Sedation Dentistry

What is Sedation Dentistry?

You may hear it referred to as “comfortable,” “anxiety free dentistry,” or “relaxation” dentistry, the terms describe the feelings most patients experience during their sedation dentistry appointments. The use of sedative medications can help make you more comfortable so the dentist and his team can work more effectively, accomplishing more in less time with great quality.

Trained sedation dentists have a variety of protocols available to customize to each patient’s physiological and pharmacological
needs. So even if you have a unique medical condition, there still may be options. A number of sedation dentistry drugs that can be taken by mouth have been developed especially for these purposes, subjected to rigorous research and testing, are safe and have been used for decades. Some of these can even help you remember little of the visit, preventing the sounds and smells from lingering in your thoughts. Other medications sometimes used in sedation protocols include antihistamines and insomnia medications which aid in creating a relaxing and calm experience. For more on these medications see “Understanding the Medications” on the “What’s it Like?” page.

The term “sleep dentistry” is inappropriate. Sedation patients should always be able to verbally and physically respond to cues and questions from the doctor or team.

Want to know a secret? It’s one most people don’t know. It’s simple. Dentistry does not have to be painful—or scary.

It’s important to know that a visit to the dentist can be a positive experience, even when treatment is necessary. Millions of Americans, nearly 30%, are afraid of the dentist. They avoid dental care at all costs, even when they are in pain or discomfort. But it no longer has to be that way. Modern dentistry offers safe, effective, and comfortable treatments, without the use of needles, to anxious and fearful patients. You may have heard this treatment called anxiety-free dentistry, relaxation dentistry or even sleep dentistry. The best and most accurate name is oral sedation dentistry.

These terms describe a way for you to get the care you want while you remain comfortable. The term sleep dentistry is considered inaccurate by some as it may refer to general anesthesia. You may also hear the term “moderate sedation” or conscious sedation dentistry.

Most fears develop in childhood, so odds are you have carried your dread of the dentist for years. You avoid receiving care and as a result, your dental health deteriorates. When you are no longer able to stand the pain or discomfort and finally seek treatment, extensive restorative work is required. That means more time in the dental chair, more procedures, and more expense, which only furthers your trepidation. It is a nasty cycle and it must be broken.

Dental fear is a hidden phobia—the monster in the closet that no one wants to talk about. Like many people, you may be embarrassed to admit your fears and even more afraid to confront them. Often times not even your loved ones are aware of your apprehension. Worse yet, you may have never known that oral sedation dentistry was an option.

Not anymore! Sedation Dentistry is not scary and can be pain-free dentistry.

Sedation Dentistry provides a dental experience like no other. Hours seem like minutes and recovery is a dream.

What's it like?

Sedation Dentistry provides a dental experience like no other. Hours seem like minutes and recovery is a dream. Discover the medications used and get answers to some of the most commonly asked questions. Learn more about treatment and financing, and sedation dentistry drugs.

Making your first appointment

This is difficult for many people, so we try to make this as easy as possible to reduce dental anxiety.

Simply call (or email) the office that you choose. The Sedation Team will answer any questions you have and ask you some simple questions to help ensure you get the care you want and deserve.

When you’re ready, you can schedule a time that works for you.

Welcoming visit

We gather information regarding your health and discuss with you your wants and desires. If you’re comfortable, we’ll take x-rays and look in your mouth. But you will never be judged or embarrassed.

Knowledge about oral sedation treatment is not only powerful—it is empowering. It is important to talk to your dentist about your fears and concerns during your consultation before any dentistry is ever performed. Request information on your dentist’s training, credentials, and the protocols they will use prior to the appointment. It is critical that you provide your dentist with an updated health history including any medications you are on, including vitamins and supplements. Factors like smoking and alcohol consumption can alter the effectiveness of sedation medications, so be sure to tell your doctor about any habits you may have. Even something as seemingly insignificant as drinking grapefruit juice can have an effect on sedation. The enzymes in grapefruit interfere with the systems that metabolize (break down) certain oral sedation medications in your body, so you should not consume grapefruit 72 hours prior to or immediately after a sedation procedure.

Preparing for your sedation/anxiety free visit

We’ll give you a prescription for a sedative to take the night before your first appointment to guarantee a good night’s sleep and to make sure you wake up relaxed.

Oral sedation is a popular treatment option for many people because it does not require the use of additional needles. Medications can be swallowed whole and/or crushed and administered by your dentist sublingually (under the tongue). Medications given sublingually are absorbed into the bloodstream quicker, so it is a preferred option by many dentists. Both methods are safe and effective.

The safety of sedation medications is measured by pharmacists and physicians on a scale called the therapeutic index. The larger the number is on the scale, the safer the drug. The sedation medications commonly used by dentists for oral sedation dentistry have the highest numbers possible on the therapeutic index, making them the least likely to cause an adverse reaction.

Arriving for Treatment

Your companion will bring you to the office. Additional medications will be provided to create the ultimate in relaxation. Your experienced sedation team will monitor you throughout your entire visit.

Appropriately trained dentists can perform a variety of protocols customized to your particular physiological and pharmacological needs. The medications are safe and have been used for decades. In fact, you’ve probably seen or heard some of their names before. Several have amnesic properties, meaning that you remember little to nothing of your time in the dental chair. Sometimes referred to as “comfort dentistry” or “relaxation dentistry,” it describes the feeling most patients have at their appointment.

While these methods and medications cannot make fear magically disappear, they can give you the confidence and peace-of-mind to experience dental procedures in a whole new way. Hours pass like mere minutes and more dentistry can be performed in a single visit because the dentist is able to work more efficiently. It is a win-win for both you and your dentist.

Going home with your new smile

In addition to providing your sedation dentist with a complete health history, you will need to choose a companion to drive you to and from your sedation appointment. You should not eat or drink six hours prior to your appointment unless otherwise directed by your dentist. Your health history can effect your before and after care plans, especially for diabetics and smokers, so make sure your dentist knows about any medical conditions your may have. For longer appointments, the remainder of the day should be taken off. For shorter appointments, only half a day may be necessary. Be sure to stay hydrated and drink lots of fluids. You should not drive or operate heavy machinery for 24 hours.

The next day

Most patients feel no discomfort or residual effects from the dental visit and you’ll be thrilled with all the compliments you will get.
You don’t have to take our word for it, read what patients just like you have to say about pain free dentistry.

Is it for me?

Are you…

  • Delaying treatment you need and want?
  • Scared, even terrified, to pick up the phone to schedule?
  • In pain especially when you eat?
  • Someone who has trouble with gagging or getting numb?
  • Having trouble finding someone you can trust?
  • Looking to smile again with confidence?
  • Overwhelmed by thoughts of repeated visits to the dentist?

Which patients benefit the most from sedation?

  • People with high dental anxiety and fear of the dentist
  • Those with a severe gag reflex
  • Those with time constraints—who need to get more dentistry done in fewer visits
  • Patients with chronic or acute jaw soreness
  • Or physical limitations such as back and neck problems
  • People who have difficulty getting numb
  • Those who need extensive treatment
  • And people with a desire to have dentistry done comfortably while they are fully relaxed

SLEEP DENTISTRY. ANXIETY FREE DENTISTRY. SEDATION DENTISTRY. WHAT’S THE DIFFERENCE?

Sleep Dentistry is an old term used to describe the way a patient perceived their sedation treatment. The patient never actually sleeps during the visit, but because there is little to no memory of the appointment it felt as if they were asleep. This term, sleep dentistry, is inaccurate. It may, however, be applied to General Anesthesia.

Anxiety free Dentistry is synonymous with relaxation. With this level of sedation, patients are calm and relaxed. Due to the sedative effects of the medication the patient still perceives as if hours go by in minutes.

Sedation Dentistry is a comprehensive term that refers to the use of medication to induce a comfortable dental experience. Patient may take medication before treatment as well as during treatment to maintain comfort levels.

With all these options, the patient has little to no memory of the visit and enjoys virtually no post operative discomfort.

Find an Oral Sedation Dentist who can help you choose the right level for you!

AS COMFORTABLE AS POSSIBLE

When you are afraid, your threshold for pain is much lower. You become hypersensitive to every sensation, prick, and noise. Fear and dental anxiety trigger the release of certain chemicals in your brain which put your “fight or flight” instincts on high alert. You anticipate that something is going to hurt and so you tense your muscles, even if it is subconsciously. Patients who have a fear of the dentist often experience more pain during and after their procedure. However that can virtually be eliminated with oral sedation dentistry! The whole purpose of an anxiety free dentistry or an oral sedation dentistry is to make you as comfortable and relaxed as possible to make a pain free dentistry appointment. It allows you to let your guard down, relax both your mind and body, and focus on feeling peaceful rather than anxious. Your apprehension and hypersensitivity to pain melts away.

Ask yourself – is sedation dentistry right for me?

HOW ‘DEEP’ WILL I GO? ARE THERE DIFFERENT LEVELS OF SEDATION?

There are different levels of sedation, even with oral medications. With anxiolysis, the lightest level of sedation, you usually take a single dose on the day of your appointment. To attain a longer and more comfortable experience you may opt for oral conscious sedation dentistry where unique protocols will be chosen for your unique needs and medical history.

HOURS WILL SEEM LIKE MINUTES

Once you are completely relaxed and comfortable, your sedation dentist will be able to work quickly and efficiently to perform larger amounts of dentistry in fewer visits. And since sedation medications have an amnesic effect, you’ll have very little, if any, memory of the sights, smells or sounds of your visit – making your visit feel short and sweet.

RECOVERY IS A DREAM

When your treatment is complete you may be a bit wobbly while the medications work their way out of your system but you will be able to walk. You will need your companion to take you home and stay with you until you’re fully recovered. Your sedation dentist will give you simple instructions on when and how much you should eat or drink and other important information.

You’ll be amazed at how much can be accomplished in such a seemingly short period of time, while you were totally relaxed, and completely comfortable. And best of all, the very next day you will feel fantastic.

TURN BACK THE HANDS OF TIME

Whether it’s a broken tooth that needs to be fixed, yellow teeth that need to be whitened, missing teeth that need to be replaced, or pain that needs to be eliminated, Dental Sedation can help you regain your health and have the fabulous smile you’ve always wanted. In fact, any dental procedure can be performed while you are sedated – including root canal, fillings, crowns, gum work and cleanings. You can have the smile you want, painlessly.

ACCOMMODATING YOUR BUDGET & INSURANCE

Your Sedation Dentist will work with you to maximize your insurance benefits and make convenient financial arrangements that will be as comfortable as Sedation Dentistry.

Each Sedation Dentist makes unique arrangements and choices regarding insurance. Please contact any of our Sedation Dentists in your area for more information.

UNDERSTANDING THE MEDICATIONS

Your dentist will decide which sedation dentistry drug is appropriate for your treatment plan. Being familiar with the different drugs available can also be helpful for you. There are several common medications prescribed, including, but not limited to Valium®, Halcion®, Sonata®, Ativan®, Vistaril®, and Versed®. With the exception of Vistaril®, which is an antihistamine, and Sonata®, which is a pyrazolopyrimidine (pi-raz′op;er-i-di-men), they all belong to a class of medications called benzodiazepines (ben′zo-di-az′e-pens). Benzodiazepines are commonly prescribed for the treatment of anxiety, insomnia, agitation, seizures, and muscle spasms. Taken in small doses, they are highly effective at relieving the above mentioned conditions. Each medication’s effects last for different amounts of time (called a half-life), so your dentist will determine which one(s) are best for your particular needs.

Valium® is the most widely recognized drug in the group. It has been around since the 1960’s and is a well known and time-tested sedative with amnesic properties. Valium® has a longer half-life than some of the other medications, so it is particularly useful for appointments where extensive dentistry is being performed.

Halcion® is most well known for the treatment of insomnia. It is highly effective when used in oral sedation protocols, and if deemed appropriate by your dentist, can be used in conjunction with an antihistamine like Vistaril® during your appointment. Much like Valium®, it is a popular choice for many dentists because of its amnesic properties and proven effectiveness. However, it has a shorter half-life than Valium® and is typically used for shorter appointments.

Sonata® is similar to Halcion® in that it is also commonly used for the treatment of insomnia. It is important to remember though that you are not intended to sleep through your oral sedation appointment. The goal is simply to be relaxed and comfortable throughout the procedure.

Ativan® is commonly prescribed for the treatment of anxiety. It possesses many of the desirable effects of other benzodiazepines with amnesic properties. It is an effective sedative with a medium length half-life and is useful for appointments that are longer than two hours.

Vistaril® while classified as an antihistamine, has also been shown to have anxiolytic (anti-anxiety) effects. It works well in conjunction with many of the benzodiazepines but has no amnesic properties.

Versed® has the shortest half-life of all of the benzodiazepines, lasting about an hour, and making it ideal for short appointments or simple procedures. It has many of the same anxiolytic and amnesic benefits of other benzodiazepines, but is less commonly used because of its duration.

WHAT ARE SOME COMMON SIDE EFFECTS OF THE MEDICATIONS?

Retrograde Amnesia or little to no memory —Many of the medications have an amnesic effect. Patients often remember little-to-nothing of their time in the dental chair by the next day.

Less Post-Operative Soreness—Fear can make your threshold for pain much lower by triggering the release of certain chemicals in the brain, like adrenaline, which put “fight or flight” instincts on high alert. Anticipation can cause muscle tension, even if it is subconsciously, leading to additional soreness post-treatment. With sedation, apprehension and hypersensitivity to pain is virtually eliminated, thus reducing the likelihood and severity of post-operative discomfort.

Dry Mouth—The sedatives administered during a sedation appointment decrease salivary flow, making it easier for the dentist to do his/her best work!

Experience what feels like sleep dentistry in your town.

IS THIS DIFFERENT THAN TAKING VALIUM® BEFORE MY APPOINTMENT?

If you have taken Valium® in the past for dental treatment, than you are already aware of some of the potential benefits of oral sedation. However, there is more to sedation dentistry then just Valium®. Countless years of research have been dedicated to studying and finding methods and new medications to alleviate pain and anxiety since Valium’s® arrival on the market in 1960’s. Additionally, there are many other components of sedation dentistry that are important that make a visit to the dentist safer and more comfortable including monitoring, benzodiazepine reversal agents, patient health history intakes, and drug-drug interaction/contraindication screening. Providing optimum sedation through DOCS’ safe and predictable sedation protocols enables sedation dentists to provide higher quality care to their patients.

WHAT ABOUT MY OTHER MEDICATIONS, ARE THERE INTERACTIONS?

Sedation medications are chosen based on an individual’s medical history. Many sedation dentists use sophisticated dental-specific drug interaction software that automatically cross-checks your medications (even herbal and nutritional supplements) with sedative medications. In addition to a thorough medical history, drug interaction screening and patient monitoring, you’re ensured oral sedation dentistry is completed safely and effectively.

WHAT ABOUT LAUGHING GAS (NITROUS OXIDE)?

Nitrous oxide, commonly known as laughing gas, is often a regular part of sedation treatments. It has been used by dentists for nearly 100 years to alleviate pain and some anxiety. It is an excellent analgesic (pain reliever), but a less effective anxiolytic (anti-anxiety) medication. It is administered through a nasal hood, which is similar to a small cup placed over your nose. It is extremely safe because it is mixed directly with oxygen to provide you with a feeling of euphoria. You may experience tingling fingers and numb lips from the use of nitrous oxide. In combination with the use of an oral sedative, it is a fantastic adjunct that allows your dentist to be able to fine tune the exact amount of sedation needed to provide you with the best possible experience.

I KNOW THE DENTIST GETS TRAINING, BUT WHAT SHOULD I EXPECT FROM MY SEDATION DENTISTRY TEAM?

A few states require some team certification, such as Missouri and West Virginia.

With sedation, you sedation dentistry team has added roles and responsibilities, including being responsible for patient admittance and dismissal, sedation-specific forms and documentation. It’s critical for clinical team to understand how to appropriately monitor patients’ vital signs using equipment like a pulse oximeter with a blood pressure monitor, and how to recognize potential emergencies before they become an actual emergency. DOCS works with sedation dentists to provide them multiple options for additional team training.

I never imagined at 32 I could get Invisalign! Dr. Lang said I was a good candidate and in just 1 year, I have straight teeth!

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Katherine H.
Patient, Rochester, NY
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