Sedation

Nitrous Oxide (Laughing Gas)

This gas, which is inhaled by the patient through a rubber nose mask, is one of the most common forms of sedation used in the dental office. We found that nitrous oxide sedation is very helpful to manage both pain and anxiety effectively. It produces a relaxed, comfortable feeling, so patients who are very nervous about dental treatment will greatly benefit from this type of sedation. Nitrous sedation has a tremendous effect on the gag reflex. Patients who have difficulty with taking radiographs or taking impressions are candidates for nitrous sedation.
Nitrous is safe to most patients without any significant side effects. Effects wear off quickly after the gas is turned off. This is the only form of sedation under which patients can drive after the procedure.

Oral Sedation

Oral sedation in healthy adults is typically safe, effective, convenient, and inexpensive way to relax patient. In many cases we use a class of sedative medication called benzodiazepines. Examples of benzodiazepines include diazepam (Valim), lorazepam and triazolam. Oral sedation, works on the central nervous system to help patients with mild to moderate levels of fear and anxiety.

The patient should be advised not to drive, make important decisions, or consume alcohol for a period of 24 hours after the appointment.

Intravenous Sedation

This form of pain and anxiety control involves injecting a sedative into a vein of a patient’s arm or hand. This approach is usually reserved for patients undergoing extensive dental procedures or for the extremely anxious patients. We monitor the oxygen level of patients receiving IV sedation and may need to give such patients additional oxygen during the procedure. With IV sedation, the patient is awake but very relaxed.

General Anesthesia

Produce an unconscious state. In this state a person is:

• unaware of what is happening
• does not feel, see, or hear anything during the procedure
• pain-free
• immobile
• free from any memory of the period of time during which he or she is anesthetized

The anesthetic medications are given  through an intravenous line or as a gas through a mask. Intra muscular injection or oral pre-sedation might be necessary separately in some cases with children and special needs patients. Insertion of an endo-tracheal tube or a similar breathing device might be needed during the anesthetic. When anesthetics reach the bloodstream, the drugs that affect the brain pass through other blood vessels and organs so they are often affected too.  Therefore, patients must be carefully monitored.  The anesthesiologist continuously monitors the patient’s heart rate, heart rhythm, blood pressure, respiratory rate, and oxygen saturation.

 Preparation for general anesthesia are:

• It is important  not to eat or drink from midnight the night before the scheduled appointment or at least eight hours prior
• If you are taking medication, you might need to continue taking some while refraining from taking the others.  Follow the instructions of your anesthesiologist and managing physician
• Refrain from smoking at least one day prior to the procedure.  If you use a nicotine patch, please stop using it at least 24 hours prior to the anesthesia
• Children might be allowed to receive certain clear liquids until four hours prior to the procedure if approved by the anesthesiologist
• Have family member or trusted friend to escort you and be responsible to drive you back home after the procedure
• Do not plan anything for the remainder of the day