Oral Sedation

Oral sedation has become a fairly common practice over the years, even in general dentistry. But as with all medical issues, there are risks as well as benefits.

It’s often thought that a few small capsules hold the answer to controlling both dental pain and anxiety at once. While this may be true in some cases, it’s not always the best option for every patient. Sedation dentistry (also known as “twilight sleep”) has become a common practice in the dental industry, one that can potentially help patients with fear of the dentist better cope with necessary dental work. Previously, it had been used mainly for complicated, long procedures like wisdom teeth removal or other surgery, and given via IV. But today’s sedation looks different. Now, sedation is often given orally in the form of pills. Unfortunately, it’s also a practice that can be over used, or used inappropriately.

Since patients all vary widely in the way they metabolize pills, it can take 20 minutes to two hours for oral sedation to take effect. And a dentist who gives multiple pills (such as Valium or Halcion) may accidentally cause an overdose if too many pills are given at once. Therefore, the ADA has stated that it advises caution when utilizing sedation dentistry, especially in the form of pills, until more research can be done on its safety.

The use of sedation dentistry is not limited to adults; it’s also used when children require dental surgery. Recently, Louisiana State University published a study showing the typical responses for children who had been sedated during dental procedures in order to help parents and practitioners better know what to expect after a child has undergone sedation.

The results showed that the effects of sedation typically last well into the hours after it is given. For instance:

— Most adverse effects were likely to occur in the first eight hours, although some took up to 24 hours to manifest.

— Different medications also resulted in different effects:

** Vomiting was seen in children sedated with certain medications.

** Prolonged sleep at home was significantly higher in the children sedated with certain medications.

“It is critical to know the effects of these medications beyond the time spent by the child in the dental office, so that parents can be appropriately cautioned about the expected effects (sleeping and vomiting during the ride home) and how to distinguish them from any potential emergencies that may lead to airway obstruction,” the researchers explained.

“It is, therefore, important to ask parents to bring another responsible adult to accompany their child in the car when planning sedations for pediatric patients,” they concluded.

– Dr. Shannon Norman-Kotre, Ann Arbor Dentist