What Is Sedation Dentistry and When Is It Used?
Sedation dentistry uses medication to help a patient feel calmer and more comfortable during dental treatment. It may be used for dental anxiety, a strong gag reflex, difficulty remaining still or procedures that are lengthy or complex.
Sedation and pain relief are not the same. Sedation reduces awareness and anxiety, while local anaesthetic numbs the treatment area. In most cases, a dentist still uses local anaesthetic even when the patient is sedated.
Are You Awake During Sedation Dentistry?
Whether you remain fully awake depends on the type and depth of sedation.
With lighter sedation, you remain awake and can respond to instructions. Under moderate sedation, you may feel very relaxed and remember little of the procedure. Deeper sedation reduces awareness further and requires closer monitoring.
General anaesthesia is different from conscious sedation. It makes the patient fully unconscious and is usually provided in a hospital or suitably equipped facility by an appropriately qualified practitioner.
The planned level of sedation may be adjusted according to the patient, procedure and response to the medication.
What Types of Dental Sedation Are Available?
The options available depend on the dental clinic, the practitioner’s qualifications and the patient’s medical history.
Nitrous Oxide Sedation
Nitrous oxide, sometimes called happy gas, is inhaled through a small mask placed over the nose. The patient remains awake but may feel calmer, lighter or less concerned about the treatment.
The amount can be adjusted during the appointment. Once treatment is complete, the patient breathes oxygen and the effects usually wear off relatively quickly.
Nitrous oxide is commonly used for mild to moderate anxiety and shorter procedures. It may not provide enough support for severe anxiety or extensive treatment.
Oral Sedation
Oral sedation involves taking prescribed medication before the appointment. It can produce a deeper sense of relaxation than nitrous oxide, although the effect varies between patients.
You may feel drowsy and remember little of the treatment, but you are generally still able to respond when spoken to.
Because the medicine continues to affect alertness after the appointment, you will need a responsible adult to take you home and supervise you according to the dental team’s instructions. You must not drive, work, drink alcohol or make important decisions while the sedative remains active.
Intravenous Sedation
Intravenous or IV sedation is delivered through a vein. It takes effect quickly and can be adjusted during the procedure.
Most patients remain conscious and can respond to instructions, but they may have little memory of the appointment. Breathing, oxygen levels, heart rate and blood pressure are monitored throughout treatment.
IV sedation may be considered for significant dental anxiety, longer appointments or more complex procedures. It must be administered by a practitioner with the appropriate training, facilities and monitoring equipment.
General Anaesthesia
General anaesthesia makes the patient fully unconscious. It may be considered when dental treatment cannot be completed safely with conscious sedation or when the procedure is particularly extensive.
It carries different risks and requires a higher level of medical support than other forms of sedation. The patient must be assessed carefully, and the anaesthetic must be administered in an appropriate setting.
When Is Sedation Dentistry Used?
Sedation may be considered when anxiety, physical responses or the complexity of treatment would otherwise make dental care difficult.
Common reasons include:
- Severe fear of dental treatment
- Previous distressing dental experiences
- A strong gag reflex
- Difficulty becoming numb with local anaesthetic alone
- Difficulty sitting still for a long period
- Physical or developmental conditions that affect cooperation
- Very sensitive teeth
- A low tolerance for dental procedures
- Several treatments planned in one appointment
- Complex oral surgery
Sedation is not automatically required for procedures such as tooth extraction, root canal treatment or implant surgery. Many patients manage these treatments with local anaesthetic alone. The decision is based on the individual patient and the planned procedure.
Does Sedation Dentistry Stop Pain?
Sedation can reduce fear and awareness, but it does not reliably numb the tooth or gum. Local anaesthetic is usually used to block pain in the treatment area.
A sedated patient may still feel pressure, vibration or movement. These sensations are different from sharp pain.
The dentist checks that the area is numb before treatment begins. If you feel pain during lighter sedation, you should still be able to alert the dental team so that the anaesthetic can be adjusted.
Who May Not Be Suitable for Dental Sedation?
Sedation is not suitable for everyone. The dentist or sedation provider must review your general health, medicines, allergies and previous reactions to anaesthesia or sedation.
Additional assessment may be needed if you:
- Are pregnant
- Have breathing or heart problems
- Have obstructive sleep apnoea
- Have liver or kidney disease
- Take medicines that cause drowsiness
- Have previously reacted badly to sedation
- Use alcohol or recreational drugs
- Have difficulty breathing through your nose
- Have recently been unwell
These factors do not always prevent sedation, but they may change the type used, the required setting or whether medical clearance is needed.
It is important to provide an accurate list of prescribed medicines, over-the-counter products and supplements. Sedatives can interact with other substances, so no relevant information should be withheld.
How Do You Prepare for Sedation Dentistry?
Preparation depends on the form of sedation. The dental team will provide specific instructions before the appointment.
These may cover:
- When to stop eating and drinking
- Which regular medicines to take
- What clothing to wear
- Whether you need an adult escort
- Transport home
- Supervision after treatment
Follow the fasting instructions exactly when they are given. Eating or drinking outside the permitted times can increase risk and may result in the appointment being postponed.
Do not take extra sedatives, alcohol or recreational drugs before treatment. Only take medication that has been prescribed or approved for the appointment.
What Happens During the Appointment?
Before beginning, the dental team confirms your medical information and checks that the preparation instructions have been followed.
The sedative is then given using the planned method. Depending on the level of sedation, the team may monitor:
- Breathing
- Oxygen level
- Heart rate
- Blood pressure
- Level of responsiveness
Local anaesthetic is given once you are comfortable. Treatment begins after the dental team confirms that the area is numb and the sedation level is appropriate.
How Long Does Recovery Take?
Recovery depends on the medication, dose, treatment length and the individual patient.
The effects of nitrous oxide generally wear off faster than oral or IV sedation. Oral and IV sedatives can affect judgement, coordination and memory for the rest of the day and sometimes longer.
After oral or IV sedation, you will usually need a responsible adult to:
- Take you home
- Stay with you for the advised period
- Help you follow aftercare instructions
- Make sure you do not drive or use machinery
You may remember little of the appointment, so written instructions should be provided to both you and your escort.
Return to normal activities only when permitted by the treating team.
Is Sedation Dentistry Safe?
Dental sedation is generally safe when the patient is properly assessed, the appropriate method is selected and treatment is provided by qualified dental professionals with suitable monitoring and emergency equipment.
However, all forms of sedation carry some risk. Possible effects include:
- Drowsiness
- Nausea
- Dizziness
- Headache
- Temporary confusion
- Changes in breathing, heart rate or blood pressure
- An unexpected reaction to the medication
The likelihood and seriousness of these effects vary according to the type and depth of sedation. Your provider should explain the expected benefits, possible risks and available alternatives before you consent to treatment.
Final Answer
Sedation dentistry uses medication to reduce anxiety and awareness during dental treatment. It may be helpful for patients with strong dental fear, a sensitive gag reflex, difficulty remaining still or a need for lengthy or complex care.
Most dental sedation does not make the patient fully unconscious, and local anaesthetic is still usually required to control pain. The safest option depends on the patient’s health, level of anxiety and planned procedure, so a medical and dental assessment is required first.
