Sedation is typically used in minor surgical procedures such, endoscopy, vasectomy, or dentistry and for reconstructive surgery, some cosmetic surgeries, removal of wisdom teeth or for high-anxiety patients.
Why do I need sedation for my dental procedure?
Sedatives are often used alongside local anaesthetic to make minor procedures more comfortable for the patient, and to help the patient relax. Often this can help the surgeon, dentist or practitioner too, by making it easier for the patient to maintain uncomfortable positions (such as keeping their mouth open for a prolonged period) and reducing or stopping the gag reflex.
A sedative will relax you, while deeper sedation or ‘twilight sleep’ will mean that although you respond to others during the procedure, you will usually remember nothing about the procedure when you become fully conscious.
Usually, teeth are extracted under a local anaesthetic. However, sometimes sedation is recommended or offered by the dentist if you are anxious, or if the dentist has reason to think the procedure may be difficult or longer than usual. This is more common where multiple teeth, compacted teeth or wisdom teeth are to be removed. In rare cases, a dentist may recommend a general anaesthetic. There may be other maxillofacial or dental procedures where sedation is the best choice too. The dentist or maxillofacial specialist will discuss your options with you.
What are the different types of sedation?
If you have inhalation sedation, you will be given a mask so that you can breathe in a mixture of oxygen and nitrous oxide that will make you feel relaxed and probably sleepy too. But you will still be able to respond to the dentist and awarene of what is happening. Inhalation sedation is only effective while you’re breathing in the gas and clears quickly from your body as soon as you begin breathing normal air, meaning that you can be back in your car or walking home within half an hour of your procedure.
Oral sedation will consist of tablets or a liquid taken at a specified time before treatment. Usually they will be a benzodiazepine such as Diazepam, which you will take two hours before your procedure. The effects are more long-lasting and you will need someone to take you to the clinic and pick you up (see ‘How long will it take me to recover from sedation?’)
If you are given I.V. (intravenous) sedation, this will be administered through a cannula, a small tube that’s usually inserted into the back of your hand. The intravenous solution will normally contain a combination of drugs to bring about ‘Twilight Sleep’, a very effective form of sedation. You can respond to simple commands and answer questions while ‘under’, but many patients remember nothing about the procedure afterwards and only ‘come around’ in the recovery room, so their experience is much like that of being under a general anaesthetic. Again, you will need someone to take you home (see below).
How long will it take me to recover from sedation?
If you have had inhalation sedation, you should feel back to normal in less than half an hour and don’t need to take any special precautions, as it clears very quickly from your system and works in a different way to the drugs used in oral and I.V. sedation.
The effects of oral and I.V. sedation vary from patient to patient, but feeling light-headed and drowsy are common and some patients feel nauseous. It may take some time for the effects to wear off and it’s very important that someone takes you home after your procedure and stays with you for at least a few hours, and preferably until the next day. You shouldn’t drink alcohol, drive or operate machinery for some time after the procedure — your dentist will give you specific advice based on the drugs used, but this may be 24 hours.
What are the risks of sedation?
Inhalation sedation doesn’t usually cause complications or side effects.
The risks of oral and I.V. sedation are far less than that of a general anaesthetic, but there are still some potential complications. Your breathing may slow (although it will be closely monitored), so there is a risk of respiratory depression, and your body may not receive enough oxygen. You may also lose consciousness, particularly if you are accidentally over-sedated. Some patients also find sedation makes them hyperactive.
Nausea and light-headedness should wear off after a few hours, so if they persist, contact your dentist.
How much does sedation cost?
In certain cases the NHS may cover some or all of the costs of dental sedation, and your dentist will advise you if this is an option. Otherwise you will have to pay privately. The price of sedation ranges from £50 to £800, with inhalation sedation starting at £50, oral sedation starting at around £100 and I.V. sedation fees starting from around £175.