Oral sedation is one of several types of sedation offered in dentistry. Sedation is intended to relieve patients of their anxiety before a dental appointment. You might be afraid of the dentist, afraid of the procedure, or even just dislike being in a dental clinic. It’s important to note that sedation is not the same thing as anaesthetic, which kills or numbs pain.
It can also be used by a dentist to relax a patient enough to be able to perform multiple procedures in a single visit. This saves both you and the dentist time and money.
What Is Oral Sedation?
Oral sedation is when you take an anti-anxiety pill designed to calm your nerves. Other forms of sedation offered in dentistry are IV sedation (injecting the sedative into the bloodstream) and oxide sedation (inhaling a calming gas).
The pills used in dental oral sedation are no different to other anti-anxiety medications people can normally be prescribed. Sedatives used are from a family called benzodiazepines, which include well-known anti-anxiety medications such as Valium, Xanax, and Ativan
How Does Oral Sedation in NW Calgary Work?
Oral sedative drugs are central nervous system (CNS) depressants. They typically work by suppressing the areas of the brain responsible for fear and anxiety while activating the areas responsible for sleepiness. Low doses act as anti-anxiety medications, high dosages are a sedative and may simply put you to sleep.
If you are already on a similar type of anti-anxiety medication, your dentist may need to modify the dose necessary to calm you for the procedure. Do not self medicate, and do not consume alcohol at the same time.
What To Expect When You Take Oral Sedation
You’re given one pill shortly before the treatment, which should last for the duration. It’s not uncommon to also be given one pill the night before to ensure you get a good rest.
Sleepiness, drowsiness, giddiness and confusion are all common. You will feel incredibly relaxed and unfazed by what’s going on around you. As the dosages used in a dental setting do increase your drowsiness considerably, you may fall asleep in the chair.
Even if you don’t fall asleep, the level of relaxation will generally make forming new memories difficult. You won’t remember much about the procedure itself, and slight to complete amnesia of the event is not uncommon.
As you’re often given a pill the night before, it’s important to be escorted to and from the appointment by a responsible adult. It’s entirely possible to get disoriented if you’re under the influence of the medication and try to get to the appointment yourself. For example, missing a stop when using public transport is not uncommon when under the influence of an oral sedative.
What To Expect After Oral Sedation
The sedative drugs used will take some time to wear off. During this period you will still feel sleepy, relaxed, giddy, and possibly disoriented. It’s important to get a responsible adult to take you home and supervise you until you’re lucid again.
Staying hydrated, lying down and resting are your best options for recovery. If you or the person supervising you notice anything abnormal or are worried about something, do not hesitate to contact your doctor.
Do You Need Sedation?
It’s important to note that you never need sedation. Whether you receive sedation or not is entirely up to how comfortable you personally feel. If you’re already calm and relaxed, there’s no requirement to receive further sedation.
When Is Oral Sedation Used?
Oral sedation is used in one of two cases:
A patient who has fear or anxiety. This might be a general anxiety about dentistry, anxiety from a past trauma, fear of pain, or anxiety over the thought of the procedure itself
A patient who needs a lot of work done in a short amount of time. Oral sedation is a great way to get a patient feeling relaxed enough to allow several different procedures to be performed at the one appointment. You won’t feel as discomforted by the constant work in your mouth, and it will save both you and the dentist time and money.
Will I Still Get Anaesthetic?
Local anaesthetic will still be necessary for work to be done in the mouth. Sedatives treat your stress and anxiety levels, they do not numb or kill pain.
Your dentist will wait until the sedative has worked before administering anaesthetic, and will then wait until the anaesthetic works before performing the procedure. While under sedation you’re still able to respond to questions and stimulus, so you will still be able to let the dentist know if you’re numb or not.
Types of Sedative Used
All oral sedatives are benzodiazepines, or benzos. Dosage varies wildly from one person to the next, as there’s no known method for identifying who is susceptible or resistant to the drugs. Low doses are used to start with, working up to an effective dose.
The exact types used by various dentists are as follow (names in bracket are popular brand-names):
One of the most well-known of the oral sedatives used. Diazepam takes about an hour to start working and has a half-life (the length of time it takes half of the substance to leave the body) of around 20-100 hours.
Much faster acting than the above — only 30 minutes opposed to one hour. Correspondingly has a much shorter half-life of only 10 hours.
Lorazepam takes about the same time to work as Diazepam — one hour — but has a half life of only 12-14 hours.
Fast and short acting, with effects taking hold in just 10-20 minutes. Usually delivered as a syrup or mixed into a drink. Causes high levels of sleepiness and short term memory loss.
This is sometimes used as an alternative to IV sedation.
The levels of sleepiness and memory less experienced varies from drug to drug and person to person. Different people are more or less susceptible to sedation and the various side-effects. You’ll be monitored closely to ensure you’re given an appropriate and effective dose.
Can I Take Oral Sedation Before IV Sedation?
Many people who are phobic of needles require some form of sedation prior to IV sedation. Oral sedatives are a popular method: the pill makes you relaxed enough for the needle, and then the IV sedation gives the dentist more precise control over your sedation levels for the rest of the procedure.
When Not To Take Oral Sedative
Different types of oral sedative react differently to certain medical conditions. For example, some are safe to take if you have liver problems and some are not.
Be sure to alert your dentist to any of the following conditions so they can accurately prescribe the correct and safe type of sedative:
- Known allergies
- Narrow-angle glaucoma
- Severe respiratory disease
- Congestive heart failure
- Impaired kidney or liver function
- Depression, bipolar disorder, psychoses
- Chronic bronchiti
Let your dentist know of any medications you’re already taking, and give clear and honest answers if they ask about any other potentially relevant conditions.
Benefits of Oral Sedation
The obvious benefit of sedation is to calm anxious patients. Another advantage is the ability to perform more procedures in a single visit.
For oral sedative specifically, they allow patients who are deathly afraid of needles to undergo sedation. They’re simple to take and generally very effective. They’re also significantly cheaper than IV sedatives.
Cons of Oral Sedation
The biggest problem with oral sedation is that its effectiveness can vary wildly from person to person. As the drug affects the nervous system, usual dosage factors such as age, height, weight, and gender don’t strictly apply. A dose which might have no effect on a petite female might knock out a large man.
Because of this, dosages have to be weighted to prevent the most susceptible people from overdosing, which means the least susceptible may not feel anything. Those who sit comfortably in the middle will be able to enjoy the effects of the sedative.
Can You Overdose on Oral Sedatives?
It is possible to overdose on benzodiazepines, however it is very difficult to do so accidentally. Ensure you tell your dentist about any relevant medical conditions and existing medications and stick only to the prescribed dosage.
How Long Will the Drug Last?
This depends entirely on the type of drug used. Valium can take a very long time to wear off, for example, while Versed is fast acting and short-lasting.
Can I Eat Beforehand?
Yes. Eating is generally recommended before ingesting any medication that’s absorbed through the stomach.
Can I Drive Home Afterwards?
No. In fact, if you’ve had a sedative the night before to help you sleep, you shouldn’t even drive to the appointment. Ensure you have responsible adult supervision to and from the appointment, and for some time after.
How Will The Dentist Know Local Anaesthetic Has Worked If I’m Sedated?
The same way the dentist would know if you’re numb if you weren’t sedated: by asking you. You can still feel pain when you’re sedated, and still respond to questions.
If you have questions about how to get started or want more information on Oral Sedation Dentistry NW Calgary, contact us online or at our North Hill location. We’re here to talk through your sedation options and make you as comfortable as possible. Get in touch with us today.