Not All Sedation Is the Same. What to Expect from IV Sedation
With IV sedation, patients experience complete relaxation while their dentists work. They have pleasant dreams and the time flies by. When it’s over, they have no memory of any of the procedures and, when they leave their appointment, they are happy.
This is so important because it shows that IV sedation offers a way to counteract even the most severe fears. Patients that wouldn’t even let dentists look in their mouths in the beginning turn into patients giving thumbs up and saying, “Wow, that was amazing.”
It is also important to note that IV sedation is not the same thing as general anesthesia. General anesthesia, though necessary for a wide range of situations, also presents serious risks. IV sedation is becoming widely used for a whole scope of medical procedures, such as certain plastic surgeries, colonoscopies, minor gynecological procedures, and others.
IV sedation is a medication administered intravenously. It works instantaneously, and it produces complete relaxation. Patients under IV sedation rest in “twilight” and dream peacefully while their dentists complete their work. Their fears are abated and their smiles are restored, and even the most complicated work can be done in just a few hours.
Under IV sedation, patients don’t know what’s going on. They feel like they’re in a happy, relaxed place, where all of their previous dental fears and anxieties just float away. When they wake up, it seems like all the work took place in a matter of minutes, and they can leave feeling good and comfortable, in a very pleasant state.
IV Sedation Can Be Titrated
Because every person is different, titration is very important. Titration is the process by which dentists determine the right concentration of sedation to use, based on a patient’s individual characteristics and needs. This allows them to customize the dosage specifically so that it will be the exactly correct amount, keeping the patient fully sedated without the dangers of going too deep. Where with other forms of sedation (such as oral sedatives or sleeping pills) it can be very hard to predict the amount needed for one individual, IV sedation can be fully titrated.
IV Sedation Is Low Risk
While IV sedation provides patients with complete relaxation and comfort, patients do not lose their ability to breathe on their own and respond to verbal commands. This is a big advantage because although patients won’t remember anything about the procedure, all factors that could make them nervous or anxious are eliminated. The state of twilight relaxation and the fact that the procedures will seem to be over very quickly help ease virtually all dental fear and anxiety.
IV Sedation dentists will offer this wonderful service to patients who want or need to take advantage of it, but they will also offer other options. Typically, it seems that about 90 percent of patients will opt to take advantage of IV sedation when it’s available. This is why specialty practices that offer the sedation method are highly skilled and sought after by patients from all over the country.
Misconceptions of Sedation
Is It Safe?
There are many misconceptions of IV sedation. Many people wonder if it is safe—it is. Before any patient undergoes IV sedation, dentists are required take a very thorough medical history to make sure that the person is healthy enough to handle it. Then, during any procedure where a patient is sedated, the dentists are legally required to monitor his or her vital signs, watching pulse, blood pressure, oxygen saturation, and electrocardiogram (EKG) constantly. Plus, there will be emergency equipment available in the very unlikely event that it would be needed. It’s very rare to have a complication during sedation, but good dentists will be prepared for anything.
The truth is, when administered by a trained and experienced specialist, IV sedation is very safe. One of the reasons it is so appealing is because there are effective reversal agents. Dentists can actually reverse the effects of the sedation instantaneously. For example, if they start noticing a concerning dip in any vital signs, they can reverse the sedation immediately. That’s another plus over the other forms of anesthesia.
Is It Reliable?
IV sedation is also very predictable compared to other forms of anesthesia. By using a combination of medications, the sedation specialist can use the needed amount to create a desired sedative effect.
Any Restriction Before and After IV Sedation?
One of the most common questions regarding IV sedation is whether patients will be able to drive themselves to and from their appointments. The answer is no; patients should plan to have an escort bring them and pick them up from their treatments because some lingering effects of the sedation could make it unsafe to drive immediately following their appointments. Additionally, patients should not eat or drink for about four hours beforehand. If a patient is taking prescription medicine, it’s important for the sedation specialist to discuss the situation and planned treatment beforehand with the patient’s physician.
How Will I Feel?
Prospective patients are also often curious about how they will feel during the sedation. The simple answer is relaxed, unaware of what’s going on, and comfortable. Afterwards, patients might be a little groggy; however, the most common medications used are short-acting, so the effects dissipate pretty quickly.
It’s also important to mention that everybody reports the same thing. During sedation, a long dental visit feels like it was completed in about 15 minutes. Time passes very quickly, making the treatment even more comfortable and painless.
Is IV Sedation Common in Dental Offices?
IV sedation in dental offices offering comprehensive treatment isn’t common at all. This service is much more common for oral surgery. However, patients who require complex dental work are in need of careful planning and replacement of the lost teeth. They need to do a thorough search to find a group of dental specialists that not only provides IV sedation but also can restore their smile to the highest standards.
Will I Lose Control of My Mind and Body under IV Sedation?
People often think that they will lose control when they are sedated. That is not true. Usually, sedated patients are calm and relaxed, as if they were sleeping. Sometimes patients will come out of the sedation and they’ll ask, “What did I say or how was I? How did I behave?” They’re worried they might give too much information or say something embarrassing, but sedation is not a truth serum. People are afraid they’ll tell all of their secrets, but nobody ever does.
People affected by the sedation are still in control. They are aware of their surroundings and situation. They know they’re in a dental chair. They just don’t feel anything. The IV sedation creates an atmosphere for them that makes it pleasant to be in a dental chair.
After the positive experience that sedation creates for them, a lot of patients see their lifelong dental fears disappear. They no longer associate the dental chair with pain and fear. For other patients, even if the fear might not completely disappear, it still lessens considerably.
For many people, IV sedation is the most effective way to overcome dental fear; without it, they might never have courage to undergo treatment. Not only does IV sedation allow patients to have much needed dentistry, but also it is a way to erase their fear of dentistry.
As all these very phobic patients progress through treatment and when they come back afterwards for follow-ups, they’re doing much better psychologically. Previously afraid to let dentists even look in their mouths, they’ll accept minor adjustments with metal tools with little to no fear. It’s the kind of thing they never thought was possible but really happens.
When she first came in, Tanya wouldn’t even let the dentist look at her. She was so fearful and anxious, even a touch would cause tears. After comprehensive treatment with IV sedation, Tanya returned every six months for her check-up and when it came time for her to need a new dental crown, she was able to have the work done without any sedation. She wasn’t afraid anymore—what caused the transformation? She had come so far. It was all because of the difference IV sedation made. She trusted her dentists, who had built significant rapport and become like friends because of the quality of their treatment. That is how dental procedures should be.
Many patients haven’t experienced a nice smile and oral health in decades, so effective treatment becomes a truly life-changing journey. The look of their mouths is something they previously couldn’t control, but after overcoming dental fear, they obtain the treatment they need to restore their smile, oral health, and self-esteem.
Fear of Needles
Society has helped build this strong fear of dentists—and along with it, the fear of needles. Many patients fear both. For this reason, although most anxious patients want to take advantage of IV sedation, sometimes they have to overcome the fear of needles—which provide the sedation—first.
There is good news. Most of the time, patients who are afraid of needles are most afraid of needles in the mouth, and because the IV needle is not placed in the mouth, it isn’t as frightening.
But for those patients who are truly afraid of all needles, there are other options. Before the IV line is started, the patient could receive a little nitrous oxide to help take the edge off. A skin refrigerant, a little coolant spray put right on the skin just before the IV injection, can help mask the pinch of the needle. In fact, this way, patients really don’t feel it at all. The IV sedation kicks in right away, so then they don’t even remember the IV needle.
Dana was a patient who was initially very apprehensive about the IV needle. She had extreme dental fear, created by negative past childhood experiences, sensitivity to being touched in the mouth, and fear of personal space invasion. When she was told the IV would be placed in her hand, she wanted avoid treatment entirely. In her case, extra measures were necessary to make it possible for her to receive the IV sedation. She was given nitrous oxide (laughing gas) as well as a light oral sedative to help her relax enough to receive the sedation and undergo necessary treatment in comfort. A skin refrigerant was also used, and the IV was placed without any discomfort or apprehension.