WebMD says that a dental phobia is more serious than just feeling a little anxious about going to the dentist. People who suffer from this phobia can have panic attacks or even avoid dental visits for years. So the quick fix is to undergo sedation dentistry, right? The answer is “it depends.” There isn’t a one-size-fits all way for sedation, so if you’ve been avoiding the dentist for years and want to go this route, you should learn about the different types (gas, oral sedatives, IV, etc.) that you can undergo:
Is Sedation Dentistry Right for you?
With sedation, the dentist administers a drug before or during the dental procedure. Only one type — general anesthesia — renders the patient completely unconscious. The other forms will relax you, but won’t knock you out completely.
The most common types of sedation dentistry include the following:
- Nitrous oxide: A gas that relaxes you during the procedure. It wears off quickly, so your dentist might let you drive yourself home after the appointment.
- Oral sedatives: Oral sedatives, such as diazepam, also help relax patients during dental procedures. You typically take them an hour or so before your appointment. You’re fully awake but less anxious, and you might feel a little sleepy until it wears off.
- Intravenous sedatives: Intravenous, or IV, sedatives can put you in varying stages of consciousness. This is also known as general anesthesia and, as mentioned above, will put you into a deep sleep until it wears off. Other IV drugs, however, can put you into a “twilight sleep.” You’re less aware of your surroundings, you might feel sleepy, and you might not remember much of the procedure once it’s over.
Some patients assume that general anesthesia offers the best solution. However, it also comes with more potential side effects than the other methods, so you might want to consider a lesser form of sedation dentistry . . .
As you can see, if you have many allergies, any secondary health conditions, and/or have had bad interactions under anesthesia in the past, you may unfortunately not be a good candidate for sedation dentistry. It’s best to talk about all your options with your dentist however. As 123dentist.com says, your provider may still be willing to let you undergo this route if you take oral sedatives that don’t completely knock you out.
If you do get the go-ahead, you and your dentist may also want to talk about which anesthetics typically have the best results. For instance, drbicuspid.com says that while every practitioner may have a personal preference at their office, some patients do better on one drug than another. For instance, one study showed that patients were able to come out of sevoflurane anesthesia easier, but that there weren’t many intense side effects (e.g. vomiting) for propofol anesthetics:
Which Dental Anesthetic Do Patients Prefer?
Every practitioner has a preference for which anesthetic to use for adult patients with severe dental anxiety. But, of sevoflurane or propofol, which do patients prefer?
“We, therefore, performed a crossover study to determine which was more preferable for ambulatory anesthesia between propofol and sevoflurane based on the comparison of the recovery profile and patient satisfaction after anesthesia,” Keita Ohkushi, DDS, PhD, and co-authors wrote.
Dr. Ohkushi is an assistant professor in the department of dental anesthesiology at the Tokyo Dental College.
Every office has adult patients who are severely anxious at the thought of treatment. These patients sometimes need to be anesthetized for treatment to occur. So researchers from Japan wanted to see which anesthetic patients preferred for ambulatory anesthesia: propofol alone or sevoflurane alone. Both are currently used for ambulatory anesthesia, and patients emerge rapidly after discontinuation.
“Propofol may be more suitable for ambulatory anesthesia for dental treatment.”— Keita Ohkushi, DDS, PhD, and co-authors
The study included 20 adult patients with severe dental anxiety who needed at least two dental treatments. All patients received both propofol and sevoflurane in this study, allowing for a direct comparison. No coadministered drugs were used.
Anesthesia was induced with propofol (1% Diprivan injection kit, AstraZeneca) with predicted effect site concentration at 3.5 ?g/mL in the patients who received propofol. In the sevoflurane group, anesthesia was induced with 3% sevoflurane (Sevofrane, Abbott Japan) using a face mask with supplemental oxygen at 6 L/min.
The effect site concentration of propofol and inhaled concentration of sevoflurane were adjusted to maintain bispectral index monitoring (BIS) value at 40 to 60 under inhalation of oxygen at 1 L/min and air at 3 L/min. Patient observation was done in the emergence phase, the recovery phase, and 24 hours after discharge.
The authors reported that time to emergence was shorter with sevoflurane anesthesia than with propofol anesthesia, but they found no difference in time to full recovery.
No participants in the propofol group reported nausea or vomiting during the recovery phase, while three of 20 in the sevoflurane group did. The average time to discharge was slightly faster for the propofol group (169 ± 45 minutes compared with 176 ± 48 minutes). The authors also reported no differences between the groups in time to first meal or fluid, on telephone follow-up about 24 hours afterward.
When asked on follow-up about satisfaction and preference, the 16 patients said they would choose propofol, and four said they would choose sevoflurane in the future . . .
If you’re phobias are getting in the way of your preventative care, don’t hesitate to talk with your dentist about your options. Learn more at dentaloasisofoc.com/preventive-dentistry/