When the thought of having your teeth cleaned makes your entire body tense, sedation dentistry can be your solution. Dental sedation can make your treatment easier and peaceful. Sedation can be administered in many forms from mild options to take the edge off, such as laughing gas, to options that can handle even the most severe anxiety, such as deep sedation. If you’ve never been sedated at the dentist’s office, you may wonder whether it’s safe.
The answer is…for most patients, dental sedation is very safe. This article will discuss everything you need to know.
Consider the risks of not doing sedation dentistry
Most people first consider the risks of treatment, and then secondly, they consider the risks of not doing a treatment. We want to reverse that thought process for a moment. Let’s first consider the risk of not having dental sedation
Dental fear creates physiological stress which increases risk
Think of how a stressful experience affects the body–the muscles tense, the heart races, blood pressure increases, hyperventilation begins, etc. In times of stress and anxiety, the body enters a fight or flight state of high alert. This state is natural but does pose significant stress and risk to the body. Surprisingly, patients that elect to “tough through” dental treatment with immense levels of anxiety are physiologically more likely to have a stress-related event like heart attack, stroke, seizure etc… than if they were peacefully resting through treatment with dental sedation.
Dental anxiety creates avoidance which increases the risk for dental decay and periodontal disease
Everyone has something they fear. Absolutely everyone. For some going to the dentist is their biggest fear. What do we do when we fear something? We avoid it. We all know avoiding things can lead to bigger problems in the future, but often fear has a power that we cannot overcome. The problem with avoiding the dentist is that tooth decay and periodontal disease begin to progress to more advanced stages that are often more difficult to treat later on. These problems, we now know, have direct links to increase risk of systemic health such as the increased risk for heart attack, stroke, Alzeihmer’s disease, and Parkingson’s disease.
Are you a good candidate for sedation dentistry?
Most healthy people are good candidates for dental sedation. Think of the millions of office procedures routinely done in other fields with sedation such as colonoscopies and endoscopies. The technique used for those routine procedures is nearly identical. Could you imagine having a colonoscopy without sedation? Why would anxious dental patients not consider a similar option?
There are two main categories that are considered before a patient is confirmed a candidate for sedation dentistry— Allergies and Uncontrolled Medical Conditions
There are numerous types of medications that could be selected as agents to achieve dental sedation. If a patient has had reactions in the past to any medications or foods this should be discussed with your dental sedation specialist prior to scheduling treatment so that the ideal medications may be selected. Some of the more common allergies that routinely are discussed are allergies to codeine, antiobiotics, eggs, diary, and sensitivity to epinephrine.
Uncontrolled Medical conditions
Your sedation dentist will also thoroughly review your medical history and medications prior to any treatment. The goal is to determine that the patient’s medical history is stable without any conditions that pose a risk for interactions. Most healthy patients are candidates for dental sedation, but there are some conditions which may contraindicate sedation or require consultation with the primary care physician. Some common medical conditions that require consideration before dental sedation are history of uncontrolled thyroid conditions, uncontrolled diabetes, uncontrolled liver or kidney conditions, pregnancy, severe use of recreational drugs, and acute or chronic respiratory issues.
Everyone responds a little differently to dental sedation
All patients are unique in their genetics, level of anxiety, and medication history. These factors all play a role in how your sedation dentist will anticipate you to respond during dental sedation. By collecting a thorough understanding of who you are and your health history the sedation dentist will have a good prediction of how you will respond to the various options of medications available during dental sedation. Even though your sedation dentist will be able to make a good prediction, there is still some variability to how the patient will respond during sedation. That is why sedation dentists do something called titrating. A sedation dentist will always test a small dose of a medication and slowly ramp up the dosage based on how the desired effect is presenting.
Make sure you have a sedation dentist that is experienced in all facets of dental anxiety and sedation dentistry
Sedation dentistry is a varied arena in dentistry. Some dentists have no experience with dental sedation, others may offer only limited options like laughing gas or oral sedation, and a few may have the ability and experience to offer a full fleet of anesthesiology and dental sedation options.
If you have only mild anxiety, your options will be quite flexible. However, if you have severe anxiety, you should spend time researching which dental practices in your region truly have the most experience with dental anxiety and dental sedation. The leading sedation practices will be able to customize treatment, sequence treatment, and offer sedation options to best fit your needs. They will typically offer to begin with a sedation option which will fully cover your fears, and then for future treatment potentially graduate you to minimal sedation options as you build trust and dental confidence.
A trend we sometimes see is that a dental practice that offers only laughing gas may persuade you from other options, and an office which offers only oral sedation may persuade you from IV sedation when in reality other options may be better suited for you. If you feel you are not comfortable with the sedation options presented, always feel comfortable to have a second opinion prior to deciding.
So which dental sedation option is the safest?
With proper candidate selection, planning, and with a trained sedation dentist, any of the sedation options your choose are very safe. Your choice for which type of sedation does not need to be made based on safety, but rather what is the best option for your level of anxiety, medical history, and background. The primary options for dental sedation are nitrous oxide (laughing gas), oral sedation (you take a series of pills prior to and during treatment), and IV sedation (medications are precisely titrated with an IV). All these options will help to reduce anxiety and make treatment more comfortable. With all sedation options, you will be breathing on your own and will be arousable when tapped for a response. During the procedure, you are closely monitored at all times. For oral sedation, and IV sedation the monitoring includes continuous monitoring of pulse, blood pressure, blood oxygen, blood CO2, and respiration. With all dental sedation options, the primary medications are also completely reversible. If there is a concern at any point about safety, the medications may be quickly reversed and you will be successfully rescued.