Sun, Dec 30, 2012
California, Cosmetic Dentistry, Dental Care, Dentist, Dentofacial Orthopedics, Endodontic Services, General Dentistry, Health, Oral Surgeon, orthodontic treatment, Restorative Dentistry, Sedation, Treatment
What is IV Sedation?
When a drug, usually of the anti-anxiety variety, is administered into the blood system during dental treatment, this is referred to as Intravenous Conscious Sedation (aka “IV sedation”). Conscious sedation is sometimes (incorrectly) referred to as “twilight sleep” or “sleep dentistry”.
A lot of dental offices use terms such as “sleep dentistry” or “twilight sleep” when talking about IV sedation. This is confusing, because it suggests that IV sedation involves being put to sleep. In reality, you 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.
Is It Safe?
IV sedation is very safe when carried out by an anaesthetist. Statistically speaking, the mortality rate is literally 1:1 million. In contrast, the mortality rate for general anaesthesia (GA) is 1:598,000.
However, contraindications include pregnancy, known allergy to the drugs used, alcohol intoxication, CNS depression and some instances of glaucoma. Cautions include psychosis, impaired lung or kidney or liver function, and advanced age (above 70). Heart disease is generally not a contraindication.
What are the advantages of IV sedation?
- 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 reliably 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 very unreliable. IV sedation, on the other hand, is both highly effective and higly reliable.
- The maximum level of sedation which can be reached with IV is deeper than with oral or inhalation sedation.
- The drugs produce amnesia for the procedure. The patient forgets the trauma of the operation even though he/she may not be unconscious.
- The effects of intubation and nausea from GA are not found in sedation. No fasting and long preparations are required before the operation.
Are there any disadvantages?
- You need to bear with the initial discomfort of having a needle inserted into your hand.
- It is possible to experience complications at the site where the needle entered, for example haematoma (a localised swelling filled with blood).
- Patients may become dependent on IV sedation such that they want IV sedation even for non-invasive procedures like fillings.
- Recovery from IV administered drugs is not complete at the end of dental treatment. You may need to be escorted by someone who can take care of you.