Anxiety-Free Dental Treatment
Sedation Dentistry Edmonton, Alberta
Dr. Nathaniel Podilsky offers sedation dentistry at his Edmonton, Alberta practice.
When an anti-anxiety drug is administered into the blood system during dental treatment, this is called Intravenous Conscious Sedation (aka "IV sedation"). Conscious sedation is often incorrectly referred to as "twilight sleep" or "sleep dentistry.” Deep sedation is not used in dental procedures, and is more closely related to general anaesthesia. Unlike deep sedation or general anesthesia, patients breathe normally and do not need a breathing tube placed in their throat. To learn more about sedation dentistry, contact our Edmonton, Alberta practice.
The Sedation Dentistry Experience
You remain conscious during IV sedation. You will also be able to understand and respond to requests your dentist makes.
However, you might not recall much about what went on because of two factors: First, in most people, IV sedation induces a state of deep relaxation and ambivalence. Secondly, the drugs used for IV sedation can produce partial or full memory loss (amnesia) from when the drug takes effect until it wears off. Time will seem to pass very quickly and you won’t recall much, if anything, of what happened. So it might seem like if you were "asleep" for the duration of the procedure.
The drugs used for IV sedation are anti-anxiety drugs, not painkillers. While they relax you and make you forget the procedure, you will still require anesthesia.
If you have a phobia of injections, you will not be numbed until the IV sedation taken full effect. If you are afraid of needles, you will likely be relaxed enough not to care by this stage. Your dentist will then wait until the local anaesthetic has kicked in before beginning the procedure.
How the Sedatives are Administered
"Intravenous" means that the drug is administered directly into a vein. A thin needle is put into a vein close to the surface of the skin in either your arm or the back of the hand. The needle is placed in a soft plastic tube. The needle is inserted into the vein, then is removed, leaving the plastic tube in place. The drugs are administered through the tube, which stays in place for the duration of the procedure.
During Sedation
Your safety is important to us. During the procedure, your pulse and oxygen levels are monitored. A sensor clips onto a finger or an earlobe and measures pulse and oxygen saturation. It gives an early warning sign if you are dangerously low on oxygen. Also, someone is always there to observe your breathing. Unresponsiveness and slow breathing are the warning signs. Other vital signs, like blood pressure and heart rate are also monitored. We also use a stethoscope head connected to a bluetooth ear piece to help us monitor your breathing.
Drugs Used in Sedation Dentistry
Drugs used for IV sedation are benzodiazepines. These drugs have 3 main effects: they reduce relax you, they make you drowsy, and they give you partial or total amnesia.
Other drugs used in conjunction with benzodiazepines are opiods. Along with the sedative quality, opiods offer a degree of pain relief. Codeine and oxycodone are both examples of opioids. Some people are sensitive to opioids and could develop nausea during or after the procedure. That’s why, it is important not to eat or drink for about 8 hours prior. If you ever reacted unfavorably to these drugs, tell us ahead of time so your sedation can be planned to exclude opioids.
A corticosteroid, such as dexamethasone is usually administered through the IV. This helps in reducing inflammation following surgery and reduces swelling on the day of the procedure.
For lengthy and complicated procedures, an IV pain killer like Toradol might be administered when the procedure is complete. This minimizes the discomfort following the procedure, until patient can return home, eat, and take oral pain medications.
Sedation Dentistry Precautions
IV sedation is safe when administered under the supervision of an experienced dentist. Statistically speaking, the procedure is safer than a local anaesthetic alone! There are contraindications such as pregnancy, CNS depression, having an allergy to benzos, alcohol intoxication, and glaucoma, in some instances. Precautions should be taken if you experience psychosis, impaired lung or kidney or liver function, and advanced age. Heart disease is not normally a contraindication.
Advantages of Sedation Dentistry
IV sedation is usually the method of choice if you don't want to be aware of the procedure. The alternative is oral sedation using Halcion, but taking sedatives orally is not as reliably effective as IV sedation. The onset of the drug is rapid, and your dosage and level of sedation can be tailored to meet your needs. This is a big advantage compared to oral sedation. On the other hand, IV sedation is reliable and effective. The maximum level of attainable sedation via IV is deeper than with oral or inhalation sedation. The gag reflex is diminished greatly. People receiving IV sedation rarely gag. But if minimizing a gag reflex is the goal, inhalation sedation is attempted first. If that fails to eliminate the gag reflex, IV sedation should be used for this purpose.
Disadvantages of Sedation Dentistry
A needle must be placed in the arm or hand. If you are afraid of needles, this isn't much fun. In most cases, this is over quickly. It's a good idea to bring a method of distraction you can enjoy (such as an i-pod or a game). There is a risk of complications at the site where the needle entered, such as hematoma (a localized swelling filled with blood). Recovery from IV administered drugs is not complete at the end of your treatment. You may need the help of a responsible adult.
After Sedation Dentistry
Have your escort take you home so you can rest for the remainder of the day. Have an adult stay near you until you're fully alert. Don't do any strenuous or hazardous activities and don't attempt to drive for the rest of the day. Don't eat a heavy meal right after. If you're hungry, eat a light meal like liquids and toast. If you feel nauseous, lie down for a while or enjoy some 7-up or Sprite. If nausea persists, you can take over-the-counter drugs such as Gravol but please try to contact our office first. Don't drink alcohol or take medications for the rest of the day without your dentist's consent. If you have more questions or concerns about sedation dentisty, please contact our Edmonton, Alberta practice today.
