Sedation dentistry is the use of medication to help the patient stay calm and relaxed during a dental procedure. This process is also commonly referred to as sleep dentistry. Sedative drugs make patients less anxious, reduce stress and memory of the treatment, and can make dental work less ominous; especially when invasive procedures are involved. At the same time, sedation dentistry makes operating easier for the dentist because it allows them to fully concentrate on a more calm and co-operative patient.
A Brief History of Sedation Dentistry
Sedation dentistry has been around for quite some time now, and it has a pretty colorful history – one that is largely rooted in Boston. Back in 1845 Horace Wells, a Connecticut-based dentist decided to use nitrous oxide to aid him in removing an aching tooth. His first successful attempt encouraged him to carry out more similar experiments in his Boston clinic. While not all of his ongoing experiments were successful, this was the beginning of what we now know today as sleep dentistry.
Later in 1846, William Morton conducted a similar experiment using ether in the place of nitrous oxide. The dental surgery went on smoothly and the patient did not experience any pain or discomfort, which was considered a great success. In fact, the word anesthesia was coined from this particular experiment. Morton’s discovery launched the use of ether as aesthetic in dental procedures and general surgery.
Dentists owe a lot to Horace Wells and William Morton for their early discovery of nitrous oxide and ether as sedative drugs. Today, dentists often use nitrous oxide in sleep dentistry, as it is simple to use, comparatively safe and compatible with a wide range of other drugs used is dentistry.
Types of Sedation Used in Dentistry
There are four general types of sedation used in dentistry. These are:
• Inhaled minimal sedation: This is where nitrous oxide gas combined with oxygen is breathed in through a mask. The gas helps to keep the patient calm and relaxed throughout out the procedure. The dentist controls the amount of sedation received. Typically, the gas wears off quickly and the patient is even allowed to drive home after the appointment.
• Oral sedation: This kind if sedation can range from minimal to moderate depending on the level of dosage. For minimal sedation, the dentist will give a pill to the patient an hour before the procedure. Typically, the pill will cause a little drowsy but the patient will remain awake throughout the procedure. A larger dose often produces moderate sedation that may actually cause the patient to fall asleep during the procedure.
• IV moderate sedation: With this type the sedative is administered intravenously and goes to work almost instantly. The dentist is able to adjust the level of sedation continuously throughout the procedure.
• Deep sedation and general anesthesia: This kind of sedation makes you either partially unconscious or totally unconscious, and you will be deeply asleep during the procedure. You cannot be easily awakened while under general anesthesia unless the effect is reversed with other medication or the anesthetic effect has worn off.
Benefits of Sedation Dentistry
Sedation dentistry comes with lots of benefits to both the patient and the dentist. Below are the most notable ones;
Dental phobia and anxiety keeps away over 12% of patients with dental problems from making a visit to their dentist. Many others postpone treatment as a result of dental fear and anxiety. Sedation dentistry is used to transform dental appointments into more pleasant experiences, will minimal stress caused by fear.
2. No discomfort
Anyone can benefit from the comfort of sedation dentistry. Patients often feel less tired and less fatigued after a lengthy dental procedure if they have been sedated. Patients with dental problems such as jaw soreness and TMJ are much more comfortable through the use of sedation dentistry. Sedation procedures involving nitrous oxide can increase a patients pain threshold and make the experience less painful and scary.
3. Saves time with fewer appointments
Sleep dentistry helps patients to withstand longer procedures with minimal exhaustion or discomfort from keeping their mouth open. Additionally, dentists can operate for longer hours with ease. With sedation dentistry, multiple or complex procedures that would otherwise require many appointments can be done in a single appointment.
4. Movement control
Sedation limits patient’s movement during a dental procedure, which is extremely important in procedures that are affected by the patients’ movement. The unexpected or uncontrolled movement can sometimes make it impossible for certain procedures to be carried out unless the patient is sedated. In more sensitive procedures, conscious sedation may not be enough and deep sleep sedation may be necessary.
5. Improved patient co-operation
Patient’s cooperation is another very important aspect to consider when carrying out dental procedures. Some very anxious kids and patients with mental conditions can be very uncooperative unless sedated.
6. Managing the gag reflex
Sedation dentistry comes with an added advantage of minimizing the gag reflex. Gagging, especially the one induced by anxiety can be successfully managed using sedation. Sedation dentistry can come in handy for patients with sensitive gag reflex who often feel the urge to throw up when the dentist is working in their mouth.
Dental Procedures That Require Sedation Dentistry
Most dental procedures can benefit from sedation dentistry, but the most common ones include gum surgery, extractions, veneers, dentures, bonding and root canals. The behaviour and condition of the patient can also influence the decision on sedation. Generally, sedation dentistry is very beneficial to the patient if they:
• Have low pain threshold
• Have very sensitive teeth
• Can’t relax in a dentist’s chair
• Have a sensitive gag reflex
• Need complex or multiple dental procedures done
• Are very afraid of the dentist
• Get easily distressed with smells, noise and tests common with dental procedures
• Are restless or have a mental condition
Qualifications for Sedation Dentistry in Australia
Many countries and states have state organs that oversee and regulate standards and qualifications in the medical field. In Australia, medical practitioners are generally overseen by the Australian Health Practitioner Regulation Agency (AHPRA) while dental practitioners in particular are overseen by the Dental Board of Australia.
Generally, most dentists are allowed to administer minimal sedation, however, only a few dentists who have earned the Dental Board of Australia accreditation in deep sleep sedation and general anaesthesia can use such complex sedation techniques. Such dentists are typically maxillofacial and oral surgeons who are often trained to give all levels of anaesthesia.