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Sedation vs Anesthesia at the Dentist

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If you have a dental procedure coming up, there may be a part of you that is afraid — but this is common. Almost half of adults in England, Wales and Northern Ireland have some form of dental anxiety, ranging from moderate to severe, according to the 2009 Adult Dental Health Survey.

It's important to know that you are not alone in your anxiety, and there are techniques available to help manage dental phobia, including sedation and anaesthesia. Learn more about the differences between sedation vs anaesthesia and why your dentist may recommend one of these during your next dental procedure.

Dental Sedation vs Anaesthesia

Both sedation and general anaesthesia are used to help patients during dental treatments. They ease anxiety, prevent pain and ensure the safety of the procedure, as the NHS explains. Both can make you feel drowsy, limit your coordination and affect your ability to remember the procedure, which is why you should always bring an escort to the dental practice if you are undergoing sedation or anaesthesia. Despite these similarities, sedation and anaesthesia are not the same.

Under sedation, you will feel relaxed and may fall into a light sleep, as the NHS also notes. Often, your dentist refers to this as conscious sedation because you are awake, though in a state of depressed alertness. You will likely be able to maintain your own airway and respond to verbal or physical cues. This method of sedation is delivered through a face mask using nitrous oxide, also known as laughing gas, or it can be administered as an oral pill or via injection, according to the Scottish Dental Clinical Effectiveness Programme (SDCEP).

As for general anaesthesia, patients are completely asleep throughout the procedure and won't remember the treatment afterwards, according to Bupa. As specified by Bupa, qualified professionals will administer general anaesthesia through an IV line, and patients often require assistance with their airway. This procedure should occur in hospital setting with trained anaesthesia professionals, as the Royal College of Anaesthetists explains.

Who Can Receive Sedation and Anaesthesia?

Before choosing between sedation vs anaesthesia, your dentist will talk you through your options and make a recommendation. In adult dentistry, your dentist may recommend these options if you need a wisdom tooth extraction, as the NHS explains. Bupa also notes that dental implant treatment often involves sedation or anaesthesia.

According to the Scottish Dental Magazine, conscious sedation can be appropriate for a patient with dental phobia, a patient who has a medical condition aggravated by stress, such as asthma or epilepsy, or any patient undergoing an extensive procedure. Additionally, mentally challenged patients and children over the age of 1 can receive conscious sedation, as can any patient who is nonresponsive to local anaesthesia, which is used to numb a specific area of the mouth.

General anaesthesia may be useful for patients with special needs, such as intellectual disabilities and physical impairments, as explained by the Dental Nursing guide to conscious sedation and special care patients. According to Cochrane, both sedation and general anaesthesia are used to help any patient with a significant gag reflex.

Associated Risks

While sedation and anaesthesia are considered very safe, any medical procedure comes with certain risks.

According to the clinical guidelines of the Scottish Intercollegiate Guidelines Network, conscious sedation may pose a risk if a child has large tonsils, as it makes them more vulnerable to airway obstructions Additionally, patients may experience arrhythmias or lose consciousness and move into a deeper level of sedation during the procedure. People of older age or those undergoing more complicated procedures may experience a stroke or brain damage under general anaesthesia, according to the Royal College of Anaesthetists, though these complications are very rare.

Your dental team is trained to monitor your vitals and be aware of your needs throughout your procedure, but you can help by providing a comprehensive medical history. Additionally, your dentist may instruct you to limit food or beverage consumption several hours prior to your procedure to minimise certain risks. Whether they recommend sedation or general anaesthesia, be sure to ask your dentist any questions you may have prior to your procedure, and rest assured that your safety is their priority.

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This article is intended to promote understanding of and knowledge about general oral health topics. It is not intended to be a substitute for professional advice, diagnosis or treatment. Always seek the advice of your dentist or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.