If used properly, the anti-anxiety medications used to achieve oral sedation have a low incidence of side effects. These side effects are usually minor, and only rarely they present an actual risk for the sedated patient's health.
The side effects that may be experienced by patients who receive oral sedation include:
Retrograde amnesia - Due to the amnesic effects of many of the oral sedatives, many patients may recall little to nothing about the dental treatment. This side effect is actually considered as an advantage by patients who do not want to remember the ‘bad’ memories of dental procedures.
Dry Mouth - A common side effect of the oral sedation medications is the decrease of salivary flow. This can cause a dry mouth feeling to the patient until the drug’s effect wears off, but it can help the dentist to perform treatment more easily in a dryer environment.
Hiccups - A small percentage of patients will experience hiccups that will usually last only for a few minutes after using oral sedation drugs.
Ineffectiveness - In some people (usually smokers or taking other drugs) oral sedatives may not work as desired, failing to provide the expected anti-anxiety effects.
Other Side Effects - Other side effects may include light-headedness, headache, dizziness, visual disturbances, hangover/jet lag feeling, amnesia, nausea or allergic reactions. Rarely, these side effects are serious in order to require medical attention.
As with all sedation methods, the risks associated with oral sedation are mostly related to the risk of over sedation. Reaching a deeper level of sedation than the desired one can be dangerous especially for certain groups of medically compromised patients. To avoid these risks, dentists use the lowest effective dose of the sedative agent chosen to best suit their patient needs.
Increased risk of developing complications related to sedation occurs in patients with significant cardiac, pulmonary, hepatic, renal, or CNS disease, obesity, sleep apnea, or in the elderly, pregnant patients, and drug/alcohol abusers. Oral sedatives tend to have a greater effect in the elderly which, in combination with other medications they usually take, can lead to over-sedation. In the above groups proper selection of the suitable sedative drug and dosage is very important in reducing the risk of oral sedation complications.
Over sedation can lead to significant depression of the cardiovascular or/and respiratory functions, causing severe complications and even death.
Patients under oral sedation must be continuously monitored to prevent any risks associated with oral sedation medications. A pulse oximeter is therefore required on a continuous basis to provide the earliest warning of hypoxia, while respiratory functions must also be monitored by observation of spontaneous breathing activity. For patients with increased risk for developing cardiac dysrhythmias during sedation, continuous electrocardiographic monitoring is recommended.