Dental treatments can relieve pain and other symptoms of oral health problems, but some people associate going to the dentist with pain. This may be due to misconceptions or bad experiences they've had in the past, before painless dentistry became the standard.
Today, dentists use a range of sedation options to prevent pain during procedures and to help nervous or anxious patients feel calm so they can get the dental care they need. Read this guide to find out who can benefit from dental sedation, what your options are and how they work.
Who can benefit from sedation dentistry?
Anaesthesia is routinely administered before any dental procedure that may cause pain, but recommendations for other types of sedation will depend on the individual and the type of procedure you're having.
You could be a candidate for sedation dentistry if:
- you have dental anxiety, a fear of dental procedures or other anxiety that may affect your visit
- you have sensitive teeth or gums that are more likely to feel discomfort when touched
- you have a low pain threshold or resistance to local anaesthetic and require more pain relief
- you have a bad gag reflex and need help calming your muscles
- you're having a long or complex procedure or multiple procedures
- you've had bad dental experiences in the past that make you concerned about visiting the dentist today
Dental sedation is not usually necessary for treatments such as routine teeth cleaning and polishing or teeth whitening, unless you have more severe anxiety, but it may be requested for everything from simple fillings to complex procedures such as placing dental implants.
What is sleep dentistry?
Sedation dentistry is sometimes known as sleep dentistry. This term can be misleading, as patients remain conscious under most types of sedation, though in a 'twilight' state of relaxation where you may feel as if you've been asleep with no memory of the experience.
Some people may fall asleep under sedation, but you will normally be awake and able to follow your dentist's instructions, depending on the level of sedation used. The exception is general anaesthesia, which induces unconsciousness for more complex procedures or severe dental phobia.
Levels of sedation
The type and level of sedatives your dentist recommends will depend on the effect you want to achieve. Sedation dentistry may be categorised as:
- Minimal sedation – you will be awake and able to respond to your dentist, but you should also feel calm and free from pain
- Moderate sedation – you may fall in and out of sleep and slur your words, but will usually be responsive
- Deep sedation – you are likely to fall asleep and may need to be woken after the procedure
- Deep sleep – you will be unconscious throughout the procedure
Types of dental anaesthesia and sedation
Sedation dentistry may use a range of sedatives, including anti-anxiety medications, depressants and tranquillisers. These are administered at precise levels by your dentist or anaesthetist and may be delivered orally (in tablet form), intravenously (through injection) or inhaled (through a face mask).
The most common sedation options are:
- Local anaesthesia
- Nitrous oxide sedation
- Oral sedation
- Intravenous (IV) sedation
- General anaesthesia
Your dentist will make sure you know what these methods involve and the possible risks so you can make informed decisions about the best sedation option for you or your child.
While other types of sedation may be used at the dentist's and patient's discretion, local anaesthetic is used as a matter of routine for any dental procedure that may involve pain. However, your dentist may offer alternative pain relief if you have a fear of needles.
Anaesthetic is injected into the specific area of the mouth being treated to numb pain responses sent from the nerves to the brain. This allows dental procedures such as fillings and root canal therapy to be completed without causing pain. Anaesthetic is not required for non-invasive treatments such as dental cleans.
The numbing effect of anaesthesia is temporary, but will last until after the procedure has been completed. If there may be pain during the recovery period, your dentist may recommend over-the-counter pain relief medication or other remedies to help, depending on the treatment.
If you're concerned about the pain of the anaesthetic injection itself, many dentists apply a topical anaesthetic to the area beforehand, so you may not feel the injection.
Nitrous oxide sedation
Also known as laughing gas or happy gas, nitrous oxide is considered a safe and effective sedative for patients of all ages, including young children. The gentle sedative helps to reduce anxiety and can also provide additional pain relief.
Nitrous oxide is administered through a nasal mask where it's inhaled into the nose. Patients report feeling calm, light, giggly or even euphoric when under nitrous oxide. You will normally remain conscious, but your response times will be slower.
The sedative can take a few minutes to take effect and its effects will normally wear off after the mask is removed. Unlike other sedatives, there is no recovery period involved, so you may drive and resume work or other activities on the same day.
If you want a deeper form of sedation, one option is oral sedatives. Your dentist will prescribe a pill that should be taken up to an hour before your procedure, so it will take effect on time. Local anaesthetic will also be used before your procedure.
You will normally remain conscious but drowsy with oral sedation, though some people fall in and out of sleep. As well as feeling more relaxed, you may notice that your response time and coordination are impaired. You may also experience memory loss or feel as if time passes quickly while you are sedated.
The effects of oral sedation can take time to wear off, so you should arrange to have someone take you to and from your appointment and not drive yourself. This type of sedation is not generally recommended if you are in poor health or for children under 12.
Intravenous (IV) sedation
A deeper level of sedation that may be recommended for more anxious patients or for a longer procedure, IV sedation induces a deep state of relaxation. You will normally be conscious, but may be prone to falling asleep and are likely to have little to no memory of the experience after.
Intravenous sedation is administered through injection and combined with local anaesthetic for pain relief. This means it takes effect quickly and can be adjusted as needed throughout your appointment, but it may not be suitable if you have a fear of needles.
The sedatives can take some time to leave your system afterwards, so it's recommended that you avoid driving or operating machinery for 24 hours.
The deepest level of sedation, general anaesthetic is administered by a specialist anaesthetist, either at a dental clinic or in a hospital. This may be recommended for severe dental anxiety or if you're having a long or complex procedure, such as multiple wisdom tooth extractions.
This method of sedation involves a combination of inhalation and intravenous injection. You will first inhale sedative that helps you to relax and numbs the pain of the anaesthetic injection. The anaesthetic will then put you to sleep and you will only regain consciousness after the procedure.
The effects of general anaesthetic last for longer than the alternatives, so you will need to arrange transport home after your appointment and to rest for up to 48 hours. General anaesthesia may be provided for adults or children, but it may not be an option if you have certain health conditions.
Can I avoid injections if I have sedation?
If you have a fear of needles or want to avoid injections, your dentist may discuss options such as oral sedation and nitrous oxide. However, these methods also normally require an injection of local anaesthetic to numb pain.
This will be done after sedation has taken effect, so you will feel relaxed and may not notice the injection happening. Topical anaesthetic may also be applied before an injection to numb the pain of the injection itself.
Is dental sedation safe?
There can be risks involved in any type of sedation, but these will be minimised when anaesthetic or sedatives are provided by a qualified dental professional or anaesthetist. They will ensure that the correct level of sedatives is used and monitor your responses throughout the procedure.
Some types of sedation will not be recommended if you have poor health, certain medical conditions or are taking certain medications. Some options are not suitable for children, but nitrous oxide is safe and widely used in children's dentistry.
If you avoid going to the dentist because of anxiety, this can put your oral health at risk, which may also affect your general health and wellbeing. Dental sedation and sleep dentistry are options to help you get the care you need.
Find out more about dental sedation in Brisbane
If you want to know more about your sedation options and other ways to help you manage dental anxiety, contact our friendly team at Face Value Dental today.
Better Health Channel. Dental anxiety and phobia [Online] 2017 [Accessed February 2022] Available from: https://www.betterhealth.vic.gov.au/health/ConditionsAndTreatments/dental-anxiety-and-phobia