Sedation Dentistry

Dental visits aren’t pleasant and understandably some people are apprehensive about it. In fact, reports claim that sometimes people would rather tolerate severe pain and discomfort than visit a dentist.

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This means that a lot of people knowingly or unknowingly give in to teeth and gum damage and are ready to face the consequences of the same if that could postpone a dental appointment.

Fact is that with local anesthetic, the patient is sufficiently numb and feels no pain. The sedation is mainly introduced to calm anxieties and stress of the mind.

Technology has made such progress that one does not have to choose between extensive gum and tooth damage due to lack or delay in treatment, and battling with one’s own fears about the pain and sensitivity related to the dental procedures. One such technological development is known as sedation dentistry.

In simple words, it is the use of pharmacological agents, the job of which is to calm and relax the patient before and during a dental appointment. Sedation can be via oral medication – which are often nicknamed as happy pills; or it can be with the help of nitrous oxide, popularly referred to as the laughing gas. Let us have a basic understanding of both:

Nitrous Oxide Sedation

Studies show that nitrous oxide sedation can reduce your dental visits to half or less. The reason for this could be  because of the sedation a patient remains calm for a longer time allowing the doctors to conduct more of the requisite procedures – something which would have kept getting postponed or would have required multiple visits because of the patient’s apprehension levels.

Nitrous oxide, which is also popularly called as Laughing Gas is a colourless, odourless, and non-irritant gas which is often used to help patients relax before a difficult procedure. It creates as pleasurable sensation in the brain of the person who inhales it and has been considered as completely safe and very effective for complicated medical procedures involving long periods of time.

Reasons for choosing NO2 for your dental procedure may be myriad. Apprehensiveness due to outside factors like the drilling sound or the chemical smells, fear of the unknown about what is going on, dental issues requiring multiple visits and long hours, gagging reflex that makes you uncomfortable during a procedure, fear of injections, busy schedule in which no time to fit a dental appointment are just some of the reasons.
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Despite a lot of controversy surrounding it a few years back, it has now been proven that NO2 is completely harmless and is extremely effective is relaxing the nerves and bringing in a sense of calm and happiness. It acts both as an analgesic and an anxiolytic, and is a non-invasive procedure.

Its effects start almost soon after its inhalation and stops within a few minutes of the gas leaving the body, making it an effective choice for many people who don’t have family to drive them around or don’t have the time to nurse the sense of a hangover. It has also been reported to be safe for patients suffering from other diseases like epilepsy, liver disorders or heart conditions.

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NO2 is administered with the help of a nasal cannula and a nasal inhalation mask. A mixture of nitrous oxide and oxygen gas is stored in canisters in a ratio of 25-50% of NO2 and the rest being oxygen. The flow is regulated with the help of a valve and modern additions like an alarm, oxygen flush button, emergency air inlet etc ensure that the patient’s health is of utmost importance.

The nitrous oxide is ideally introduced to the patient through a method called titration so that chances of drug overdose are limited. Upon reaching the desired level of the drug, a patient can experience  two effects – (a) analgesic – altering the way pain is processed making the procedure pain free for the patient; or (b) anxiolytic – transmitting of a nerve impulse that makes the patient feel stress free and without anxiety.

How will I feel under Nitrous Oxide sedation?

Feelings of euphoria, numbness, lightness, tingling and a sense of well being are common effects reported by our patients.

What If I Don't Like The Feeling of N2O?

If you do not like what you feel under N2O or feel uncomfortable or uneasy, it can be discontinued at any time. The effect wears of in a few breaths. We can also adjust the amount of gas delivered, some patients prefer less.

Is N2O administration safe for pregnant women?

Nitrous Oxide is a commonly recommended sedation method and even though it crosses the placenta, it does not get metabolized by the body; hence, there is no effect on most organs and it’s eliminated from the body quickly. You may want to consult your obstetrician prior to treatment.

What Should I Do Before Taking Nitrous Oxide?

Discuss any concerns and questions about the sedation with us. Inform us of your medical history and any medications that you are currently taking. It i best to avoid eating a large meal before the treatment and advisable that you use the restroom prior to your procedure. Also, the less you breathe or talk during your treatment, the quicker and more efficiently the gas works.

Oral Sedation

Oral sedation works with the prescription of psychoactive drugs by your dentist which help you to feel calm and composed. The benzodiazepines in the drug act on the nervous system and act as a catalyst to the gamma amino-butyric acid GABA which helps in bringing in a hypnotic effect.

Oral sedation is a safe, easy to administer, non-invasive, and is said to be highly effective. It helps the patient feel less pain and apprehension, thereby helping to reduce their anxiety levels. However, it must not be confused with general anaesthesia where the patient is unconscious and unaware of their surroundings. With oral sedation, you may feel drowsy and relaxed and you may appear to have slurred speech or might experience some dryness in the mouth, all of these side effects actually wear off in some time.

What should I do before and after procedure involving oral sedation?

Before the administration of an oral sedative, it is crucial that you discuss with the dentists and let him know about your general health and medical history. Since the dosage of each drug depends upon several important factors like physical structure, psychology, pre-existing health conditions etc; it is very important to give answers as accurate as possible so that the dentist can calculate a dosage that is best suited for you. Driving is a strict no-no after leaving the dental office and it is strongly advised that you get a friend or family who can drive you to and from while you sit back and relax.

How long will the effects of oral sedation last

We prescribe short acting low dose medications whose effects wear off under 12 hours.

Is N2O administration safe for pregnant women?

Nitrous Oxide is a commonly recommended sedation method and even though it crosses the placenta, it does not get metabolized by the body; hence, there is no effect on most organs and it’s eliminated from the body quickly. You may want to consult your obstetrician prior to treatment.

Note:Regardless of Oral or NO2 sedation, an anesthetist is typically present during the procedure to administer you with local anaesthetics – something which helps relieve the pain and discomfort.