There's so much dentistry can do these days to make your mouth healthier and your smile more beautiful. Yet many people don't take advantage of this because of a long-standing fear of dental treatment. If you are one of these people, rest assured that it's possible to have an experience that's free of anxiety and pain.
This can be accomplished by blocking your sensations of pain with local anesthetics or by giving you medication that can help you relax. Sometimes both are needed to ensure maximum comfort, especially if you are someone for whom the injections that deliver local anesthetics are themselves a major source of anxiety.
When you are afraid of dental treatment, your guard goes up and your pain threshold goes down; anticipating that something will hurt makes you hypersensitive to every sensation — even sound. If this describes your experience in the dental chair, then you might benefit from sedatives that can be given during your visit to make that anxiety melt away.
Before any particular sedative is recommended, you will be asked to provide your complete health history, including any medications you are currently taking — both prescription and over-the-counter. It is also important to know if you smoke or drink. On the day of your treatment, you may need to have someone drive you to and from your appointment as certain medications take time to wear off.
Ways to Relieve Anxiety
Oral Sedation — Oral sedation (given by mouth) is a popular option for many people precisely because it does not require the use of needles. Oral sedatives are either swallowed whole in pill form or can be dissolved under the tongue. Both methods work in a matter of minutes. A variety of oral sedative and anxiolytic (anxiety-dissolving) medications have been developed through extensive research and testing to make your experience of dental treatment as comfortable and relaxing as possible. All have long safety records after decades of use, and several even have “amnesic” properties, meaning you will remember little to nothing, even though you are conscious throughout the treatment. Commonly prescribed medications include Valium®, Halcion®, Sonata®, Ativan®, Vistaril®, and Versed®. To learn more, view our chart on Types of Oral Sedatives
Conscious Sedation — Nitrous oxide, a sedative you inhale, has been used in dental offices for nearly 100 years. It is a relatively poor pain reliever but a very good anti-anxiety medication. It is administered through a nasal hood, which resembles a small cup that is placed over your nose. The oxygen mixed with nitrous oxide provides a light-headed or even euphoric feeling, which is quick to wear off so there is no “hangover” effect. All bodily functions remain essentially normal during the use of this sedative, which is very safe.
IV Conscious Sedation — Sedatives delivered directly into the bloodstream intravenously (into the vein) are more potent than when taken orally, and the amnesic effects may be more profound. Because IV sedation has an almost immediate effect on the body and its functions — including heart rate, blood pressure, and breathing — there is a higher degree of risk associated with it than with other types of sedatives. There is also a higher level of training required for those who administer it. As with all sedation (except nitrous oxide), you must be monitored with specialized equipment throughout your IV sedation treatment. The main advantage is that drugs administered this way work immediately and the level of sedation can be adjusted more quickly and easily. And with most sedatives, you won't remember a thing about your dental procedure after the sedative wears off.
Some people fail to receive the benefits of modern dental treatment because of a simple yet seemingly overwhelming problem: Fear.
It isn't uncommon to have a little anxiety about an upcoming dental procedure. But if your fears have kept you away from the dental office when you know you really should go — take heart! Conscious sedation with nitrous oxide can help you lose that anxiety, and make the whole experience so stress-free that you may not even remember it when it's over.
Nitrous oxide, a colorless gas with a slightly sweet odor, has been used in medicine for about a century; however its outdated nickname, “laughing gas,” is undeserved. It's a safe and effective method of administering conscious sedation — which means that you'll stay awake during the procedure. But when nitrous oxide is used in combination with a local anesthetic, you won't feel pain or anxiety. In fact, many patients report a feeling of well-being during this type of sedation. All bodily functions remain normal during the administration of nitrous oxide, and its effects wear off quickly afterward.
How Is Nitrous Oxide Administered?
As a form of conscious sedation, nitrous oxide is inhaled through a small mask that fits comfortably over your nose. The gas is mixed with oxygen as it is being delivered, and both gases are always kept at a level that is safe for the body. In just a few minutes, you may start to experience a floating sensation, and perhaps some tingling in the hands and feet. That's a sign that the sedation is working. Once it has been verified that you're calm and comfortable and that the dose is correct, your dental procedure can begin.
Nitrous oxide itself isn't a substitute for a local anesthetic — it's considered an anxiolytic, which means it makes anxiety disappear. For some procedures, you may still need an anesthetic injection. The difference is, you won't mind. Yet, you won't be asleep — you'll be able to speak, be aware of what's going on, and you will remain in control during the procedure. In fact, the dose can be fine-tuned to just the level of sedation you need.
When the procedure is over, the flow of nitrous oxide is decreased to zero, and the oxygen may be increased. After resting in the chair for a few minutes, you'll be able to sit up, and soon you can resume normal activities like driving. Although the experience has been compared to “having a couple of drinks,” there is very little “hangover” effect afterward.
Who Can Benefit From Nitrous Oxide?
Most people whose anxiety would otherwise keep them out of the dental chair can benefit from conscious sedation with nitrous oxide. Before beginning treatment, we will take a complete medical history, including your use of both prescription and non-prescription medications. If you are pregnant, have COPD (Chronic Obstructive Pulmonary Disease) or some other pulmonary diseases, or are taking certain drugs, it may not be right for you. However, if you feel that you would benefit from a more stress-free experience in the dental office, ask about nitrous oxide conscious sedation.
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