.

Types

• Dentists and oral surgeons use three main types of sedation in their practices, according to the SedationDentistry website. These are oral sedation, also known as enteral conscious sedation; intravenous (IV) sedation; and inhalation conscious sedation. The latter involves the use of nitrous oxide, often called "laughing gas," which is inhaled by the patient, who may or may not fall asleep but is unlikely to remember much, if any, of the procedure. In oral sedation, the patient takes an anxiety-reducing drug by mouth, often falling into a light slumber. IV sedation works much more quickly because the drugs are introduced directly into the patient's bloodstream.

Considerations

• The dentist and his assistants must carefully monitor patients who undergo any form of sedation. This is particularly true of IV sedation, which is used least frequently because of the stringent state regulations governing its administration and the training required. In all cases, patients who have been sedated must be kept at the dentist's office until they are able to stand and walk on their own and must be accompanied by an adult who can drive them home.

Benefits

• The availability of sedation makes a trip to the dentist less daunting for those patients who otherwise might stay away because of their fears of pain and anxiety over the invasiveness of the experience. It also makes painful procedures easier to endure, a plus that is appreciated by all dental patients.