What is sedation and why is it used in dentistry?
Sedation involves the use of a variety of drugs that relax the patient during a medical or dental procedure. It can vary in depth from very light sedation where the patient is tranquillised but fully aware of what is going on, right through to almost a general anaesthetic there the patient is unconscious. In dentistry, CONSCIOUS SEDATION is used whereby the patient may be relaxed enough to drop off, but can easily be roused. Sedation does not control pain, but can alter the patient's perception of it, and can often raise the pain threshold in those patients who find that local anaesthetics don’t always work.
A variety of drugs may be used singly or in combination, delivered either by mouth, nose or by injection. Pain control is carried out by local anaesthesia.
Some dentists use RELATIVE ANALGESIA, commonly known as gas and air, which has the advantage of being suitable for all ages and does not depend on the patient being in good health and wears off very quickly.
Who carries it out?
Some dentist are qualified to carry out basic sedation, but most would employ an anaesthetist or sedationist if the case is complex. This leaves the dentist free to concentrate on the dentistry.
Who can benefit from it ?
Sedation helps calm patients who are nervous or anxious about treatment and is useful for lengthy and unpleasant procedures. patients with a history of cardiac problems may also benefit from sedation to reduce stress during long treatment.
Is there anyone it is not suitable for?
Sedation is not suitable for young children, nor people suffering from very ill-health, whose sedation should be carried out in a hospital setting. Conditions such as high blood pressure(hypertension), diabetes, asthma, allergies, etc in isolation are not aggravated by sedation- in fact reducing the stress may be helpful in these cases.
Is it safe?
Sedation is a very safe technique, provided it is carried out by a qualified and experienced person and all the necessary monitoring and resuscitation equipment is on hand.
Some patients experience amnesia for a few hours or sleepiness for a day or so afterwards. However all patients who have been sedated are advised not to drive for the rest of the day or to take any major life decisions, and should be given a number to contact for the first 24 hours afterwards in case of concerns.
For safety reasons full general anaesthesia may not now be carried out in the dental surgery.
Are there any drawbacks?
Sedation may be costly, especially if an anaesthetist is employed in addition to the dentist. The process may also take slightly longer, as a lead-in time and recovery period are added to the time taken for the dental procedure. Most sedation is carried out in private practice, though some units may offer it on the NHS. Dentists are under no obligation to provide sedation for patients, but it is fairly widely available
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