Sedation

Firstly, please rest assured that you are not alone. It is rare that anyone actually likes coming to the dentist and it is estimated that at least 10-30% of the UK population has either moderate or high dental anxiety.

However, even high levels of dental anxiety can be managed comfortably when seen by an appropriate team of dental professionals. Sometimes all it takes is just an understanding dentist who will listen to your concerns and will ensure that these are addressed.

Taking care to be extra gentle and talking through everything that is happening can work wonders, and we are known to be particularly proficient at this. We also take further steps such as simply always using numbing gel to make everything as comfortable as possible.

When these measures are not enough, or if we think a treatment is particularly complex, intravenous dental sedation is a very effective and safe option for treatment.

Intravenous sedation is a form of conscious sedation using a single sedative drug.

A dose of the drug is chosen for you individually. It is given via a thin and flexible plastic tube into your vein, called a cannula. A very small needle is used to put the cannula in but is then removed immediately. It is normal to feel a sharp scratch when the cannula is inserted. Once the cannula is in the vein, the sedation drug can be given without using any more needles. The cannula remains in until the dentist has checked that you have recovered from the sedation but it will be removed before you go home.

You will remain awake throughout this procedure, so it is not the same as being asleep, which is called a general anaesthetic. However, the vast majority of patients become so relaxed that they feel like they were actually asleep and do not recall much from the whole appointment.

No. People usually prefer to have dental sedation near home as it can be more comfortable than going to a busy hospital. As long as the treatment is carried out by trained and competent clinicians, there is no absolute requirement to be seen in the hospital. We have years of experience in providing dental sedation in a practice setting and are experts at seeing nervous patients.

The best way to describe the feeling is that even though you are awake, you will essentially not care about anything that is going on because the drug makes you very relaxed and comfortable.

It is important to note that sometimes, you will not feel particularly sleepy, but you will still feel very relaxed and comfortable.

When asked, most patients say that they did not feel anything and later on cannot recall anything about the treatment. Some patients remember things more than others and there is no way to predict this.

For the vast majority of patients, intravenous sedation is extremely effective and works as described above.

In a minority of patients, the drug just does not have as much of an effect and we have no way to predict this if you have never been sedated before.

Some factors increase the likelihood of intravenous sedation not being effective. Some of these include: the use of recreational drugs, particularly cannabis, long-term use of benzodiazepine medications and some mental-health disorders.

Furthermore, if you are severely needle phobic and will not in any way tolerate the insertion of a cannula, then intravenous sedation alone may not be the best option. There may be other options such as the use of inhalation sedation or intra-nasal sedation prior to the insertion of the cannula.

In short, yes.

We have many years of experience delivering intravenous sedation both in practice and in hospital, where more complex cases are seen.

Every year, thousands of patients in the UK receive dental treatment with intravenous sedation safely and effectively. It is much safer than a general anaesthetic, which is why it is possible to offer this treatment in a practice setting.

Some common side-effects of intravenous sedation include:

• A reduction of oxygen in the blood stream due to slowed breathing during sedation. You may be asked by your dentist/sedationist to take deep breaths to correct this. Your breathing and oxygen levels will be monitored throughout the procedure.
• Bruising at the site of the cannula. This may take several days to fade completely.
• Anterograde amnesia, which means not being able to recall events after receiving the drug. This is usually a good side-effect as patients cannot recall things that they do not want to remember and will have less anxiety for any further appointments.

Very rare risks include allergic reactions to the sedative drugs that you have been given, or vomiting during the procedure.

If there is any chance that you may be pregnant, you will not be able to have intravenous sedation due to the risks to the fetus.

You will require an initial consultation appointment to carry out a full assessment, to be able to safely plan and discuss your treatment. We will go through all the details of your treatment following this appointment.

One of the prerequisites for having treatment under intravenous sedation is being able to arrange for an able-bodied adult to accompany you to your appointment and to look after you for the remainder of that day.

As far as practically possible, yes.

However, this is dependent on individual factors and we will be happy to discuss the details of your particular case with you.

Yes, you need to at least take off the day of treatment.

Following intravenous sedation, your judgement will be affected by the drugs. This is similar to the effects of consuming alcohol. You should not drive a car, ride a bicycle or operate machinery until the following day. In some cases, this may be for as long as 24 hours. You should also not take responsibility for the care of others, use sharp implements or cook. It would be unwise to make any irreversible decisions for up to 24 hours following your treatment. Owing to the after effects of the drugs used, care should be taken when using the internet for personal communication.

Most patients are able to return to their normal work from the following day.

Being fully asleep is known as a general anaesthetic. This is something that is not available in a dental practice and is only carried out in hospitals.

General anaesthetics are only carried out where clinically necessary and not a personal choice.

The other most common type of conscious sedation for dental treatment is known as Inhalatation Sedation, also known as gas and air.

This can be a useful method for many patients but the level of relaxation is not as strong as intravenous sedation.

We do not have the facilities to offer inhalation sedation.

You should talk to your dentist beforehand if you don’t like needles. We always use numbing gels to minimise discomfort during the injection and have several techniques to make having a dental injection really quite comfortable.

The thought of someone putting their hands in your mouth and altering your teeth while you can’t see what’s going on, can seem off-putting. Speak to your dentist about these worries, so they can suggest ways to help you feel comfortable. For example, your dentist will be more than happy to talk through what they’re doing at each stage or come up with a signal such as raising a hand if you want them to stop and take a break at anytime during treatment.