Dental treatment in sedation

Sedation is a medical procedure involving the administration of sedative drugs, generally to facilitate a medical procedure with local anaesthesia.
Sedation is now typically used in dentistry for reconstructive surgery, some cosmetic surgeries, removal of wisdom teeth, or for high-anxiety patients. Sedation methods in dentistry include inhalation sedation (using nitrous oxide), oral sedation, and intravenous (IV) sedation.

Sedation is also used extensively in the intensive care unit so that patients who are being ventilated tolerate having an endotracheal tube in their trachea.

Sedation is often recommended for “severe dental phobia”. However, there is no consensus as to what constitutes a “severe” phobia. Scores on dental phobia tests bear little or no correlation to the need for (or desirability of) sedation. As a rule-of-thumb, sedation can be useful.

Sedation Pros and Cons

PROS

  • You tend to agree with the following statement: “If I could be worked on without knowledge of the procedure, pain or memory of the treatment, then there wouldn’t be much to fear”.
  • Your primary aim is “to get your teeth fixed”.
  • You have a “gut feeling” that sedation would help you and allow you to get work done on your teeth which otherwise you wouldn’t be able to tolerate.
  • You need to get a lot of work done “in one go”, because you’re very busy or because an important social event is coming up.
  • You’re facing a long procedure which can’t be broken down into shorter visits.
  • You’re facing a procedure which would otherwise be uncomfortable or on the gory side (e. g. extraction of impacted wisdom teeth, certain types of gum surgery – your dentist will advise you if things could become uncomfortable). In some cases of complex oral surgery, a general anaesthetic may be required to make the procedure comfortable.
  • You have a bad gag reflex, and attempts at bringing it under control using behavioural methods have persistently failed. In this case, laughing gas is the method of choice, and if that fails, IV sedation is an option. Both methods greatly reduce the gag reflex.
  • You need extra painkillers administered into your blood-stream for whatever reason.
    You’ve tried things like meditation or hypnosis in the past and found them to be quite effective in calming you.

CONS

  • One of the major features of your phobia is a lack of trust in the dental profession, and a fear of loss of control.
  • Your primary aim is “to get your phobia fixed”.
  • Research suggests that the chances of overcoming dental phobia are much greater using behaviour modification compared to using pharmacological methods alone, where fear has been found to return to baseline levels.
  • Sedation is more expensive. Some forms of sedation (e. g. “laughing gas” and oral sedation, i. e. pills) are only somewhat more expensive, while others (e. g. intravenous sedation) can be quite a lot more expensive.
  • In many areas, sedation is not widely available. You’re limiting your choice of dentists.
  • Certain medical conditions can contraindicate the use of certain types of sedation drugs.

Pin It on Pinterest