Whether you are having your wisdom teeth removed, are getting dental implants or are having a root canal procedure, there are times at the dentist's office when you'd rather not feel what's going on inside your mouth. Fortunately, there are a variety of sedation and anesthesia options available to help make your dental visit and treatment more comfortable. Some anesthetics only numb the treatment area, while others help you sleep during your treatment.
One option is deep sedation, which puts you into what the American Dental Association (ADA) describes as a "drug-induced depression of consciousness" in which you are not easily aroused. Learn more about what exactly that means, why your dentist might recommend it and what you can expect to experience under sedation.
Three Types of Sedation
In dentistry and medicine in general, there are three levels of sedation. The one that's right for a particular patient depends on a few different factors, including their health, the treatment they are receiving and their age, notes the American Society of Anesthesiologists (ASA).
The first type is minimal sedation. With minimal sedation, a patient is likely to feel more relaxed during treatment, but should still be able to answer questions and follow simple instructions.
The next level is moderate sedation. With moderate sedation, a patient usually gets pretty drowsy and might drift off to sleep. They are less likely to be able to answer questions and might not remember what went on.
The third level is deep sedation. Patients in this state are likely to be asleep but will respond to a repeated sharp touch, such as being poked or pinched, reports the ADA. After the sedation wears off and the treatment is over, a patient likely won't remember most of the experience. Some patients may need equipment to help them breathe while they are deeply sedated.
Sedation vs. Anesthesia
Whether it's deep, moderate or minimal, sedation is a type of anesthesia. Other types of anesthesia used during dental work include local and general. Local anesthesia simply numbs the area being treated, leaving the patient alert and awake during the procedure, explains the ASA. Patients who undergo sedation may also receive a local anesthetic.
When a patient receives general anesthesia, they are unconscious. Unlike sedation, where a patient can be woken up with stimulation, patients under general anesthesia will be unresponsive until the anesthetic wears off, according to the ADA.
When Is Deep Sedation Used?
When would a dentist recommend deep sedation instead of local or general anesthesia? It depends. According to the National Institutes of Health (NIH), procedures to place a dental prosthetic or dental reconstructive surgery might require sedation so that the patient can stay comfortable during the treatment.
Patients often have a choice when it comes to the sedation or anesthesia options they receive. However, if a dentist recommends a deeper level of sedation for a particular procedure, there is often a compelling reason for them to do so. You can ask your dentist why they are recommending a particular form of sedation and discuss your options.
What Happens During Sedation
At the start of the procedure, your dentist will most likely give you the sedative through an IV line, explains the NIH. When you are under deep sedation, at least three dental professionals need to be in the room, including the trained dentist who will perform the procedure and administer the sedative, as well as two other healthcare professionals who will assist the dentist and keep an eye on you, according to the ADA.
The ADA also specifies that any room where sedation is administered has to contain specific equipment, including devices to monitor your breathing and systems to support you in the unlikely case that complications develop. Throughout the procedure, your dentist will monitor your breathing, temperature, blood pressure and heartbeat. The NIH states that you will likely be able to go home one or two hours after the procedure.
Sedation Risks and Concerns
Not all dentists are qualified to administer sedation. A dentist needs to complete an advanced training program and obtain specific certifications to comply with ADA guidelines.
Your qualified dentist will review your medical history with you before treatment to verify that sedation is an appropriate choice for you. It's important to tell your dental professional if you are pregnant and to list the medications you're taking, as those factors may affect their decision to put you under sedation, according to the NIH.
All types of sedation are generally safe for many patients. The precautions taken during the procedure — having three trained professionals in the room and using equipment to monitor and assess the patient's condition — help make the process even safer. If you have any concerns or questions about sedation, your dentist can answer them and put your mind at ease.