IV Sedation for Dental Treatment
Intravenous sedation involves giving you an injection of a sedative drug through a plastic tube into a vein in your arm or hand. The sedative drug will relax you and make you feel sleepy during your treatment. However, many people do not remember anything about their treatment. Sedation by injection will help you cope with dental treatment and reduce your anxiety. Even people who do not feel anxious about dental treatment choose to have sedation for uncomfortable procedures such as extractions.
How does dental sedation work?
“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. It makes the entry into the vein, then is slid out leaving the soft plastic tube in place. The drugs are put in through that tube (which is correctly referred to as an “indwelling catheter”, but more commonly known by the tradename of Venflon). The tube stays in place throughout the procedure.
Throughout the procedure, your pulse and oxygen levels are measured using a “pulse oximeter”. This gadget clips onto a finger or an earlobe and measures pulse and oxygen saturation. It gives a useful early warning sign if you’re getting too low on oxygen, although if your dentist and the nurses are paying attention they should see it way before the machine does. Blood pressure before and after the procedure should be checked with a blood pressure measuring machine (a tongue-twister called “sphygmomanometer”, which for obvious reasons is referred to as “sphyg”).
What are the risks of dental sedation?
- Anterograde amnesia. Due to the amnesic effects of the medications, patients have little or no recollection of the treatment.
- Less post-operative soreness. When patients are afraid, their threshold for pain is much lower. Fear and anxiety trigger the release of certain chemicals in the brain, like adrenaline, which put a patient’s “fight or flight” instincts on high alert. They anticipate that something is going to hurt and so they tense their muscles, even if it is subconsciously, leading to additional soreness post-treatment. With sedation, a patient’s apprehension and hypersensitivity to pain is virtually eliminated, thus reducing the likelihood and severity of post-operative discomfort.
- Dry mouth: Sedative medications will decrease salivary flow and allow the dentist to perform treatment in a dryer environment.
- Nausea: A small percentage of patients will experience nausea.
What happens during the sedation?
The dentist will explain the planned treatment and check that you understand what will happen. The dental nurse will take your blood pressure. You will be asked to lie back in the dental chair and a small plastic tube (cannula) will be placed in your arm or hand. The dentist will then give the sedation slowly through this tube and encourage you to relax. The dental team will monitor your breathing throughout treatment.
The sedative will help you feel calm and relaxed. With IV sedation, you will also be less aware of what’s going on, although still able to communicate as normal.
Will I feel any pain?
Your dentist will give you an injection of local anaesthetic to numb the area where you will be having treatment. You might feel a slight stinging sensation while having the local anaesthetic but then the area should feel numb. We will do our best to make sure you feel as comfortable as possible during the procedure. Please let us know if you feel any discomfort.
What happens after the procedure?
At the end of treatment, we will walk you to the recovery area where your accompanying person will be waiting. You will still feel sleepy and many people feel unsteady and forgetful. For these reasons you will not be able to leave hospital until you have been checked by the dentist or dental nurse.
What do I need to do after I go home?
For your safety, it is important that you follow the advice given below. Although you might feel fine, your reasoning, reflexes, judgement, coordination, and skill can be affected by the sedation until the next day.
Please rest at home until the following day. During this time you should not:
- drive any vehicle or ride a bicycle
- operate any machinery, including domestic appliances
- drink alcohol or smoke
- make any important decisions or sign any contracts
- use the internet
- be responsible for children or other dependants.