Sedation Dentistry Cincinnati
Sedation dentistry is used to provide a relaxing, fear and anxiety-free experience for certain people receiving dental treatment. It enables individuals who experience fear or anxiety about their dental care to receive the dental treatment needed to maintain sound and emergency free oral health.
Fear and anxiety are two terms that are often used interchangeably, but there is a distinct difference. Fear tends to be a short-lived phenomenon that disappears once the threat or danger passes. Anxiety, however, is more of an internal emotional response, one learned from either personal negative experiences or second hand via the recounts of others. When the fear or anxiety presents they ignite your sympathetic nervous system, the "Fight or Flight" control center, takes over apprehension overwhelms you and you feel like a mess.
If you have any of the following:
- Fear of dental treatment
- History of traumatic dental experiences
- Difficulty getting numb
- Very sensitive gag reflex or difficulty opening
- Extremely sensitive teeth
- Limited time to get your dental care completed
- Complex dental problems; or a need for surgery
- Above average disdain for “getting numb”
- Embarrassment about your teeth
- In denial of a dental problem until the pain is unbearable
- Have not received professional dental care in many years, perhaps decades
- Go from dentist to dentist, or doctors, to renew painkiller prescriptions for dental problems
- Often make and then cancel dental appointments
- Make numerous, lengthy phone calls to the dentist's office
- Experience sweaty palms or find yourself gripping the armrests
…then yes, you are a candidate for sedation dentistry!
At Fennell, Baron & Yoxthimer, your fears and anxieties will be given the same diagnostic attention as your dental needs, you can relax. We focus on being gentle, friendly, and attentive – all in a relaxing and modern facility.
Sedation dentistry usually takes the form of three different types.
- Conscious sedation involves the use of nitrous oxide, or laughing gas.
- Oral sedation involves taking a pill to help control anxiety.
- IV sedation simply means that the patient is given medications to control anxiety through an IV line, directly into the venous circulation.
Nitrous Oxide and Oxygen ("laughing gas") has been used as the most frequent and primary means of Sedation used in Dentistry for many years. 35% of all US dentists offer Nitrous Oxide Sedation to their patients.
Advantages or Dental Inhalation Sedation:
- Works well for mild to moderate anxiety
- Rapid Onset
- Flexible duration can be used for any appointment length
- Absolute Control. It is easy to quickly control the level of sedation which may be altered moment to moment.
- People recover quickly
- Very few side effects
- There is an analgesic effect
- You can drive yourself to and from your dental appointment
- You can return to normal activities immediately
- Disadvantages of Dental Inhalation Sedation:
- Severe anxiety may require a deeper level of sedation
- Not indicated for people who have respiratory problems (Asthma and Emphysema)
- Claustrophobic patients do not like anything covering their nose
- What medications are used for Dental Inhalation Sedation?
- Nitrous Oxide (N2O)
- Oxygen (O2)
The safety features of the machine insure a patient receives no less than 30% Oxygen mixed with Nitrous Oxide. Usually the patient receives 50 to 70% Oxygen.
Oral Medication used for Oral Conscious Sedation in dentistry are from a group of drugs known as Benzodiazepines. Not only do these medications have a sedative effect they also have some degree of amnesic effect for most people. Patients remember little or nothing about their dental appointment.
Advantages to Dental Oral Sedation:
- Easy to administer: Swallow a small pill
- It is safe and easy to monitor
- Works well for most people
- Low Cost
Disadvantages of Dental Oral Sedation:
- The level of Sedation is not easily changed
- Someone must drive you to and from your dental appointment
- There is no analgesic (pain relief effect)
What medications are used for Dental Oral Sedation?
- The most common medication is Halcion (triazolam). Halcion provides a deep level of relaxation and amnesia effect.
- For children the most common medication is Versed (Medazolan) which is a liquid.
IV “Intravenous” Sedation:
IV Sedation also known as Deep Conscious Sedation can be used by dentists with specialized training and special certification. With this type of sedation, medications are administered directly into the blood stream. The greatest advantage of IV Sedation is that if someone is not sedated enough, the doctor can administer more medication and the effects are instantaneous. IV Sedation is not used commonly in most dental offices because of the specialized advanced training required and the requirements for certification by the State Board of Dentistry. All the doctors at Fennell, Baron & Yoxthimer are qualified to provide IV sedation and are Advanced Cardiac Life Support (ACLS) certified. The drugs used for IV Sedation are more effective then the same drugs taken orally. There is a more profound amnesia associated with this technique.
Advantages of Dental IV Sedation:
- IV sedation tends to be the method of choice if you don't want to be aware of the procedure - you "don't want to know". The alternative in the US is oral sedation using Halcion, but oral sedation is not as reliably effective as IV sedation.
- The onset of action is very rapid, and drug dosage and level of sedation can be tailored to meet the individual's needs. This is a huge advantage compared to oral sedation, where the effects can be very unreliable. IV sedation, on the other hand, is both highly effective and highly reliable.
- The maximum level of sedation which can be reached with IV is deeper than with oral or inhalation sedation.
- IV medications used produce amnesia for the procedure.
- The gag reflex is hugely diminished - people receiving IV sedation rarely experience difficulty with gagging. However, if minimizing a severe gag reflex is the main objective, inhalation sedation is usually tried first. Only if that fails to diminish the gag reflex should IV sedation be used for this purpose.
- Can be ideal for those with a phobia of dental injections.
- Unlike General Anesthesia or Deep Sedation, conscious IV sedation doesn't really introduce any compromises per se in terms of carrying out the actual procedures, because people are conscious and they can cooperate with instructions, and there is no airway tube involved.
- Are there any disadvantages?
- A needle is placed in the arm or hand ("venipuncture"). This is done with the aid of inhalation sedation ("laughing gas") prior to the venipuncture. This relaxes you and produces a tingling feeling in arms and legs which distracts from the venipuncture.
- It is possible to experience complications at the site where the needle entered, for example hematoma (a localized swelling filled with blood).
- Recovery from IV administered drugs is not complete at the end of dental treatment. You need to be escorted by a responsible adult.