Local Anesthesia ~ The most
frequently used type of anesthesia. Used to numb the area being worked on, it
is given by injection (although dentists often swab a topical anesthetic gel
on the injection site for the patient's comfort). The numbing effects can last
from five minutes to three hours after treatment.
Inhalation Anesthesia
~ The most commonly used inhalation agent is Nitrous Oxide or "laughing gas. "
Nitrous Oxide is a sedating gas that is combined with oxygen to make patients
feel more comfortable during dental care. A small rubber inhaler is placed
over the patient's nose and adjusted so that the patient breathes through it.
With Nitrous Oxide, most patients experience an initial feeling of
lightheadedness, which gradually leads to an overall feeling of well being.
The advantages of inhalation sedation are its rapid onset, lack of
lingering effects, the ability of the patient to engage in conversation while
under its influence, and the ability of the patient to drive home unassisted.
Oral Conscious Sedation
~ The patient is administered either a pill or oral liquid before
treatment. The patient becomes sleepy, and develops a diminished awareness of
sounds and smells. The effects can last for up to four hours. Commonly
administered oral sedatives include: Valium, Halcion, Xanax, Midazolam ,and
Ativan.
Advantages of oral conscious sedation include: It is easily administered
(no needles), generally has a low incidence of side effects, the patient can
breathe independently, and the patient retains the ability to interact with
and respond to the dentist.
This mode of sedation is gaining popularity as "sedation" or "sleep"
dentistry; however, oral medications do not and should not put a patient to
sleep. Therefore, patients using this method who want to be to be "asleep" may
be more aware of dental treatment than they want to be.
Intravenous Sedation ~
Also known as IV or "conscious sedation." Patients often think they are asleep
and have no memory of the procedure but can respond to the dentist when
necessary. IV sedation is a safe, precise, and highly effective technique for
management of moderate to more severe levels of dental fear. This method may
also be used for patients who are not physically or behaviorally able to
cooperate with dentistry. Commonly used drugs include Valium, Versed, Fentanyl,
Propofol, and Demerol, either alone or in combinations selected by a doctor.
A major benefit of some of these IV drugs is amnesia. The patient will have
no memory of most, or even all, of the dental treatment. Another benefit is
the comparatively quick recovery time. Most patients relax and have a light
meal the evening following treatment.
During the procedure, devices will be attached to the patient to monitor
breathing, blood pressure and heart rate.
General Anesthesia ~ The
most uniformly dependable of all the sleep sedation modalities, because
medication can be accurately dosed and the patients response can be
appropriately monitored. It can be a combination of injected or inhaled
sedation. While the effects can last for hours, many patients safely return
home within 2 to 4 hours after treatment is complete. Most people resume
normal activity on the day following treatment.
As with I.V. sedation, an anesthesiologist is present and uses monitoring
devices, which are attached to the patient during the procedure.
Because the patient is deeply asleep, general anesthesia is the most
controlled, effective and predictable method for highly anxious and fearful
patients. General anesthesia is also often used for patients who are not
physically or behaviorally able to cooperate with dentistry, for patients with
special needs, and for patients whose medical conditions place them at risk.
