Dental Phobia affects a large part of the general population and it is one of the most common reasons why people don’t visit the Dentist. This in turn leads to poor dental health and neglect.

We at Applecross House have a great solution for you. It’s called Conscious Sedation.

When a drug, usually of the anti-anxiety variety, is administered during dental treatment, this is referred to as Conscious Sedation (which can be IV Sedation or oral sedation). These drugs reduce your anxiety and apprehension which in turn makes you receive dental treatment with little to no discomfort. This page answers the most common questions regarding conscious sedation.

What does it feel like?

It feels like you are very relaxed and drowsy. It has been suggested that IV sedation involves being put to sleep. In reality, you remain conscious during IV sedation. You will also be able to understand and respond to requests from your dentist. However, you may not remember much about what went on because of two factors: firstly, in most people, sedation induces a state of deep relaxation and a feeling of not being bothered by what’s going on. Secondly, the drugs used for sedation can produce either partial or full memory loss (amnesia) for the period of time when the drug first kicks in until it wears off. As a result, time will appear to pass very quickly and you will not recall much, or perhaps even nothing at all, of what happened. So it may, indeed, appear as if you were “asleep” during the
procedure.

Is it still necessary to be numbed with local anaesthetic?

The drugs which are usually used for sedation are not painkillers, but anti-anxiety drugs. While they relax you and make you forget what happens, you will still need to be numbed. If you have a fear of injections, you will not be numbed until the sedation has fully kicked in. If you have a phobia of needles, you will very probably be relaxed enough not to care by this stage. Your dentist will then wait until the local anaesthetic has taken effect (until you’re numb) before starting on any procedure. “But how does the dentist know
whether I’m numb?”. We check the LA [local anaesthetic] has worked by asking the patient. Just because they’re sedated doesn’t mean they can’t answer you…in fact they better be able to answer or they aren’t sedated, they’re anaesthetised! If they’re not numb enough they’ll soon tell you. But they won’t remember telling you of course [because of the amnesia effect]…

How is IV Sedation Administered?

“Intravenous” means that the drug is put into a vein. An extremely thin needle is put into a vein close to the surface of the skin in either the arm or the back of your hand. This needle is wrapped up with a soft plastic tube. The needle makes the entry into the vein, and then is slid out leaving the soft plastic tube in place. The drugs are put in through that tube. The tube stays in place throughout the procedure.

What is Oral Sedation?

There is option of taking pills that sedate you. These have to be taken an hour before the procedure. They are great when IV sedation is not possible for some reason. But IV sedation is considered better than Oral Sedation because of better control and safety.

Monitoring

Throughout the procedure, your pulse, oxygen levels, carbon dioxide, Blood pressure etc are measured using advanced monitors. These gadget clips onto a finger and your arm and measures the stats. It gives a useful early warning sign if you’re vital stats are changing. There are means available for early intervention and recovery. Your blood pressure is constantly monitored every 15 minutes using an automatic blood pressure cuff.

Is It Safe? Are There Any Contraindications?

IV sedation is EXTREMELY safe when carried out under the supervision of a specially trained dentist. Purely statistically speaking, it’s even safer than local anesthetic on its own! But with any procedure there are risks associated. However, contraindications include pregnancy, known allergy to benzos, alcohol intoxication, CNS depression, and some instances of glaucoma. Cautions include
psychosis, impaired lung or kidney or liver function, and advanced age. Heart disease is generally not a contraindication.

What Are The Main Advantages Of IV Sedation?

IV sedation tends to be the method of choice if you don’t want to be aware of the procedure – The alternative in the NZ is oral sedation using medazolam, but oral sedation is not as reliably effective as IV sedation.The onset of action is very rapid, and drug dosage and level of sedation can be tailored to meet the individual’s needs. This is a huge advantage compared to oral
sedation, where the effects can be very unreliable. IV sedation, on the other hand, is both highly effective and highly reliable.
The maximum level of sedation which can be reached with IV is deeper than with oral or inhalation sedation.

Gaggers can relax too!

With sedation the gag reflex is hugely diminished – people receiving IV sedation rarely experience difficulty with gagging.