Intravenous Sedation
A lot of dental offices use terms such as “sleep dentistry” or “twilight sleep” when talking about IV sedation. This can be confusing, because it suggests that IV sedation involves being “knocked out”. In reality, most people remain conscious during IV sedation. You will also be able to understand and respond to requests from your dentist. However, you may not remember much about what went on because of two factors: firstly, in most people, IV sedation induces a state of deep relaxation and a feeling of not being bothered by what’s going on. Secondly, the drugs used for IV sedation can produce either partial or full memory loss (amnesia) for the period of time when the drug first kicks in until it wears off. As a result, time will appear to pass very quickly and you will not recall much, or perhaps even nothing at all, of what happened. So it may, indeed, appear as if you were “asleep” during the procedure.
The drugs which are usually used for IV sedation are not painkillers (although some pain-killing drugs are added) but anti-anxiety drugs. While they relax you and make you forget what happens, you will still need to be numbed. If you have a fear of injections, you will not be numbed until the IV sedation has fully kicked in. If you have a phobia of needles, you will very probably be relaxed enough not to care by this stage. Your dentist will then wait until the local anaesthetic has taken effect (i. e. until you’re numb) before starting on any procedure.
IV sedation is EXTREMELY safe when carried out under the supervision of a specially-trained dentist. Purely statistically speaking, it’s even safer than local anaesthetic on its own! However, contraindications include pregnancy, known allergy to benzos, alcohol intoxication, CNS depression, and some instances of glaucoma. Cautions include psychosis, impaired lung or kidney or liver function, and advanced age. Heart disease is generally not a contraindication.
Some advantages included:
- IV sedation tends to be the method of choice if you don’t want to be aware of the procedure – you “don’t want to know”. The alternative in the US is oral sedation using Halcion, but oral sedation is not as deeply effective as IV sedation.
- The onset of action is very rapid, and drug dosage and level of sedation can be tailored to meet the individual’s needs. This is a huge advantage compared to oral sedation, where the effects can be more unpredictable. IV sedation, on the other hand, is both highly effective and highly reliable.
- The maximum level of sedation which can be reached with IV is deeper than with oral or inhalation sedation.
- Drugs that we use produce amnesia for the procedure, so you don’t remember anything!
- The gag reflex is hugely diminished – people receiving IV sedation rarely experience difficulty with gagging. However, if minimizing a severe gag reflex is the main objective, inhalation sedation is usually tried first. Only if that fails to diminish the gag reflex should IV sedation be used for this purpose.
- Can be ideal for those with a phobia of dental injections.
If any of these fit you, contact us for a consultation to treat your dental needs!