Sedation dentistry for nervous patients can be assessed for treatment to be carried out under oral or intravenous sedation.
Intravenous sedation is given by using a single drug called midazolam. The amount of drug you are given is based on your response to it as an individual and not your size or weight. It is given by injection. This is usually into a vein in your arm or in the back of the hand through a cannula.
A cannula is a thin flexible tube. A needle is used to put the cannula in but is then removed immediately. It is normal to feel a scratch when the cannula is inserted. Once the cannula is in the vein, the sedation drug can be given without using any more needles. The cannula remains in until the dentist has checked that you have recovered from the sedation but it will be removed before you go home.
It is usual to have at least two appointments. The first appointment will be an assessment when your dental treatment under sedation will be planned and discussed with you. The dental treatment under sedation will take place at the second and any subsequent appointments.
Your dentist and members of the dental team are trained to give sedation. They watch you closely and treat any problems that may develop. They are also required to use appropriate monitoring equipment during sedation. You will stay in the surgery to recover where you will be observed until you have made a full recovery from the sedation.
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What to Expect?
You will remain conscious during this kind of sedation dentistry and be able to respond to questions.
You may experience a temporary loss of memory during the time that you are sedated. Many patients have no memory of the procedure at all. You may feel unsteady on your feet for some hours afterwards. Your ability to think clearly and make judgements may be affected for the next 24 hours. You may experience some forgetfulness.
Once you are sedated, the dentist may use local analgesia (pain relief that numbs the site of the dental treatment). Local anaesthetic as a paste is sometimes used to numb the site of the treatment. Any injections that you may need can be given through this numbed area to reduce the chance of any discomfort.
You will spend some time recovering following your treatment either within the surgery or in a separate private area, following your treatment. You will be checked by the dentist before you can go home. You MUST be accompanied by an able-bodied adult who can take responsibility for you following your treatment. This person may need to stay with you overnight. If arrangements have not been made for someone to accompany you after treatment, you will not be able to have the sedation.
If you have any questions or are unclear about sedation dentistry, then do not hesitate to ask your dentist.
After The Treatment
Your judgement will be affected by the drugs. This is similar to the effects of consuming alcohol. You should not drive a car, ride a bicycle or operate machinery until the following day. In some cases, this may be for as long as 24 hours. You should also not take responsibility for the care of others, use sharp implements or cook. It would be unwise to make any irreversible decisions for up to 24 hours following your treatment. Owing to the after effects of the drugs used, care should be taken when using the internet for personal communication.
Before you are discharged, the dentist or dental nurse will give you and the adult accompanying you (chaperone) important information about your care both verbally and as a printed sheet. The dentist will also provide details of any after care necessary for your mouth.
As with the administration of any medicines, there are risks associated with intravenous sedation. These might include:
- A reduction of oxygen in the blood stream due to poor breathing during sedation. You may be asked by your dentist/sedationist to take deep breaths to correct this. Your breathing and oxygen levels will be monitored throughout the procedure.
- Bruising at the site of the cannula. This may take a few days to fade completely.
It is very important that you let the dentist know your medical history, including any medicines that you are taking. The dentist will need to know if you have ever had any problems with having either sedation or a general anaesthetic. Your dentist/sedationist will discuss any concerns that you may have prior to the procedure taking place.
If you think you may be pregnant, you need to let the dentist know. You should also let the dentist know if you are breastfeeding.
Have a light meal before your treatment but at least two hours before and take any routine medications. You will also be given this information in writing, it is important that these instructions are followed carefully.
The information provided here is a general guide for patients having dental treatment with sedation. As part of the face-to-face discussions with your dentist, you may be given advice that is specific to your treatment plan. This may differ in some areas to the principles outlined here.
Before any treatment is started, the dentist will ask you to confirm consent. This means that you understand the planned treatment and how you will receive the sedation.
Benefits of sedation include:
Overcome fear and anxiety allowing the patient to comfortably go through their procedures
Ease of treatment which will allow the dentist to work faster and more efficiently, because he doesn’t have to worry about your reaction to the procedure
Reduced gag reflex means the dentist can work faster and more efficiently, and the patient will be much more comfortable