Conscious Sedation Dentistry for Anxiety-Free Dental Treatment

Many people feel anxious about visiting the dentist – or avoid it completely – because they worry about experiencing pain and discomfort. Fortunately, dental sedation can help make it a less daunting experience. Sedation dentistry has become quite common over the past few years, and the various styles of dental sedation available today have made it easier for people to overcome dental anxiety and get their dental problems fixed.

But what exactly does conscious sedation dentistry involve?

Here we will explain the different types of dental sedation available both privately and on the NHS in the UK. We also look at what sedation dentistry costs and how you can find a sedation dentist near you.

We hope this information helps you understand your options so you can speak to your dentist with more confidence and ultimately get the treatment you need.

What is sedation dentistry?

Dental sedation includes a range of different techniques that are used by a dentist or anesthesiologist to calm a patient or make them more comfortable prior to and during a dental procedure. One example that you've probably heard of is laughing gas (nitrous oxide), which is often used in childbirth and has an instant calming and pain-relieving effect.

However, sedation dentistry includes a variety of options for patients with dental anxiety. Some simply make you feel more relaxed, while others put you into a sleepy state and you won't remember much about your treatment.

How does sedation dentistry work?

There are different methods used for dental sedation, each with its own purpose and strength. Your dentist will choose the most appropriate sedation and protocol for your situation. This will be based on certain factors such as:

• The dental procedure being performed
• The duration of the dental procedure
• Your level of dental anxiety

A dentist may choose any one of the following forms of sedation:

• Minimal sedation, in which patients are awake but in a relaxed state
• Moderate sedation, in which patients are conscious but may experience slurring of speech and slight memory loss
• Deep sedation, in which patients are at the verge of unconsciousness but can still communicate
• General anaesthesia, in which patients are completely unconscious

With all types of conscious sedation, the sedative is used alongside standard anaesthetics which numb the mouth and make the procedure pain-free.

Types of dental sedation

Prior to performing a procedure, the sedation dentist has to choose the appropriate type of dental anaesthesia for the patient. While some of these sedatives can make patients completely unconscious, others like oral sedation simply relax them without knocking them out completely.

The most common types of sedatives used for dental procedures are:

Inhalation sedation (gas and air)

Nitrous oxide is an agent that is inhaled by patients in order to relax. It is administered through a nosepiece. The effects of nitrous oxide wear off quickly, so you may be able to return to your regular schedule after leaving the dentist's office.     

Oral sedation

Oral sedation includes the use of medicines that can be taken via the mouth, either as a tablet or a liquid. It takes about 10 minutes to start working, but you might be asked to take the medicine up to an hour before your appointment.

Oral sedatives are a form of conscious sedation. They make patients feel calm and relaxed, and perhaps a bit sleepy, but still able to communicate with the dentist throughout.

Intravenous sedation

Intravenous or IV sedation is an important component of sleep dentistry and uses drugs that can put patients into varying stages of consciousness. It's sometimes called ‘twilight anaesthesia' or ‘conscious sedation'. Although you are still awake and able to communicate, the sedation will make you feel quite sleepy. Crucially, it also stops you from forming new memories so once the procedure is over, you'll hardly remember it.

During IV sedation, your vital signs will be monitored as it can slow down your breathing. You may be given additional oxygen if needed.

Watch this video to see more about how IV sedation dentistry is performed and how it helps dentists and patients:

IV sedation dentistry also extends to general anaesthesia, which induces a deep sleep until the effects wear off. This is generally only used for extensive dental procedures such as complicated or multiple extractions (especially in young children) and also some kinds of dental surgery.

How long does dental sedation last?

The amount of time it takes for the effects of a dental sedative to wear off depends on the form of sedation used, the dose used, the duration of treatment, and the ability of the body to recover. The clinician carefully plans and administers the right amount of sedative for your situation.

While nitrous oxide wears off minutes after inhalation stops, oral and IV sedation take at least 1-2 hours to wear off and often much longer.

What is conscious sedation dentistry like?

Dental anxiety can affect different people in different ways. Some feel nervous just entering the waiting room, while others fear pain during a procedure – perhaps because of a bad experience earlier in life. Some treatments, like wisdom tooth removal, are naturally unpleasant, so patients may opt for dental sedation for reasons of comfort.

If you are undergoing sedation for a tooth extraction or any other treatment, here's what to expect.

Before sedation

During your first checkup, your dentist will explain the treatment you need and discuss your options for sedation. You will probably be asked to sign a consent form to show you have agreed to the treatment.

If you are having oral or intravenous sedation you should arrange for someone to accompany you to the clinic and ensure you return home safely afterwards, because you will feel drowsy for a while after your treatment.

Depending on the form of sedation chosen, you may be advised to fast for several hours before treatment, or it may be better to eat a light meal about an hour before your appointment. Follow your dentist's instructions.

If you have high levels of anxiety about the appointment, your dentist may give you an oral sedative to take before you arrive at the clinic.

During sedation

As soon as the dentist administers the sedative, it will enter your bloodstream and make you feel relaxed, calm, and a bit lightheaded. Your arms and legs may feel heavier than normal, and you might feel a bit sleepy if you have oral or intravenous sedation.

Your dentist will then administer an anaesthetic to the area of your mouth being treated. They can use a numbing gel to keep discomfort to an absolute minimum as they do this. Within a minute, the anaesthetic will have taken effect and the dentist can begin the procedure without you feeling any pain.

The sedative will help you feel calm and relaxed. With IV sedation, you will also be less aware of what's going on, although still able to communicate as normal.

After sedation

With nitrous oxide, the effects wear off within a few minutes and you can go about your day as normal. Your mouth will probably feel numb for 30 minutes or more, so be careful not to bite your cheek or tongue by mistake.

If you have had oral or IV sedation you will need to stay at the clinic for a while after treatment while a clinician monitors your recovery. It can take up to 12 hours for the sedative to fully wear off, and it's normal to feel drowsy and lightheaded during this time. Therefore, you should make sure that you have someone to accompany you home and, if possible, stay with you until you feel back to normal.

If you have any children, try to arrange childcare for the day of your appointment. Even after you get home, the sedative can affect your reflexes, coordination and judgement until the following day. The same goes if you are a carer.

It's advisable not to do any of the following until the next day after your dental treatment:

• Drive any vehicle or ride a bicycle
• Exercise
• Return to work
• Drink alcohol
• Smoke or use any kind of nicotine products
• Take sleeping tablets
• Use any machinery, home appliances, or sharp utensils
• Cook or heat anything in the kitchen, including water for a cup of tea or coffee
• Make important decisions including financial transactions

This NHS sedation dentistry video sums up what the procedure will involve for you and your escort:

How much does sedation dentistry cost in the UK?

Private dental sedation costs vary according to the method used and the treatment duration. Sometimes dentists apply a charge per 30 minute session, or per hour. You can see approximate charges in the table below. Note that these are sedation costs only; regular treatment fees still apply.

NHS dental sedation charges also vary. You may find that the cost of sedation is included in the standard NHS dental treatment fee, or an extra charge may be applied. Note that if you are referred to a different dentist for treatment with sedation, this will usually count as a separate course of treatment. This means you will have to pay for a checkup at your original dentist as well as for the treatment at the sedation dentist.

How do I find sedation dentistry near me?

Not all dentists offer all kinds of sedation, so you may need to look around to find sedation dentists near you. Here are some ways you can find a suitable clinic:

• Ask friends and family for recommendations
• Look online for dentists near you who specialise in treating nervous patients
• Ask your regular dentist to refer you to a nearby sedation dentist

If you're nervous about booking an appointment, you can begin by just visiting the clinic to have a look around. When you do meet with the dentist, tell them about your anxieties so they can plan your treatment accordingly. Your first appointment will just be a checkup where they examine your mouth and maybe take an x-ray. From there, the dentist will discuss your treatment and your options for conscious sedation.

Visiting an NHS sedation dentist

If you want to see an NHS sedation dentist and your usual NHS dentist doesn't offer this service, they will refer you to a nearby NHS sedation clinic. Your first port of call should still be your usual NHS dentist, as you can't go directly to a specialist clinic without a referral.

If you aren't registered with an NHS dentist, click here to find your nearest one accepting new patients.

Is dental sedation safe?

Nervous as you may be about your dental treatment, you might also be worried about the safety of sedation dentistry. Fortunately, there are minimal risks involved with the dental sedation methods described here, and your dentist will take several precautions to keep you safe during sedation.

You'll be asked about any medications you're taking, and you may be advised to stop taking them for a certain time before your treatment. You will be monitored during your treatment in case your breathing slows and you need to be given oxygen.

Dental sedation is not safe for pregnant women, and breastfeeding should be avoided for 12 hours after sedation.

Conscious sedation side effects

After intravenous or oral sedation, it's normal to feel drowsy, possibly for the rest of the day. You should take the precautions described above to stay safe during this time. You may also experience some bruising in your arm or hand from the injection, but this should disappear within a few days.

The risk of other sedation side effects is very low. In some very rare cases, patients experience an allergic reaction or vomiting. Tell your dentist if you have any history of allergies to medicine. Your dentist will explain the risks and answer any questions you have before proceeding with any kind of sedation dentistry.

Conclusion

If you are particularly worried about an upcoming dental procedure, or visiting the dentist in general, sedation dentistry can help you overcome this anxiety. You can get dental sedation on the NHS or with a private dentist.

If getting oral or IV sedation, you'll need to prepare for the procedure by making sure you have someone to look after you and any dependants while you recover.

Dental sedation will make you feel calmer before getting in the dentist's chair, and will help you relax during your treatment. You might not remember much of it at all, and the idea of returning to the dentist will feel less daunting. You'll also probably feel a great sense of relief at having finally got the dental treatment you have been putting off!

FAQs

Will I feel anything during the treatment after dental sedation?

In most cases, patients do not feel a thing. Some may feel slight discomfort, but at the end of the appointment, most are relaxed with no memory of the procedure.

Am I a good candidate for sedation dentistry?

Any of the following may make you a good candidate for dental sedation:

• Anxiety of visiting a dentist
• Fear of shots or needles
• History of a traumatic dental experience
• Inability to handle noises or smells in a dentist's office
• Having sensitive teeth
• Need of a complex treatment

In addition, patients with special needs might benefit from dental sedation.

Is sedation dentistry safe for children?

Yes, paediatric sedation dentistry is just as safe as adult sedation dentistry. It is routinely performed in multiple clinical settings, so there is no need to worry.