Sedation Dentistry: What You Need To Know

Costello Family Dentistry is the trusted source for safe, comfortable sedation dentistry in Carleton Place and surrounding communities.

What is Sedation Dentistry?

Sedation dentistry is the the practice of using medication to help patients relax while they are having a dental procedure performed in their mouth. It is an especially effective practice for patients with severe anxiety, or phobias about dental procedures, or for patients receiving a procedure which could cause more pain than a safe dosage of a local anesthetic can fully mitigate.

Levels of Sedation

There are four levels of sedation that a patient could receive for a procedure.

  • Minimal sedation where the patient is awake but relaxed.
  • Moderate sedation where the patient is awake but has slurred speech and won't remember much of the procedure.
  • Deep sedation where the patient is barely conscious but still awake.
  • General anesthesia where the patient is completely unconscious.

Dentist holding a nitrous oxide mask
Female dentist performing a procedure on a sedated patient.

Types of Sedation used in Dentistry

There are four types of sedation that are commonly used in sedation dentistry.

Inhaled Sedation

The patient inhales a mixture of nitrous oxide, or "laughing gas," and oxygen through a mask placed on the nose to provide minimal sedation. The dentist controls the amount of gas the patient receives and it tends to wear off quickly.

Oral Sedation

The patient is given a pill to take orally about an hour before the procedure. Depending on the dosage given, the level of sedation can range from minimal to moderate. As the sedative takes effect, the patient will feel drowsy but still be awake. In some cases, the sedative can make the patient drowsy enough to fall asleep. However, they can usually be woken up by a gentle shake. This type of sedation is most commonly associated with sedation dentistry.

IV Sedation

Intravenous sedation involves injecting the sedative medication directly into the patient's veins. This allows the sedative to take effect more quickly than with oral or inhaled sedation. The dosage is then controlled by the dentist as needed, aiming for a moderate level of sedation.

Deep Sedation & General Anesthetic

Stronger medications are given to the patient to bring them to a barely conscious, or unconscious state. If the patient is under the effects of a general anesthetic, they are in a deep state of sleep that they can't be awoken from until the effects of the anesthetic wears off, or is reversed with medication.

Regardless of the type of anesthetic a patient receives, they will also often need a local anesthetic like dental freezing to mitigate pain in the area of the mouth where the dentist is working. This combination allows patients to remain comfortable while the dentist completes their work.

Dentist performing a procedure on a sedated patient
sedation dentist administering nitrous oxide before a procedure

Who Can Benefit from Sedation Dentistry

On top of being a great help for people who struggle with fear and anxiety about dental procedures, sedation dentistry can benefit patients with:

  • A low pain threshold.
  • Problems sitting still in the dental chair
  • Very sensitive teeth
  • A bad gag reflex
  • A need for a large amount of dental work

Risks of Sedation Dentistry

There is always a risk involved with using an anesthetic medication. Patients can have an unexpected reaction to the medication, or an improper dosage could be administered. A dentist who is experienced in sedation dentistry will know what information to ask for when consulting with the patient and will know how to control the dosage of the anesthetic, making these risks particularly low.

People who are obese, or have obstructive sleep apnea are at greater risk of complications from sedation dentistry and need to consult with their doctor before undergoing any dental procedures with sedation.

Who can perform Sedation Dentistry

Most dentists are able to administer minimal sedation in the form of nitrous oxide and oral medication. Many dentists these days have also received training to administer moderate oral sedation. In order to be able to administer IV sedation, deep sedation and general anesthesia, a dentist must become certified by the dental regulatory authority in their province. For Ontario, that is the Royal College of Dental Surgeons of Ontario. Dentists who receive this certification are usually oral and maxillofacial surgeons and dental anesthesiologists. These types of dentists are qualified to administer any type of sedation to both children and adults. Often times, a dental anesthesiologist will work closely with a dentist who is not qualified to administer heavier forms of sedation.

Teenage boy receiving nitrous oxide sedation in a dental chair.