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Have No Fear

Sedation Dentistry Can Help You To Receive The Dental Care You Need

ByJudy Latta

Did you know that your oral health is critical to your overall wellness?  Regular dental care is imperative for keeping your teeth healthy and preventing oral disease, as well as for preventing medical conditions that can result from poor oral health. Additionally, some medical conditions have symptoms that develop in the mouth that are likely to go undetected in the absence of a dental examination. Thus, it is very important to visit your dentist every six months to protect both your oral and physical health.

The American Dental Association (ADA), however, estimates that each year 100 million Americans fail to see a dentist. One major reason is that many people feel very anxious about dental care. A 2017 study by White, Giblin and Boyd published in the Journal of Dental Hygienefound that at least 50 percent of adults in the United States have some anxiety associated with visiting the dentist, and as many as 20 percent have severe dental anxiety or phobia. Of those anxious about dental care, 1 in 5 do not see a dentist regularly, and as many as 15 percent avoid dental care altogether.

People fear the dentist for a variety of reasons. Some people have had traumatic and/or painful dental experiences in the past. Some have trouble becoming numb or staying numb during dental procedures, no matter how much anesthesia is administered, while others fear needles, making the administration of local anesthesia a challenge. Some patients can’t relax in the dentist’s chair due to a low threshold for pain, severe tooth or gum sensitivity, or a very sensitive gag reflex. For others, it is merely the sights, sounds, smells and/or tastes involved with dentistry that make them feel queasy or anxious. Some people are so phobic about going to the dentist they would rather deal with the agony of a toothache than face dental care. This can be very problematic because neglected dental problems will worsen over time, probably leading to the need for more complex and extensive dental work in the future, possibly even emergency dental care, which can be even more anxiety-inducing than a standard visit to the dentist.


Sedation Dentistry

Fortunately, modern medicine is offering those with dental anxiety options for calmly and comfortably receiving dental care. In addition to traditional local anesthesia, which dulls pain in the area of the mouth where the dentist is working, dentists can also administer medication before or during a dental procedure to relax a patient, or even make a patient lose consciousness in the most severe cases. Sedation can be used for any type of procedure, from teeth cleaning and examinations to aggressive dental care. For children who are afraid of the dentist or cannot sit still in the dentist’s chair, sedation can keep treatment safe and swift. Sedation can even be used for elective cosmetic and restoration dentistry procedures to enable you to get the smile you want without pain or fear.

There are several, varying levels of safe and effective sedatives that can be used by dentists to calm and comfort patients.

Nitrous oxide, also known as laughing gas or inhalation analgesia, is a sedative gas that is combined with oxygen and administered by dentists to patients through a small mask that is applied over the nose. It relaxes you but does not put you to sleep. Because nitrous oxide provides minimal sedation, the effects wear off relatively quickly after administration ends.

Enteral sedation is given in the form of a pill or liquid. Usually, you take these prescription oral sedatives prior to your appointment so you are relaxed when you arrive for treatment. Enteral sedatives can provide minimal sedation, relaxing you and making you feel sleepy; or moderate sedation, making you feel groggy. They may make you drowsy enough to drift off to sleep but will not cause you to become completely unconscious. Enteral sedation has become a very popular form of dentistry sedation due to its ease of administration and because, while it makes the patient drowsy and calm to the point that they often don’t even remember the treatment, it keeps them awake enough that they can cooperate with the dentist.

For intravenous (IV) sedation, the sedative is injected directly into a vein. IV sedation can put you into varying degrees of consciousness, allowing the dentist to adjust the level of sedation depending on the patient’s needs. Your dentist can provide minimal IV sedation to help you relax, moderate sedation to make you feel groggy, deep sedation to put you to sleep but on the edge of consciousness so you can easily be awakened, or even deeper sedation so you completely lose consciousness.

General anesthesia, or sleep dentistry, is the IV sedation procedure that causes you to completely lose consciousness for the duration of your treatment. General anesthesia sometimes requires patient preparation before the procedure, such as fasting and abstaining from other medication, and involves a recovery period after you awaken before you can leave the office. It can involve side effects, such as dizziness and nausea. General anesthesia is not used regularly for dental procedures but can be used for cases of severe dental anxiety or for very complex and/or painful procedures.

Regardless of which type of sedation your dentist administers, you will probably still need a local anesthetic, which is typically administered via injection, to numb the area of the mouth where the treatment will take place to prevent pain and discomfort. The sedation can be administered prior to the local anesthetic, however, to minimize pain associated with the injection and to alleviate anxiety for those who fear needles.

It’s also likely that  you will likely need someone to accompany you to the appointment and then to drive you home when your dental visit is over. If you are receiving enteral sedation you definitely will need a caregiver to drive you to your dentist’s office because you take this sedative prior to your appointment.

If you have been putting off going to the dentist because of anxiety, you may want to speak to your dentist about sedation dentistry. Most dentists can administer at least minimal sedation, and many can administer more intense doses. To receive sedation in a dental office, you must be in relatively good physical health, so you may need to take care of any health concerns and receive clearance from your physician before you can schedule your appointment, particularly if you are considering deep sedation or general anesthesia.

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