Dental treatment under sedation
Indications for sedation
The fear, anxiety and discomfort during dental treatment are widely spread conditions. It is completely understandable because patients do not often feel comfortable in a dental chair because of the sounds and other sensations during treatment that could be very agitating. Stress, inattentiveness and, in more serious cases, panic attacks caused by these conditions lead to extensive suffering and complicate the treatment process. We at Sakala Hambaravi do everything in our power to make our patients feel comfortable and well. Nowadays it is possible to alleviate the fear of dental procedures safely and effectively by sedation or reduction of irritability. This procedure is also know as dental treatment under sedation.
What is dental treatment under sedation?
Sedation is a procedure of calming and causing a slight sleep-like state in the patient by administrating sedative drugs. Although the patient is emotionally and physically relaxed and calm and he or she does not feel fear or a sense of discomfort when sedated, the patient is conscious and able to talk, if necessary. Sedation enables to carry out dental procedures in a peaceful state. All vital reflexes are maintained during sedation. Usually the patients do not remember the procedure afterwards, which helps overcoming the fear of dental procedures. We recommend sedation to people who have the fear of or feel uncomfortable during various dental procedures, such as removal of wisdom teeth or several teeth, installation of implants, tooth transplantation, elongation of a tooth crown as well as root and caries treatment. Sedation is also indicated for people with well-expressed emetic reflex during a dental procedure.
In our clinic, sedation is carried out by an anaesthesiologist. At the dentist office, a soft plastic cannula is placed in the patient’s arm to allow injection of sedative drugs. After injection, the patient goes into a soft and relaxed state. If the patient feels that he or she is not sufficiently relaxed, the dose of the sedative is increased. During longer dental procedures, sedative drugs are administered repeatedly if necessary. The patient’s well-being and vital indicators, such as blood pressure, frequency of heartbeat and oxygen saturation of haemoglobin are monitored during the procedure. Sometimes it is necessary to administer extra oxygen. All the devices used, including syringes and needles, are non-reusable and all the drugs, pieces of equipment and qualification of the personnel are in compliance with the industry’s best practice and applicable requirements.
After the procedure, the patient can rest in the appropriately furnished room where their close ones can stay with them. It is natural to feel slightly drowsy, weak, dizzy and unsteady while walking. We allow the patient to go home in the company of a companion after the effect of the sedative drugs has cleared and the patient feels well, which usually happens in one hour after the end of the procedure.
Safety of sedation
Although we do everything in our power to make sedation during a dental procedure as safe as possible, it must be remembered that not one medical procedure is one hundred per cent without adverse effects. Dangerous complications are very rare and the frequency of occurrence of possible fatal adverse effects (cardiac arrest, respiratory arrest, thrombi in large blood vessels, brain damage, malignant hyperthermia, anaphylactic reaction etc.) is comparable to the risk of dying in an airplane accident and smaller than the likelihood of dying in a traffic accident. An excessively deep state of sedation is possible in which case it may be necessary to put the patient under general anaesthesia. In rare cases, saliva or stomach contents enter the respiratory tract, which could lead to lung damage. Pain and redness in the drug injection site is possible, as well as nausea and, infrequently, numbness of an extremity due to compression. The drugs used for sedation have amnestic or memory loss causing effect, which is why patients sometimes do not remember what happened during the dental procedure. Sedation does not have a pain-killing effect and thus the dentist has to use local anaesthesia. There are all required devices available at Sakala Hambaravi to prevent and treat adverse effects, if necessary.
Who is sedation suitable for?
Sedation is usually not suited for patients with limited cooperation capability, for example due to an intellectual disability, and for infants that have difficulties communicating with the dentist. We do not recommend sedation during a very extensive or long dental procedure. In these cases, we recommend dental treatment under general anaesthesia, which is also possible at Sakala Hambaravi. For safety reasons we do not suggest sedation to patients who are overweight (body mass index over 35), suffer from a lung or heart disease or a muscular-nervous system disease. At Sakala Hambaravi we always decide whether sedation can be used safely on case-by-case basis. For that purpose, we ask the patient to fill in a special questionnaire that will be reviewed by an anaesthesiologist.
Before the procedure
In order to ensure safety, we ask patients not to eat or drink (coffee, tea, juice etc.) at least 6 hours before their procedure. The patient is allowed to drink pure water up to 2 hours before treatment. If this requirement is not followed, the patient’s stomach contents could enter his or her respiratory tract and cause lung damage. We recommend taking regularly administered drugs as usual, except for in cases the anaesthesiologist has given different instructions. When the patient comes to the procedure, he or she must not suffer from a disease causing fever, including coughing and runny nose. At least 7 days must have passed from last illness. We ask the patients not to paint their nails because nail polish disturbs the functioning of the monitoring device (pulse oximeter). We also kindly ask to remove jewellery, glasses and contact lenses, bars and rings in face and mouth, and removable dentures. We reserve the right to refuse or postpone a procedure to ensure the safety of the patient, if necessary.
We allow the patient to go home after the procedure only in the company of an adult person provided that the patient feels well, he or she does not feel nauseous or suffer pain and has received instructions for further treatment. It is forbidden to drive a motor vehicle, perform actions that require attention and sign legal documents on the day of sedation procedure. We recommend the patient to rest at home after sedation.
We wish your dental treatment experience at Sakala Hambaravi to be as pleasant as possible.
Read more about our other dental treatment services here.
Read more about oral health here.