What Is IV Sedation?
IV Sedation is short for intravenous sedation, sometimes even referred to as intravenous conscious sedation.
A thin, fine needle attached to a tube is inserted into a vein either in the arm or back of the hand. The needle is then withdrawn, leaving the tube in place. The sedative then enters the bloodstream through the tube.
The sedative used in IV sedation is not designed to put you to sleep, but rather make you feel incredibly relaxed. You’re still awake — hence “conscious sedation” above — and are able to follow the directions of your dentist. You can even still respond to questions.
However, you will be so relaxed that you’re unlikely to remember most of the procedure.
What Should You Expect Before the Procedure?
Here’s what to expect when you choose to get IV sedation:
Firstly, a needle will be inserted into a vein. If you’re anxious about needles or don’t like the sensation, numbing cream will be applied to the area first. Otherwise you’ll just feel a slight pinch where the needle enters the skin.
Next the sedative is slowly fed into the bloodstream. The sedatives make you feel light-headed, but not unpleasantly so.
You’ll still be able to respond and interact with your dentist as usual. The difference is that you’ll be far more relaxed. Keep in mind that these sedatives won’t put you to sleep. You’ll be conscious the whole time.
What Should You Expect After the Procedure?
When you go to a sedation dentist in NW Calgary, you can expect to experience these effects after the sedatives wear off:
You’ll have some memory loss of the procedure. While you won’t be asleep, you will be so relaxed that you won’t form many memories of the event.
It’s not advisable to drive after receiving any type of sedation. You may feel some confusion, and it can take some time for the sedative to completely wear off. Typically you’ll still feel a little woozy afterwards, and your reaction times may be impaired. Always arrange alternate forms of transport to get home after getting sedated.
It’s generally best to lie down and rest for the rest of the day. Don’t drink alcohol and only take medications as directed by your dentist. If you’re nauseas, make sure to lie down.
If you experience any unusual problems, contact your dentist.
Do I Need IV Sedation?
The short answer is “no”.
The long answer is that it’s up to you. If you’re not anxious about your visit to the dentist, or about the particular procedure being performed, there’s no reason to administer sedation. It’s entirely dependent on how comfortable you are.
Will I Still Need To Be Numbed?
If the procedure you’re undergoing normally uses local anaesthetic, this will still need to be applied.
Sedation only works to calm your anxiety, it doesn’t work as a painkiller. While some IV sedatives include painkillers, local numbing still needs to happen before work can be carried out.
The dentist will wait until you are sedated and numbed before beginning the procedure.
What Types of Sedative Are Used?
The most common are anti-anxiety sedatives called benzodiazepines, or “benzos”. These have three primary effects: they reduce your anxiety, make you sleepy, and produce partial or total memory loss while in effect.
Different brands of benzodiazepine are more likely to produce total memory loss than others.
Midazolam is generally the first choice because it clears out of your body faster. Diazepan is another type of benzodiazepine; it’s longer lasting and can sometimes have a burning sensation when it first enters the bloodstream.
How much needs to be used changes depending on the person. Each drug is administered at 1-2mg per minute, with a space to evaluate the effect before proceeding.
The plastic tube is left in place in the vein during the procedure in case additional sedative is required, or if a reversal agent needs to be administered in an emergency.
Is There Anyone Who Can’t Get IV Sedation?
There are a few instances where you might not be a suitable candidate for IV sedation. These include
- Allergy to sedatives
- Alcohol intoxication
- CNS depression
- Some instances of glaucoma
Things to be wary of, but which do not outright disqualify someone include:
- Impaired lung, kidney, or liver function
- advanced age
- sleep apnea
Heart disease is generally not a problem, but always alert your dentist.
If you’ve had benzodiazepines over many years, such as valium, it’s best to let your dentist know beforehand. A tolerance can make the sedative ineffective and call for larger doses or a different type of drug altogether.
Do I Need to Go to A Hospital for IV Sedation?
Generally, the answer is no. So long as the dentist is qualified you’ll be fine getting IV sedation in-chair.
That being said, there are some instances where it’s necessary to be treated in a hospital-based clinic. The American Society of Anaesthesiology Classification of Physical Status classifies patients in the following groups:
- I – Normal, healthy patient
- II – A Patient with mild systemic disease, e.g. well controlled diabetes or epilepsy, mild asthma
- III – A patient with severe systemic disease limiting activity but not incapacitating, e. g. epilepsy with frequent fitting, uncontrolled high blood pressure, recent heart attack
- IV – A patient (usually hospitalised or bedridden) with incapacitating disease that is a constant threat to life
- V – A patient who is expected to die within 24 hours with or without treatment
Patients in category one and two are suitable for treatment in a dental clinic. If you’re a category three, it’s best to consider a hospital setting. Your dentist will be able to advise you accordingly.
Advantages of IV Sedation
The obvious advantage to any sort of sedation is to calm you if you’re anxious and let you be comfortable during the procedure.
Sedation also makes procedures easier than under general anaesthesia or deep sedation. Patients can still comply with instructions and there’s no breathing tube necessary.
Compared to other forms of sedation, IV has its own unique advantages.
IV sedation can be tailored to the individual, creating predictable and reliable results. Oral sedation, by contrast, can be inconsistent and unreliable due to less precise control.
IV sedation can allow patients a deeper level of sedation than is available through oral or inhalation sedation.
Recovery from IV Sedation
Recovery isn’t immediate, so supervision by a responsible adult is necessary after your appointment.
Is IV Sedation Safe?
Yes. Like with any medical procedure there are conditions which will exclude you from it, but for most people sedation is perfectly safe.
I’m REALLY Afraid of Needles, What Can You Do?
Numbing cream can be applied to the injection site. If you’re terrified of even the idea of needles, laughing gas can be administered to ease your anxiety first.
If the problem is too severe, IV sedation may not be an option for you.
Can I Eat Beforehand?
Standard advice is to avoid eating or drinking for 8 hours before receiving any sort of sedative. Your dentist will advise you whether you should fast or not prior to your appointment.
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 couldn’t, you’d be anaesthetised, not sedated!
Can I Drive Home Afterwards?
No. After sedation it’s important to get a lift home. It’s also preferable to be under responsible adult supervision until you become fully lucid.
Want to Learn More?
If you’re afraid of the dentist in NW Calgary, sedation dentistry might just be what you need. It’s okay to be nervous about any procedure because we can help you to feel relaxed and calm. Our warm, friendly staff will answer any questions that you might have. Contact us at our NW Calgary clinic today.