Conscious Sedation is defined as a minimally depressed level of consciousness that retains the patient's ability to independently and continuously maintain an airway and respond appropriately to physical stimulation and verbal command and that is produced by pharmacological or nonpharmacologic method or combination thereof.
Sedation Dentistry, sometimes called Relaxation Dentistry, refers to the way dentist's manage Pain and Anxiety during dental appointments.
Unlike General Anesthesia where a patient is completely unconscious, asleep, and unable to respond, patients under Conscious Sedation, are able to respond to commands and breath on their own.
There are actually 14 different ways that sedation drugs can be administered. There are 3 primary ways that Sedation is administered in the Dental Office:
1. IV Sedation also known as Deep Conscious Sedation is usually used by Oral Surgeons and dentists with specialized training and special certification. With this type of sedation, medications are administered directly into the blood stream. The greatest advantage of IV Sedation is that if someone is not sedated enough, the doctor can administer more medication and the effects are instantaneous. IV Sedation is not used commonly in most dental offices because of the specialized advanced training required and the requirements for certification by the State Board of Dentistry. The drugs used for IV Sedation are more effective then the same drugs taken orally. There is a more profound amnesia associated with this technique.
2. Enteral Conscious Sedation "Orally Administered Sedation", sometimes called "Sedation Dentistry" is administered by taking a pill. All body functions remain normal and the person is able to breathe on their own. The patient will often fall asleep. Some degree of amnesia is common. The disadvantage with this method of sedation, is that the level of sedation for each person is not predictable.
3. Inhalation Conscious Sedation, Nitrous Oxide/Oxygen Sedation also known as "laughing gas". This is the most frequently used sedation method used in dentistry. All bodily functions remain normal and the person is able to breathe on their own. The patient will often fall asleep and experience some degree of amnesia about what happened during their dental appointment. Inhalation Sedation has been used my dentists for many years.
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This Oral Medication used for Oral Conscious Sedation in dentistry are from a group of drugs known as Benzodiazapines. Not only do these medications have a sedative effect they also have some degree of amnesic effect for most people. Patients remember little or nothing about their dental appointment.
Advantages to Dental Oral Sedation:
Disadvantages of Dental Oral Sedation:
- Easy to administer: Swallow a small pill
- It is safe and easy to monitor
- Works well for most people
- Low Cost
What medications are used for Dental Oral Sedation?
- The level of Sedation is not easily changed
- Someone must drive you to and from your dental appointment
- There is no analgesic (pain relief effect)
- The most common medication is Halcion (triazolam). Halcion provides a deep level of relaxation and amnesia effect.
- For children the most common medication is Versed (Medazolan) which is a liquid.
Inhalation Conscious Sedation
Nitrous Oxide and Oxygen ("laughing gas") has been used as the most frequent and primary means of Sedation used in Dentistry for many years. 35% of all US dentists offer Nitrous Oxide Sedation to their patients.
Advantages or Dental Inhalation Sedation:
Disadvantages of Dental Inhalation Sedation:
- Works well for mild to moderate anxiety
- Rapid Onset
- Flexible duration can be used for any appointment length
- Absolute Control. It is easy to quickly control the level of sedation which may be altered moment to moment.
- People recover quickly
- Very few side effects
- There is an analgesic effect
- You can drive yourself to and from your dental appointment
- You can return to normal activities immediately
What medications are used for Dental Inhalation Sedation?
- Severe anxiety may require a deeper level of sedation
- Not indicated for people who have respiratory problems (Asthma and Emphysema)
- Claustrophobic patients do not like anything covering their nose
The safety features of the machine insure a patient receives no less than 30% Oxygen mixed with Nitrous Oxide. Usually the patient receives 50 to 70% Oxygen.
- Nitrous Oxide (N2O)
- Oxygen (O2)