Many people picture sedation dentistry as being put to sleep for a procedure. With nitrous oxide or oral sedation, the two kinds Icon Dental Center offers, you can still respond when the dentist speaks to you, though oral sedation may make you doze. Here’s what sedation dentistry actually is, what it can help with, how safe it is, and who needs extra care before choosing it.
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What Sedation Dentistry Is, and What It Isn’t
Sedation dentistry uses medicine to help you feel calmer and less stressed during dental treatment. It can be a gas you breathe in, a pill you take, or medicine that’s injected, and the right approach depends on the procedure, your overall health, any allergies and how anxious you are.
Sedation isn’t the same as numbing. It eases anxiety, and the dentist still numbs the area with a local anesthetic, usually once you feel relaxed.
The levels of sedation
Sedation is described in levels, and the level depends on the effect, not on whether the medicine is a gas, a pill or an injection.
| Level | What it’s like |
|---|---|
| Minimal | Relaxed and awake; you respond normally when spoken to |
| Moderate | Sleepy but awake; you still respond when spoken to or touched lightly, and you breathe on your own |
| Deep | Barely awake; hard to wake, and breathing may need support |
| General anesthesia | Unconscious; can’t be woken, and breathing often needs support |
Deep sedation and general anesthesia aren’t offered at Icon Dental Center.
Nitrous Oxide vs. Oral Sedation
Nitrous oxide is a gas that works within minutes and wears off within minutes, while oral sedation is a pill that works more slowly, lasts much longer and means someone else drives you home.
| Nitrous oxide | Oral sedation | |
|---|---|---|
| How it’s given | Breathed in with oxygen through a small nosepiece | A prescription pill, taken exactly as your dentist instructs |
| How fast it works | Within a few minutes | More slowly, and it varies from person to person |
| How it feels | Calm, relaxed or light-headed; you stay awake and can respond | Very drowsy; you may doze off, and the dentist can wake you |
| Wearing off | Within minutes once the gas is turned off | Recovery can take up to 24 hours |
| Driving | Usually fine after nitrous oxide alone, once the dentist confirms it has worn off | Someone else takes you home, and no driving for 24 hours |
Nitrous oxide dulls pain rather than removing it, and because it clears from the body so quickly, it doesn’t give pain relief after the appointment. It also works best when you breathe through your nose, so a blocked nose can make it less effective. Not everyone laughs on it, either, whatever the nickname laughing gas suggests.
Oral sedation can make you very drowsy, and dozing off is expected. Everyone reacts a little differently to sedation, so plan to take it easy afterward.
Questions about sedation? Call our Everett dental office to talk it through.
What Sedation Can Help With
Sedation can make it possible to get dental care that fear has kept you from, and it can help with a strong gag reflex, a long procedure or trouble sitting still.
Fear of the dentist is common: about 36% of people in the US have some fear of dental treatment, and 12% have an extreme fear, according to Cleveland Clinic. It can come from a bad past experience, family history or a feeling of losing control, and severe fear can keep people away even when they’re in pain. Patients put it plainly: one Google review of Icon Dental Center describes “horrible dental anxiety.”
A dentist may suggest sedation if you have:
- a fear of dental treatment or of needles;
- a very sensitive gag reflex or very sensitive teeth;
- a closed-in feeling in the dental chair;
- difficulty controlling your movements, or physical, behavioral or cognitive needs that make it hard to relax;
- a long procedure ahead.
When you’re calm, the dentist can often work more efficiently, and some treatment may be done in fewer appointments. Sedation doesn’t prevent tooth decay or gum disease on its own, but it can help you keep up with the checkups and cleanings that anxiety has made you put off. In trials in adults, oral sedatives reduced anxiety during dental treatment, although the reviewers judged the evidence limited.
Children and nitrous oxide
The American Academy of Pediatric Dentistry considers nitrous oxide, used judiciously, a safe and effective way to control a child’s anxiety about dental treatment. It can help a child who’s fearful, has a strong gag reflex or faces a long procedure, and it works best when the child accepts the nosepiece and breathes through the nose. Whether it suits your child depends on their age, health and needs, which the dentist will talk through with you. At Icon Dental Center, nitrous oxide is available for children as part of children’s dentistry.
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Is Sedation Dentistry Safe?
Used appropriately, nitrous oxide with oxygen is a safe and effective way to manage pain and anxiety in dentistry, according to the American Dental Association (ADA), and serious side effects are rare. Like any medicine, though, sedation has side effects and risks.
The most common side effects of nitrous oxide are nausea and vomiting, and headache or dizziness can also happen; these usually pass once the gas leaves your system. Sedation in general can also cause dry mouth or drowsiness that lingers, and most side effects go away within a day. Some people have allergic reactions to sedatives.
How deeply a person is sedated can’t always be predicted exactly, and dentists who provide sedation are expected to review your health first, get your consent, give you instructions and monitor you until you’re ready to go home. Taking sedatives together, or with opioid painkillers, strengthens the effect, which is one reason your dentist needs to know everything you take.
Who needs extra care
Some health conditions mean sedation needs a conversation first. Nitrous oxide may not be suitable if you have:
- COPD or certain other breathing conditions, or a cold, sinus infection or blocked nose;
- an untreated vitamin B12 deficiency;
- a current ear infection or recent ear surgery;
- raised eye pressure, such as glaucoma, or recent retinal surgery;
- some severe psychiatric conditions.
Anyone who can’t breathe through the nose or keep the nosepiece on can’t have nitrous oxide. If you’re pregnant or might be, tell your dentist: nitrous oxide isn’t recommended in the first trimester, and your dentist may suggest waiting until after pregnancy for treatment with sedation. Sleep apnea and serious heart or lung conditions are worth mentioning too, since they’re part of deciding which kind of sedation is right for you and may mean your dentist checks with your physician.
What to Tell Your Dentist Before Sedation
Your dentist needs your full health picture before sedation, so share these details and bring your own questions.
- your health conditions, allergies, and any past sedation or anesthesia and how it went;
- every medicine you take, including over-the-counter medicines, supplements and herbal products;
- whether you are or could be pregnant;
- any cold, blocked nose, sinus or ear infection, breathing condition or sleep apnea;
- what worries you most, whether that’s needles, gagging, the sounds or feeling closed in.
It’s also reasonable to ask which kind of sedation is planned, how you’ll be monitored and what to expect afterward.
Sedation at Icon Dental Center
Icon Dental Center offers nitrous oxide and oral sedation, given by our general dentists and our periodontist, and doesn’t offer IV sedation or general anesthesia. Our sedation dentistry page explains how each option works at our Everett office.
Common Questions About Sedation Dentistry
Why do you breathe oxygen after nitrous oxide?
Pure oxygen helps flush the nitrous oxide out of your system at the end of the procedure. You breathe it until you feel alert, and you’re checked before you leave.
Can I eat before sedation?
Follow the instructions your dentist gives you. Guidance on eating, drinking and your usual medicines depends on the type of sedation.
How long has nitrous oxide been used in dentistry?
Dentists have used nitrous oxide since the mid-1800s, and it remains one of the most common inhaled sedatives.