Oral Sedation Dentistry
There are three common delivery methods used in sedation dentistry: nitrous oxide gas, inhaled through a gas mask; liquid medication, delivered through a tube and needle into the bloodstream; and solid medication, delivered orally, in pill form. In most cases, oral sedation dentistry is a non-invasive way for patients to achieve conscious sedation, deeply relaxing while remaining able to follow verbal commands and gentle manual guidance. While some patients fall asleep under oral sedation, they can generally be gently awakened. On the day of the dental visit, about an hour before the scheduled procedure, the patient takes a pill that makes them drowsy and relaxed. These rapid-onset medications work quickly, meaning that the patient will need to secure a trusted ride to the dentist, and they’ll also need a trusted ride home. While the duration of oral sedation is meant to be relatively brief, the effects can take up to a day to fully wear off. In some cases, dentists might recommend an additional dosage of oral sedation the night before dental treatment to help a potentially anxious patient get a restful night’s sleep.
The medication used in oral sedation dentistry is usually a benzodiazepine, which is the drug family that includes Valium, and the dosage will depend on the patient’s size and desired level of sedation. These medications are considered safe at effective dosages, providing a wide variety of patients with the ability, whether physical, emotional, or psychological, to comfortably receive dental treatments. While most oral sedation is delivered in pill form, dentists may provide liquid sedative syrup for children or people with swallowing difficulties. Regardless of the delivery type, sedation dentistry has helped restore the oral health of millions of people by allowing them to visit their dentist and undergo dental treatment. People may avoid the dentist because of previous trauma, fear of sharp tools, or generalized anxiety, and sedation dentistry can help reduce these stresses. Patients may also seek sedation dentistry because of physical issues, like difficulty relaxing the muscles or following verbal commands during routine dental procedures.
Oral sedation dentistry is convenient, easy to administer, and cost-effective, but its effects are less predictable than other types of sedation dentistry. Oral sedation takes longer to start working than inhaled nitrous oxide gas or intravenous benzodiazepines, and its effects are generally milder than IV sedation, while its duration is longer than nitrous oxide. Because of this short duration, dentists reserve nitrous oxide for very brief procedures. Patients may choose IV sedation when a deeper, more controllable level of conscious sedation is desired. This may be preferred for longer, more complicated procedures, as the benzodiazepine or other sedative flows right into the vein, where the dosage can be easily adjusted as needed for patient comfort. In many cases, patients partially or completely forget what happens when they’re under IV sedation, and patients also report memory loss with oral sedation, despite being conscious enough to physically respond to verbal commands. While IV sedation is more powerful than oral sedation, it is invasive and can be expensive, and it requires highly specialized and experienced dental teams to ensure patient safety.