Sedation Dentistry
Different Degrees of Sedation
Sedation can be administered through several different methods, depending on the overall health and level of relaxation required by the patient. The type of sedation that is best suited for you will be discussed with Dr. Warren prior to your restorative or preventive appointment. This will allow you to ask any questions regarding this safe and effective way to "calm your nerves". During this visit, you and Dr. Warren will decide the type and level of sedation that will be needed to accommodate your anxiety and fears. Everyone is built differently and one form may suit you more than another, in order to achieve the desired level of sedation. Dr. Warren will discuss with you the procedure ahead of time so that you will be well-informed and comfortable in your decisions.
Depending on a patient’s degree of fear or anxiety, different levels of sedation may be required. These varying levels include:
- Anxiolysis – This is a level of sedation that controls anxiety. At this level, you will not be able to fall asleep but will feel relaxed. In most cases, this level is a great way to calm the nerves enough to have the necessary treatment completed. The common methods of sedation used to achieve this level are Nitrous Oxide and Oral Sedation.
- Mild Conscious Sedation – This level of sedation is where a small portion of patients may achieve the comfort needed to complete any necessary or elective restorative, preventive, and cosmetic dental procedures. At this level, most patients will not have amnesia and will likely remember the entire procedure. Most individuals will still feel little to no discomfort or pain. This level of sedation is very mild and while you may not be able to fall asleep, you will be very relaxed. Many dentists use this conscious level of sedation to provide a state that lets patients feel relaxed, but also remain awake and able to respond to commands. The common method of sedation used to achieve this level is Oral Sedation.
- Moderate Conscious Sedation – This level of sedation is where most patients will experience the degree of comfort needed to complete any necessary or elective restorative, preventive, and cosmetic dental procedures. At this level, you will have little to no memory of the procedure, feel very little to no discomfort or pain, and will likely be able to sleep through all or a large portion of your dental procedure(s). While this level will not "put you to sleep" many feel that they were completely "out" because they have no memory. At this level, you will be relaxed and in most cases sleepy, but you will be able to breathe on your own and communicate with Dr. Warren. Most patients with a high dental fear and anxiety will require this level to be comfortable enough to have their dental treatment completed. The most common method to achieve this degree of sedation is intravenous (IV) sedation, but there are a few patients that can achieve this level with an oral sedation. The benefit of an IV over an oral medication is that it is controlled and specific to the patient, the absorption of the drug works at a much faster rate, and the recovery time needed is much less. Patients requiring this level of sedation overwhelmingly have a higher success rate in their sedation when we use the intravenous method.
- Deep Sedation – Patients with extreme fear may feel more comfortable with deep sedation, which provides a state somewhere between consciousness and unconsciousness. In this state, patients cannot respond to commands and may need breathing assistance. This level of sedation is most commonly used for the most fearful patients that cannot be successfully sedated with traditional sedative medications. This is an IV sedation commonly performed in an outpatient setting by a Medical or Dental Anesthesiologist or by an extensively trained Oral Surgeon.
- Unconsciousness – General Anesthesia – Unconsciousness is also occasionally needed, but requires general anesthesia by a highly trained Anesthesiologist or Surgeon. This level of sedation requires a patient to be paralyzed completely and have an airway maintained by a ventilator. The risk involved is much greater than of the other conscious levels, but is still safe in the hands of a skilled doctor. This is usually only used for major oral surgery and complex restorative procedures in a hospital surgical setting.
Dr. Warren has been extensively trained to offer Conscious sedation techniques to his patients. Deeper sedations or General Anesthesia generally requires an oral surgeon to perform the procedures; however, the vast majority of general dentistry services can be completed in the first few levels of sedation and give the patient a safe and comfortable experience.