Sedation Dentistry Options for Overcoming Dental Anxiety

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Dental phobia and anxiety can cause immense distress at the thought of going to the dentist but it should not stop you from getting necessary care. There are many ways of making your dental experience more tolerable. There are medication options and sedation dentistry that can help patients safely deal with phobias and anxiety, while performing common procedures such as tooth extraction, root canals and dental implants, just to name a few.

What Exactly Is Dental Anxiety?

The thought of visiting the dentist may not be pleasant for most people but in some it causes severe anxiety, and they even lose sleep at the night. Dental anxiety is more common than you think, with over 15% Americans avoiding a dental visit due to fear. There are varying reasons for people to feel nervous in the environment of a dental office, from a bad experience at the dentists as a child to being more sensitive to pain, or because of horror stories heard from friends or family. Dental anxiety may be more common in older people, because of experiences they had growing up when technology and anesthesia was not as advanced.  Dental anxiety is normal and is manageable.  People with dental anxiety should not feel embarrassed because the dental teams primary concern is to help you feel comfortable and receive the dental care the patient needs.

How Sedation Works

Sedation dentistry refers to dental work that focuses on reducing pain, patient anxiety, and discomfort, through control sedative treatments in the form of oral, intravenous and inhaled medication that are administered before, during and after the dental services are being provided.  Appropriate medications can be used for common procedures like cleaning your teeth or for complex oral surgery, depending on your pain tolerance levels. Sedation calms the mind and body by targeting the neurotransmitters in the brain to release chemicals related to emotions like panic and fear.

Not all patients are suitable for sedation; ones who benefit from sedation are those with a strong gag reflex, a phobia of dentists, and those with back and neck problems leading to discomfort. Those with a history of severe allergies to drugs used as sedatives, or those with a tolerance to dental sedatives may not respond to sedative treatment well. Patients should also make their dentist aware of any other medications they are taking and complete a thorough health history. Advances in oral conscious sedation can help ease the fear in patients and allow them to keep their dental appointments for better oral health.

Types of Sedation

There are different types of sedation available.

Dental professionals use nitrous oxide, which is administered through a nasal mask as a gas.  It is a mild sedative and anesthetic.  Nitrous oxide, also known as laughing gas provides both pain relief and relaxation, but it wears off quickly too so patients can drive home after their appointments. Dentists often give patients this sedative prior at the beginning of the treatment so all aspects of the appointment are as comfortable as possible.

Oral sedatives are prescribed medication, usually from the benzodiazepine family of drugs. Recognizable benzodiazepines brand names are Valium Xanax, Halcion or Ativan. They reduce pain and decrease anxiety by stopping the chemical responses in the brain that produce panic. Since this medication has stronger sedative effects, patients will not be able to drive home from their appointments. Some dentists also prescribe anti-histamines as a sedative, which causes dry mouth as a side effect. Reduced saliva flow makes the dentists work easier.

Conscious sedation works on a deeper level.  Conscious sedation is delivered through the IV using benzodiazepines such as Midazolam or Diazepam, which is typically reserved for complex treatments. Delivery is controllable because the dosage can be adjusted through the IV line.  Dentists also administer barbiturates and opoids in sedation dentistry on occasions. After conscious sedation, patients should not drive until the sedative wears off. A dentist must have a special permit to provide IV sedation safely.

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