Putting Pain and Anxiety to Rest: Your Anesthetic and Sedative Options
Panicking at the mere thought of visiting the dentist? From mild anxiety to a full-blown phobia, fear of
dental work is an all-too-common problem that stands between many individuals and the oral health care they need. However, you need not choose between suffering in the chair or staying away until it is an emergency. Between various types of anesthesia and several kinds of sedatives, there are more options than you might think to avoid pain or discomfort.
If pain is your primary fear, local anesthesia can numb you against feeling any discomfort while essential dental work is under way. Depending on the type of treatment required (and your threshold for pain), options include:
Topical Anesthesia: Typically applied with a cotton swab, topical anesthesia numbs the surface of your gums to take the sting off an upcoming injection, dulls the gingiva against certain procedures such as tooth cleanings, or eases painful conditions like mouth sores. While topical applications are normally a light and temporary numbing measure, oral "patches" containing anesthesia have been developed to provide longer, more targeted relief for cases where larger needles are necessary.
Injectable Anesthesia: For dental work near or involving sensitive nerves or tissue, anesthesia is injected into that particular area of the mouth beforehand in order to block out any pain. Often resulting in a "fat lip" or a puffy-cheeked feeling, injectable anesthesia is mostly used for treating cavities, gum disease or in preparation for crown placement.
Non-Injectable Anesthesia: Those who are afraid of needles, yet still need to eliminate pain caused by procedures such as root planning or scaling, may benefit from non-injectable anesthesia. Using this method, anesthesia is delivered directly into the periodontal pocket via a single-use cartridge and an applicator. It lasts for up to 20 minutes, and can be re-applied numerous times throughout your appointment.
For your safety, dentists follow detailed dosage guidelines based on your weight and medical history, and must be licensed in order to administer anesthesia.
When local anesthesia is not enough to soothe a patient's fears, sedatives to calm your nerves – or in certain cases, put you in a "deep sleep" of unconsciousness – may be necessary. Depending on your level of fear and the procedure itself, the dentist may call for different levels of sedation, such as:
Minimal Sedation: "Laughing Gas", or nitrous oxide, is inhaled through a gas mask in order to help you relax. The patient remains completely conscious, and, in many cases, due to the quick-wearing nature of the gas, may even be able to drive home after the appointment.
Moderate Sedation: Often given in pill form, drugs such as Halcion (a close relative of the drug Valium), is taken an hour before the start of any dental work. For faster results, it may also be given via an IV, but either option results in a level of grogginess. Though many remain conscious throughout the appointment, it is not uncommon to fall asleep and be woken after the procedure is complete. If given moderate sedation, you should have someone drive you have from your appointment.
Deep Sedation: Also known as "general anesthesia", this is the strongest form of sedative an individual can receive, and results in a partial or complete state of unconsciousness. Nothing is felt throughout the procedure and it very difficult to wake up the patient until the medication has worn off. Similar to moderate sedation, you should not drive or operate a motor vehicle following your procedure.
If sedation seems like a good option for you, speak to your dentist about the types of sedatives he or she is able to administer. While many dentists are accredited to administer both minimal and moderate sedation, deep sedation often requires the expertise of a dental anesthesiologist or oral surgeon.
Minimizing Your Risk
Dentists keep your safety top of mind when administering anesthesia or a sedative, but there are always risks involved. To protect your health, consult with your dentist at length about which option might be best for you, and come prepared with a detailed history of current and past illnesses, medications and health conditions.