TWILIGHT SLEEP/CONSCIOUS SEDATION

Dental Sedation. What is it?
Dental sedation was once more commonly known as "twilight sleep". However, in recent years the more accurate term "conscious sedation" has become popular because it better describes the semi-conscious state that this kind of sedation provides. Conscious sedation allows patients to be comfortable and pain free during certain surgical or medical procedures, often while remaining awake. This article will provide you with information on conscious sedation which many doctors call "sedation analgesia," and will also describe other levels of sedation, including deep sedation that are available and their uses.

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Safe - Effective - Comfortable
When approximately administered by your anesthesiologist, Sedation is safe and effective for many procedures done in the dental office setting. Most people wake up and ask "when are we going to start?" When told their procedure is over. They commonly reply. "that was the best sleep I've had in years"

Most patients request deep sedation because they want to be completely asleep. Some people ask for lighter levels or may require lighter levels due to preexisting medical conditions. About a week before your procedure you will be contacted by your anesthesiologist to review your general medical condition and discuss the appropriate level of sedation required.

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Your Anesthesiologist. Well-Trained, Board Certified
Your anesthesia provider is a Board Certified Anesthesiologist, a medical doctor who after graduating from medical school completed a one year medical or surgical internship in the field of Anesthesiology.

Anesthesiology is the field of medicine concerned primarily with rendering patients insensitive to pain and supporting vital organ function during surgery. Anesthesiologists are certified by The American Board of Anesthesiology, which has examined and certified your physician's competency in the field upon his or her completion of an accredited program of anesthesiology training in the United States.

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What are the different sedation levels?
The medical term analgesia means pain relief. Most forms of medical sedation include varying levels of pain relief. Sedation analgesia provides pain relief and also helps alleviate the anxiety that may arise when you visit dentist or the health care providers for certain treatments or diagnostics tests.

Minimal sedation (anxiolysis) leaves you feeling relaxed. You may even be fully awake. You will be able to understand and answer questions as well as follow instructions. You may or may not remember your procedure.

Moderate sedation (conscious sedation) results in a drowsy sensation. Most patients will sleep through much of their procedure but will be easily awoken when spoken to or touched. You may or may not remember your procedure.

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Do any of the following situations sound familiar?
Are you anxious about going to the dentist - or are even very afraid - especially if you had painful experiences at the dentist during childhood?

Do you have a "gag reflex" that is triggered by dental work, or do you have difficulty controlling your movements in the dental chair because of other medical conditions?

Do you have extremely sensitive teeth that do not respond to NovocaineTM or other more conventional forms of dental pain medication?

Do you need long, complex dental treatments that require multiple visits - such as bridgework, crowns or implants?

Do you need a battery of diagnostic tests that make you nervous?

If any of the above situations apply to you, then you're probably a good candidate for dental sedation.

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Here are a few questions you may want to discuss with your dentist prior to receiving sedation. The answers will give you a better understanding of the sedation process.

Q: How will I be monitored during my procedure?
A: Your vital signs will be monitored the same equipment used in a hospital setting. The standard monitors are an electrocardiogram (EKG). Blood pressure cuff, pulse oximeter to measure oxygenation and a capnogram to measure ventilation.

Q: What kind of medications are used and how are they administered?
A: The drugs used are a combination of several sedative-hypnotics and pain medications given intravenously. These medications are used in combination with the injection of a local anesthetic, or "numbing medicine", at the site of surgery. All patients also receive supplemental nasal oxygen.

Q: When can I eat before the procedure?
A: Do not anything solid for six hours before your scheduled appointment. You can have clear liquids such as water, apple juice or black coffee no later than four hours before your procedure.

Q: What about side effects? I always get sick with anesthesia.
A: Compared to the side effects from inhaled gases commonly used during surgical procedures, all levels of IV sedation rarely cause any post-operative nausea or vomiting. Patients also recover much faster because the medications used are short-acting and rapidly excreted by the body.

Q: Will the level of sedation I receive be sufficient to make me comfortable during the procedure as well as the recovery period immediately afterward?
A: Yes

Q: Who will be monitoring my recovery after the procedure and who decides I'm ready to go home? Can I drive home after my procedure?
A: The anesthesiologist will monitor you for a 30-60 minute recovery period at the end of your procedure. You will not be allowed to drive home. So arrangements should be made for a friend or family member to drive you home.

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