Sedation

Sedation is the state of a patient’s mind and body once they have been exposed to a sedative drug like anesthesia. When sedated, patients feel calm or asleep depending on the method of anesthesia used, which could be administered via gas or injection. There are several reasons why dental professionals use sedation to treat patients.

Sedated patients are calmer and less prone to sudden movements, which can negatively impact a surgical procedure. Being calm also improves their experience and allows them to overcome dental anxiety. The provider can work more quickly and accurately. Finally, sedated patients are less prone to having a gag reflex during dental procedures.

With as much as 15% of the adult population experiencing severe dental fear, sedation is a useful tool for providers trained and certified in anesthesia to administer more empathetic and effective care.

• Minimal Sedation (previously known as anxiolysis) is a minimally depressed level of consciousness produced by a pharmacological method that retains the patient’s ability to independently and continuously maintain an airway and respond normally to tactile stimulation and verbal command. Although cognitive function and coordination may be modestly impaired, ventilatory and cardiovascular functions are unaffected. Nitrous oxide/oxygen when used in combination with sedative agent(s) may produce minimal, moderate, deep sedation or general anesthesia.
• Moderate Sedation – a drug-induced depression of consciousness during which patients respond purposefully to verbal commands, either alone or accompanied by light tactile stimulation. No interventions are required to maintain a patent airway, and spontaneous ventilation is adequate. Cardiovascular function is usually maintained.
• Deep Sedation – a drug-induced depression of consciousness during which patients cannot be easily aroused but respond purposefully following repeated or painful stimulation. The ability to independently maintain ventilatory function may be impaired. Patients may require assistance in maintaining a patent airway, and spontaneous ventilation may be inadequate. Cardiovascular function is usually maintained.
• General Anesthesia – a drug-induced loss of consciousness during which patients are not arousable, even by painful stimulation. The ability to independently maintain ventilatory function is often impaired. Patients often require assistance in maintaining a patent airway, and positive pressure ventilation may be required because of depressed spontaneous ventilation or drug-induced depression of neuromuscular function. Cardiovascular function may be impaired.

Patients considered for sedation must be suitably evaluated prior to the start of any sedative procedure. In healthy or medically stable individuals, this should consist of a review of their current medical history and medication use. In addition, patients with significant medical problems may require consultation with their primary care physician or consulting medical specialist.

During surgery, various methods of sedation can be used to control pain and anxiety, including local anesthesia, nitrous oxide-oxygen, intravenous sedation, and general anesthesia.