Oral Sedation Procedure
Oral Sedation Dentistry medications

Oral Sedation Procedure

Oral sedation procedures can provide a relaxed, comfortable and safe experience for the patient, allowing the dentist to maximize its service both in quality and quantity without distractions. Oral sedation techniques allow patients with increased dental fear and anxiety to visit the dentist in an anxiety-free condition and receive proper dental health care.

Before the Oral Sedation Procedure

One of the factors that have increased its popularity is that the oral sedation procedure is considered as the most patient friendly compared to other methods of dental relaxation. If you want to feel relaxed during dental treatment, oral sedation can help in a simple and easy way; all you have to do is just taking a pill.

But before you can get the dental treatment that you need under the relaxation offered by oral sedation, your dentist must first:

  • determine if you are a suitable candidate for this type of dental sedation.
  • decide the specific sedative that you must take before the treatment
  • provide the necessary instructions

Therefore, two appointments are generally required for completing a procedure using oral conscious sedation.

Oral Sedation Procedure - The consultation appointment

Medical history

Before starting an oral sedation procedure, the dentist must determine if the patient is a suitable candidate for oral sedation. Taking a complete health and medical history of the patient is essential for identifying any contra-indications in using this type of conscious sedation.

If your dental treatment will be done under oral sedation, you must provide your dentist with a complete health history including:

  • Chronic health conditions. Oral sedation may not be suitable for certain health conditions, or the sedation protocol must be modified according to the specific health condition of the patient.
  • Recent health conditions for which you are or have been treated in the last days. Even a temporary condition such as a cold, may have some effect on the way oral sedatives are absorbed by the body.
  • Medications, either prescription drugs or over-the-counter medications, that you have to take daily and any other drugs that you have taken in the last days.
  • Alternative medicines, vitamins or herbal supplements. Although they are considered natural and safe, your dentist must be aware because some of them contain chemicals that may interact with oral sedatives.
  • Smoking and alcohol consumption, which can influence the effectiveness of sedation medications. Especially alcohol should never be consumed when you take any type of sedative drug.
  • Foods that you have consumed in the last 72 hours. Enzymes in certain foods, such as grapefruit, may affect the metabolism of oral sedatives in the body, therefore they should be avoided prior and after the oral sedation procedure.

Depending on the patient’s medical history, the dentist will decide if:

  • Oral sedation can be used, or if any other sedation method is more suitable
  • Which oral sedation medications can be used and which have to be excluded
  • Which sedation protocol (drug / dosage) is more suitable for the patient.

It is critical that you fully and honestly disclose your medical history and drug usage to your dentist before the oral sedation procedure. Trying to hide some drugs that interact with the oral sedatives administered by the dentist, may lead to serious complications and even death.

Treatment planning - Selection of oral sedative drug and sedation protocol

The selection of the proper sedation protocol (drug to be used, dosage, and administration method) is the next step of the oral sedation procedure.

The most important factors in this process are the medical history, the invasiveness of the scheduled dental treatments, and the estimated length of the procedure, in combination with the anti-anxiety needs of the individual patient.

Depending on the level of dental anxiety of the patient and the desired level of relaxation that has to be achieved, the dentist will determine the appropriate protocol for either light or moderate oral sedation. The available protocols include the recommended type of drug and dosage for different types of patient groups and treatment lengths.

The amount of time required for completing the treatment must be compatible with the drug duration. The dosage will have to be adjusted accordingly for patients who are eldery, disabled, on CNS depressants, highly fearful or resistant to drugs.

Finally the dentist will either give you the pill that you will have to take or prescribe the medicine in order to be purchased by you from a pharmacy. The medications commonly prescribed for anxiolysis and oral sedation, include Valium®, Halcion®, Sonata®, Ativan®, Vistaril®, Versed® and several more. Most of them, with the exception of Vistaril® and Sonata®, belong to a group of medications called benzodiazepines.

Benzodiazepines are often used for sedation and analgesia. They are considered to be sedatives/hypnotics or tranquilizers. They are used for anxiolysis, sedation and amnesia. The most widely used for sedation include diazepam (Valium), midazolam (Versed) and lorazepam (Ativan). Midazolam use has overtaken that of diazepam due to a shorter duration of action and water solubility that helps to decrease the pain associated with injection.

Oral Sedation Procedure Pre-operative Instructions

Before you leave from the dental office after your planning appointment, you will be given written instructions that you have to follow before and after your sedation treatment appointment. Following the exact instructions of the dentist regarding the drug’s dosage, time of taking the drug and recommended diet, will help you have a safe and effective oral sedation experience.

You will also be instructed that someone must drive you to and from the dental office because it is not safe to drive or walk under the influence of the sedative drug. Therefore you will have to make the necessary arrangements for someone to escort you.

You will probably have to plan to take the day off from work, because you will not be physically and mentally fully competent until the drug wears off completely.

The night before the Oral Sedation procedure

You will have to follow the dentist’s dietary instructions. Avoid heavy meals, do not drink alcohol or take any other drug that is not approved by your dentist.

Sometimes the dentist will give a patient an additional prescription for a sedative to be taken the night before the procedure is scheduled. This overnight sedation helps the patient to get a good sleep during the night, and it ensures the patient will wake up relaxed on the day of the procedure.

next page -> The Oral Sedation Procedure (cont'd)

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