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Intravenous sedation

Intravenous sedation

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IMPORTANT: Aimed at the general public, the Bücco Guide is a general educational guide. Its content presents some of the most common dental practices. However, there are many approaches and philosophies in dentistry and your dentist / specialist will be able to advise you on what he believes to be the most appropriate for your oral health. Do not hesitate to consult a dentist / specialist for more information.

Age group Adolescents Adultes 40+ Adultes 40- Adultes 60+ Bébés et enfants

Definition

Intravenous sedation is the administration of one or more drugs intravenously to soothe the central nervous system. Sedation slightly alters the perception of reality, which contributes to lower anxiety levels and gives the impression that the procedure takes place in a short period of time. Under sedation, the patient can receive treatment in a relaxed manner while maintaining verbal contact with the dentist for the duration of the procedure. This is why this technique is called “conscious sedation” (unlike general anesthesia where the patient is unconscious). Sedation is a method of choice to break the vicious circle of fear of dental treatment.

Indications for treatment

  • Considerable decrease in a patient’s stress and anxiety level during treatment;
  • Increase in the confidence and motivation of a patient who is anxious about dental treatment.

Advantages

  • This is a method of choice for those who prefer not to remember the procedure;
  • Intravenous medications work quickly (within 30 seconds);
  • The sedative agent can be administered gradually, allowing the dentist to monitor and adjust to the patient’s vital and clinical signs;
  • The effect can be reversed if a complication occurs or if the sedation is too deep;
  • Sedation is deeper and more effective than oral or inhalation sedation;
  • Nausea reflexes are diminished;
  • Spontaneous respiration and protective reflexes are not disturbed;
  • The patient is conscious and able to cooperate as instructed by the dentist;
  • Intravenous sedation, when administered by a well-trained professional, does not present a health hazard.

Disadvantages

  • The patient must be accompanied for the return home as he or she will not be able to drive a vehicle for 12 hours after the procedure;
  • Rest must be ensured for the rest of the day and physical exertion should be avoided.

Before the procedure

  • Being on an empty stomach. The dentist will tell you how many hours you must abstain from eating and/or drinking before the procedure, depending on the sedative that will be used (on average 4 to 6 hours).

Processing steps and times

  • The attending dentist or surgeon ensures that all the conditions required for sedation have been met by the patient;
  • The sedative is administered gradually by intravenous administration (benzodiazepines, in some cases in combination with opiates), controlling the dose required for optimal patient relaxation;
  • Throughout the course of treatment, he will work with the patient to assess his level of anxiety and adjust the dose if necessary;
  • Once the treatment is completed and the recovery time has elapsed, he makes sure that the patient has understood the instructions to be followed following the intervention.

After the procedure

  • Avoid physical exertion;
  • Avoid eating a large meal immediately after the procedure (only light snacks);
  • Avoid alcoholic beverages;
  • Take the medication prescribed by the dentist.
  • Consult your dentist if you have any concerns.

Restrictions

  • Pregnancy;
  • Benzodiazepine allergy;
  • Alcohol consumption;
  • Glaucoma;
  • Myasthenia gravis;
  • If you suffer from psychosis, sleep apnea, obesity, or kidney, lung or liver failure, it is essential to tell your dentist or surgeon;
  • If you have been taking benzodiazepine-based medications (e.g. Ativan, Valium, etc.) for several years, sedation may not have the desired effect due to your addiction to these drugs. Talk to your dentist so that he or she can evaluate your sedation options.

Alternative solutions

  • Anxiolytics (benzodiazepines) that can be prescribed in tablet form and taken orally. However, they have some disadvantages compared to sedation (the effect is slower and more difficult to predict, as it depends on absorption from the stomach, which differs from one individual to another). Recovery time is also longer and the level of sedation is not always sufficient);
  • Inhalation of laughing gas (a mixture of nitrous oxide (N2O) and oxygen). Because it works quickly and can be adjusted up or down very quickly, the recovery time after the procedure is very short. It is possible, however, that the level of sedation induced by laughing gas inhalation is insufficient for patients who are very anxious, or for those who cannot breathe well through the nose.

Other services

Intravenous sedation
Local anaesthesia

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