Nitrous oxide is a gas breathed though a small rubber inhaler placed over your nose that helps decrease anxiety, allowing you to feel more relaxed. The recovery time is very short, and the effects pass within minutes, so you will be able to drive yourself home. Nitrous is best used for patients with mild anxieties that are having short, uncomplicated dental treatment. Some contradictions would be pregnancy, asthma, COPD, emphysema, sinus congestion and claustrophobia.
Oral Conscious Sedation
A pill is taken about two hours before your treatment, which will make you feel relaxed and somewhat sleepy. You will, however, remain awake, and will be able to interact with and respond to the dentist. The sedative effects can last for up to eight hours. Sometimes you may also be prescribed a pill to take the night before your treatment to help you sleep. The most commonly used oral conscious sedation medications are Halcion, Ativan and a combination of Phenergan and Demerol. (Demerol 50 mg/Phenergan 25 mg), Valium, all of which generally have a low incidence of side effects.
This mode of sedation is gaining popularity and is now heavily advertised as “sedation dentistry” and “dentistry with oral conscious sedation”. However, if you hear the term “sleep dentistry” associated with the use of oral medications, understand that pills do not and should not put a patient to sleep. If you are a patient who wants to sleep through your dental treatment, oral medications should not be your choice of sedation. You will need to have a responsible, familiar adult drive you home.
IV Anesthesia produces a state of unconsciousness wherein you are completely asleep during your treatment. IV anesthesia is fast-acting, taking effect in approximately one minute, and can be controlled to increase or decrease your level of sedation safely and precisely. If you are afraid of receiving dental treatment, you will not have to “get over” your fear on your own, because you will sleep through your treatment. If you have special needs, such as physical or mental disabilities, are in recovery from an addiction, or have complex medical conditions, IV anesthesia may be the safest option for you.
When you receive IV anesthesia during your dental treatment, you will feel no pain; you will not hear, smell or taste anything, and you will have no memory of the procedure. This modality is predictable, comfortable, and ensures that your dental treatment can be easily completed.
Who may benefit from these techniques?
Very young uncooperative children who require multiple fillings may be unable to sit for treatment. By providing dental care with oral sedation and nitrous, all of the child’s treatment can usually be completed in one visit.
Fear, Anxiety and Phobia:
One of the major reasons why patients don’t go, or delay going to the dentist is severe fear and anxiety. In some cases, patients have a dental phobia and refuse to go to the dentist until they are in so much pain that they have no other choice. Their treatment by this time is usually irreversible treatment, such as extractions. Patients that have these problems are well treated with conscious sedation or IV anesthesia.
Low Pain Threshold & Inability to get Numb:
There are many patients who have a low pain threshold and others who are unable to get numb with local anesthesia injections. These patients are good candidates for oral sedation and nitrous or in some situations, IV anesthesia may be recommended.
Child and adult patients who require a great amount of dental care can have that care provided in a shorter amount of time under oral sedation or IV anesthesia. For example, if a patient has several teeth that require root canal treatment, all these teeth can usually be treated in one visit while the patient is treated with conscious sedation or IV anesthesia. This enables the patient to combine multiple visits into one.