At the most basic level a local anesthetic is used to prevent pain. Applied directly to the treatment site, used on its own it will not alter consciousness. Sedation in conjunction with anesthetic medications is used to relieve pain or to relax and calm a patient in preparation for a dental procedure.The following questions address the use of sedation and general anesthesia in dentistry. Click on each question to expand the answer.
Various levels of sedation may be used for dental procedures. The level of sedation ranges from mild sedation to general anesthesia (which affects the whole body to varying degrees).
While the use of a local anesthetic to prevent pain is sufficient for many dental patients, sedation or general anesthesia may be appropriate to ensure the safe, efficient and competent delivery of dental procedures.
Sedation or general anesthesia is determined on a case-by-case basis and may be recommended for patients that:
Any decision regarding sedatives is based on an individual assessment and discussion with your dentist.
The most common form of sedation in dentistry is the use of minimal sedation, such as nitrous oxide (by inhaling through a mask) or taking a sedative, such as Ativan, to relax the patient. Nitrous oxide is provided in conjunction with oxygen. It enables a patient to maintain consciousness in a sedated state. As the level of sedation increases it may be used in conjunction with other medications to temporarily increase its effectiveness, and may cause a little drowsiness.
Dentists are trained in minimal sedation; however, those offering moderate sedation to general anesthesia must have the appropriate qualifications and be registered with the BC College of Oral Health Professionals.
Dentists may work with other health care professionals to provide sedation and anesthesia such as an anesthesiologist, a registered nurse as well as specifically qualified dental team members. The dentist and the facility where the sedation is being administered must meet rigorous requirements in order to be accredited to deliver moderate sedation, deep sedation and general anesthesia.
Training determines what level of sedation a dentist or certified specialist can provide. Competency is based on education through the undergraduate dental program, postgraduate training and continuing professional education. Supervised clinical practice experience is also required for advanced levels of sedation.
Speak to your dentist about their qualifications before treatment, as well as the qualifications of their staff and any other health care professionals they work with (i.e. anesthesiologists, registered nurse). Contact the BC College of Oral Health Professionals to confirm the dentist can provide sedation or general anesthesia in their office.
Dental patients often don’t realize that dental procedures are surgical and as with all surgery, there is some degree of risk. Sedation and general anesthesia are safely and effectively used for thousands of dental procedures each year.
What can patients do?
Depending on the level of sedation, it can be completely normal to feel drowsy and have limited recollection of your appointment.
For all types of sedation, mild, moderate, deep sedation or general anesthetic, it is expected that your coordination and reasoning skills may be impacted for up to 24 hours following treatment. Your dental office will request that you have a friend or family member pick you up from the appointment, and that you not drive.
Talk to your dentist before treatment about any expected side-effects for the level of sedation that you will have.
Whether or not sedation is used for your specific procedure, as well as the type of sedation recommended, will depend on a few factors: the nature of your treatment; your level of anxiety; and your overall health and medical history. Discuss the sedation options with your dentist to make an informed decision for your health.
A dentist may recommend sedation for your child's dental treatment due to:
Children may receive dental treatment under various levels of sedation up to general anesthesia. Sedation provides a stress-free experience for the child and enables the dental team to deliver care safely and efficiently.
Very young children may require treatment in hospital. Speak to your dentist about your child's needs.
Dentists are required to meet specific requirements for the safe use of sedation in children including the American Academy of Pediatric Dentistry’s Guidelines for Monitoring and Management of Pediatric Patients During and After Sedation for Diagnostic and Therapeutic Procedures, as well as BC College of Oral Health Professionals BC Minimal and Moderate Sedation services in Dentistry Standards and Guidelines.