Sedation is the safe and effective administration of drugs that relieve anxiety and reduce pain. The aim of Conscious Sedation is to make the patient as comfortable as possible. Unlike a General Anaesthetic where a patient is completely unconscious, asleep, and unable to respond, patients under conscious sedation are able to respond to commands and breathe on their own.

There are 3 primary ways that sedation is administered in the Dental Office: Deep conscious sedation (Intra venous sedation), Nitrous Oxide (laughing gas) and Oral sedation.

IV Sedation

IV sedation or Deep Conscious Sedation is usually used by Oral Surgeons or for patients with extreme fear of dental treatment. Anaesthetists with specialized training in sedation use medications that are directly administered into the blood stream. The greatest advantage of IV Sedation is that if someone is not sedated enough, the doctor can administer more medication and the effects are instantaneous. IV Sedation is not used commonly in most dental offices because of the specialized nature of the treatment. The drugs used for IV Sedation are more effective then the same drugs taken orally and there is more profound amnesia associated with this technique. IV sedation presents a cost-effective alternative to general anaesthetic and can be done in the dental surgery.

Laughing Gas

Commonly known as laughing gas, nitrous oxide is the most frequently used sedation method in dentistry. All bodily functions remain normal and the person is able to breathe on their own. The patient will often fall asleep and experience some degree of amnesia about what happened during their dental appointment. Dentists have used inhalation sedation for many years.

What to expect with laughing gas

The gas is administered through a control box giving the dentist the ability to adjust the concentration of N2O according to the level of sedation required. There are four levels of sedation that can be experienced.

1. A tingling sensation, especially in the arms and legs, or a feeling of vibration ("parasthesia")
2. This is quickly followed by warm sensations
3. And a feeling of well being, euphoria and/or floating ("drift"). This is the ideal level for dental treatment. During heavier sedation, hearing may dissolve into a constant, electronic-like throbbing.
4. At a deeper level of sedation again, sleepiness, difficulty to keep one's eyes open or speak ("dream") can occur. Nausea would indicate over sedation.

For use in dental treatment you should be maintained within the first three stages. The "dream" stage is indicative of too high an N2O concentration.

Oral sedation

The Oral Medication used for Oral Conscious Sedation in dentistry is from a group of drugs known as Benzodiazepines. The most commonly used product is South Africa is Dormicum. Not only do these medications have a sedative effect they also have some degree of amnesic effect for most people. Patients remember little or nothing about their dental appointment.