Patients who are more anxious may need an oral medication that is stronger than nitrous oxide. With oral sedation, the patient may be sleepy but can be aroused if necessary and can respond to simple commands.
Minor side effects such as nausea or vomiting can occur with some medications. Before a visit in which a patient is to receive oral sedation, he/she should receive instructions about eating and drinking, what to expect and what to watch for after treatment. You may need assistance to get home after sedation. Patients may need to stay for a short observation after dental treatment has been completed.
Nitrous oxide, also known as laughing gas, is most often used for patients who are mildly or moderately anxious or nervous. It eases their fears so that they can relax and receive treatment comfortably and safely. Nitrous oxide is administered by placing a small mask over the patient's nose. As the gas begins to work, the patient becomes calm, although he or she is still awake and can talk. When the gas is turned off, the effects of sedation wear off almost immediately.
Injection or intravenously (into a vein) methods require more experience to be administered and monitored properly. Injections and intravenous medications should be used only by dentists with extensive training in these techniques.
General anesthesia puts a patient into a deep sleep. He or she is unable to feel pain or to move around. General anesthesia may be recommended if the patient:
- Can't relax or calm down enough for treatment to be performed safely, even with conscious sedation and other behavior management techniques
- Needs oral surgery or other dental treatment that would be difficult for the patient to tolerate while awake
- Needs a lot of dental work that can best be done in one long appointment rather than many shorter visits
- Has a medical, physical or emotional disability that limits his or her ability to understand directions and be treated safely as an outpatient
Some general dentists have received training and a certification in general anesthesia, while others contract with an anesthesiologist. These professionals are trained to deliver the medications and monitor patients during the procedure and handle any complications that may occur.