Understanding Conscious Sedation

The dental procedure termed "conscious sedation" doesn’t literally make sense. Is it possible to be sedated and remain conscious at the same time? Dental advertisements often refer to this procedure as "twilight sleep" which is supposed to soothe the patient into a calm state of mind during a dental procedure. Unlike general anesthesia, where a patient is unable to respond or breathe on their own, conscious sedation allows the patient to respond to questions or stimuli, and breathe without artificial assistance of any kind.

Some people do not fear a trip to the dentist at all, or do well with some relaxation techniques or open discussion with their dentist about what each procedure might involve. But, many people avoid even the most basic dental work because of their fear of discomfort associated with dental treatment.

There are generally three systems by which conscious sedation is achieved - intravenous drugs, oral medicines and inhalation of sedative gases. The type of sedation required depends on the specific dental treatment being administered and the patient’s overall level of comfort, and will be decided in consultation with the dentist. For example, the patient who doesn’t want to remember anything about the dental treatment would likely choose IV sedation because it frequently provides partial or full amnesia.

A patient who is more worried about the potential side effects of intravenous and oral medication can choose the inhalation technique in which the effects of the gas disappears from the system almost instantly. When a patient is really afraid of dental procedures or even a regular dental check up, they might opt for the most effective sedation technique available, IV sedation or inhaled gaseous sedatives.

What are the negative aspects of choosing sedation? Apart from the health factors and possible allergies to the medications used, an IV or oral sedation patient will require a ride to and from the dental procedure. Many patients are terrified of needles, in which case IV sedation may not be an appropriate option since the sedative is injected into the patient’s arm or hand. Local anaesthetic will still need to be injected into and around the treatment site, although this is done once the IV sedation has taken effect.

The efficacy of the oral sedative varies from patient to patient and the dosage prescribed.

It is wise to discuss in detail with the dentist everything related to the treatment before deciding on a method of sedation.