I’ve often had dental patients ask me “Can’t I just be asleep for my dental work?” The short answer is that yes, you can…but most patient don’t really understand the different options for sedation when having your dentistry done. So, here’s an explanation so you can understand your options for the most comfortable dental treatment experience.
Kind, Gentle, Caring Dentistry
For the majority of patients, this really is enough to be able to have routine dental treatment completed, and it is the most common way dental work is done. Find yourself a compassionate, caring dentist and team that works very hard to make your dental visits as comfortable as possible. However, many patients still need more…
We are pleased to currently be the only dental office in the Ottawa area offering NuCalm. This is a non-medicinal relaxation option consisting of four parts: chewable all-natural dietary supplements (they taste like Vitamin C tablets), sensation-free nerve stimulation, noise cancellation headphones playing a special type of classical music, and a sleeping mask. Within 5-15 minutes, patients using NuCalm will achieve a sensation similar to meditation. Patients “drift in and out” of the treatment being performed, lose track of time passing, and when NuCalm is stopped patients report feeling as though they’ve just had a nap! You can drive home right away after using NuCalm, which is a great benefit. NuCalm can also be used together with other types of sedation options, and there is no contraindication when taking other regular medications.
Nitrous Oxide (“Laughing Gas”)
Used for many years, Nitrous Oxide is a slightly sweet-smelling gas (mixed with air) that patients breathe in through a mask during treatment. Most people feel a sensation of floating, tingling fingers and toes, dreaming…all very similar to the feeling you might have after a glass or two of wine. At the end of treatment, the medication is turned off and patients breathe in only air through the mask. Withing 5-20 minutes, a patient can drive home alone with no lasting effects. This is a very safe treatment when handled properly by a trained dentist, and can be used by most patients as long as they can breathe through the nose easily.
Oral Medication (swallow a pill)
There are a variety of medications available that are usually taken by mouth in pill form an hour prior to the appointment time. Patients choosing to take an oral medication must be driven to and from the dental appointment for safety. It is advisable for patients to take the medication in the dentist’s office and sit quietly for about an hour before starting treatment. Your dentist should monitor things like your pulse and blood pressure before, during, and after treatment either manually or with an automated machine. Patients taking this type of medication feel a variety of symptoms, including light-headedness, floating sensation, losing track of time, forgetting what happens during treatment (which is great!). During treatment, you will be breathing on your own and you can respond to requests (like “please turn your head”), but you may not remember this afterwards. Oral medications can be combined quite safely with Nitrous Oxide as well for the patient desiring an even more calm feeling during dental treatment. There are limitations for taking this type of medication based on other medications you may be taking, or medical conditions you have, and different dosages may work for different patients. After using this type of sedation, it is best for the patient to go home and rest quietly (in the presence of a responsible adult) for the remainder of the day.
Intravenous (IV) Sedation
This is the most common type of sedation used today in the office of an Oral Surgeon when a lot of surgery is to be done, either removing a lot of teeth, removing wisdom teeth, or placing several dental implants…but all kinds of dentistry can be completed while using IV sedation. Usually, a needle is placed in the patient’s arm or hand before any dental freezing is given, so by the time you get your dental freezing you are already quite sedated. It’s a great way to have longer treatments completed because it is easy for the oral surgeon to add or change medications through the IV and increase or decrease the amount of medication for their patients quickly. Automatic monitoring of blood pressure, pulse, and heart rate are very important for this type of sedation, and the patient still is breathing on their own and can respond to requests and questions, but much more slowly. Dentists using this type of sedation for their patients must have a special level of education above that of a regular dentist, or a dentist may have an anesthesiologist come to the dental office to take care of the sedation while the dentist does the dentistry. Patients having this type of medication must be brought to and home from the dentist’s office by a responsible adult, and these patients may feel groggy the remainder of that day as well as the following day, depending on the amount of medication used and the length of the procedure carried out.
General Anesthetic (Deep Sedation)
This is the type of sedation carried out in the hospital. In dentistry, this is usually used for the patient who is too anxious to even have the needle placed in the hand or arm prior to treatment, or for those patients with certain very unstable medical conditions like very reactive asthma or unstable heart disease. In these cases, there is equipment used to do your breathing for you during your procedure, and an anesthesiologist carries this out while the dentist or oral surgeon does the dentistry. These patients are often kept in the hospital for several hours to overnight after the treatment is completed for monitoring. Before dentists used IV sedation in their offices, this was the most common sedation method for patients having wisdom teeth removed (it’s the way I had mine removed many years ago!).
What’s the best type of sedation for me?
The answer is…there are clearly many choices! This should be thoroughly discussed with your dentist or oral surgeon when planning your appointments, and depending on the type of sedation you wish to have or any medical conditions, your dentist may refer you to a different practitioner to complete the work. In our office, we are proud to currently offer NuCalm or Oral Sedation (with a pill), and in 2015 we will also be offering Nitrous Oxide sedation. If you have specific questions about what kind of sedation (if any) is best for you, we would be happy to schedule an appointment to discuss. And…as always, we also offer kind, gentle, caring dentistry for everyone!
Dr. Andrea Stevens is a cosmetic and family dentist in practice in Kanata, Ontario. If you have dental questions, you can call her at 613-271-7091 or visit her at kanatacosmeticdentist.com Please also feel free to leave comments or questions below, and Dr. Stevens will be happy to answer!