Most dental procedures, such as fillings, are carried out using injected local anaesthetic. However, for people who are extremely nervous about visiting the dentist, sedation dentistry may be recommended.
NHS sedation clinics may offer inhalation sedation using a nosepiece, or a sedation injection into a vein.
In both cases, the patient is still awake and can talk, but the drugs used give a relaxing and calming effect.
For some dental procedures, general anaesthetic may be recommended.
What is sedation dentistry?
Sedation dentistry uses medication to help patients relax during dental procedures. It's sometimes referred to as " sleep dentistry", although that's not entirely accurate. Patients are usually awake with the exception of those who are under general anaesthetic.
The levels of sedation used include:
- Minimal sedation -- you are awake but relaxed.
- Moderate sedation (formerly called "conscious sedation") -- You may slur your words when speaking and not remember much of the procedure.
- Deep sedation -- you are on the edge of consciousness but can still be awakened.
- General anaesthetic -- you are completely unconscious.
What types of sedation are used in sedation dentistry?
The following types of sedation are used in dentistry:
- Inhaled minimal sedation. You breathe nitrous oxide, otherwise known as "laughing gas", combined with oxygen through a mask that's placed over your nose. The gas helps you relax. The amount of sedation you receive can be adjusted, and the gas tends to wear off quickly. This is the only form of sedation where you may be able to drive yourself home after the procedure.
- Oral sedation. Depending on the total dose given, oral sedation can range from minimal to moderate. For minimal sedation, you take a tablet. Typically, a type of drug called a benzodiazepine is used, often taken about an hour before the procedure. The tablet will make you drowsy, although you'll still be awake. A larger dose may be given to produce moderate sedation. This is the type of anaesthetic most commonly associated with sedation dentistry. Some people become groggy enough from moderate oral sedation to actually fall asleep during the procedure. They usually can, though, be awakened with a gentle shake.
- Intravenous (IV) moderate sedation. You receive the sedative drug through a vein, so it goes to work more quickly. This method allows the dentist to continually adjust the level of sedation.
- Deep sedation and general anaesthetic. You will be given medications that will make you either almost unconscious or totally unconscious during the procedure. While you are under general anaesthetic, you cannot easily be awakened until the effects of the anaesthetic wears off or is reversed with medication.
Regardless of which type of sedation you receive, you'll also typically need a local anaesthetic, which is a numbing medication, to relieve pain if the procedure causes any discomfort.