Oral Versus Intravenous Sedation Dentistry

Which Method is Best for Me?

There are two common methods of “Conscious sedation” sedation dentistry.

1. I.V. Sedation– I.V. stands for intravenous, meaning that the sedation medication is administered directly into the person’s blood stream. There is only one shot that needs to be given and the effects of the sedation are instantaneous. Another advantage of IV Sedation is that if the patient is not as sedated or “deep” as the doctor would like, or if the medication is wearing off more medication can be administered and the effects are instantaneous.

2. Oral Sedation– This medication comes in pill or liquid form. This form of sedation avoids any type of shots or injections to the patient while they are “awake” which is good news if you are a needle shy patient. However, oral sedation medication is more variable in effectiveness. The medication affects each person different, based on factors like age, weight, genetics, medications they are currently and have taken. Since it is swallowed, there is a delay from the time the medication is taken and it actually causes sedation. Almost all people respond very favorably to orally administered sedation.

Use Oral Sedation If:

  • You want the advantage of sedation and at the same time do not want the higher fees associated with I.V. sedation.
  • It is greatly easier to administer than I.V.
  • You are needle shy

Use I.V. Sedation If:

  • You need to drive yourself to your appointment. Oral Sedation needs to be taken an hour or more before your appointment, and you should never drive or perform demanding tasks after taking sedatives until your doctor tells you.
  • Are not averse to receiving a shot or injection. I.V. sedation gives your doctor better control of your sedation level and the sedation wears off faster since the dosage can be controlled more precisely.

Basic I.V. Sedation Information

I.V. sedation is the most powerful type of conscious sedation dentistry. This is because the effects are immediate (you will be completely sedated within moments of injection) and produces the most powerful amnesic effect of the three primary sedation methods; oral, inhalation and I.V.

I.V. is most common for Oral Surgery Cases. Oral Surgeons perform extractions, implants, reconstructive and cosmetic surgery as well as emergency and diagnostic surgery. Far from your average check up, these procedure are almost always more pleasant under sedation, even if you are not afraid or anxious of your visit.

I.V. sedation requires special training by the dentist and certification. The reason why some patients and dentists prefer I.V. sedation more than oral or inhalation is because I.V. sedation allows the dentist to quickly administer more medication if the patient isn’t sedated enough. The drugs are also much more effective and powerful than the same drug taken orally. I.V. sedation also provides a more powerful amnesic effect than the other methods of sedation dentistry. This works best for long procedures, like those commonly performed by Oral Surgeons.

Unfortunately, since I.V. sedation requires special advanced training and certification by the State Board of Dentistry, it isn’t common in most general dentists’ offices.

Basic Information About Oral Sedation

The medications, or oral sedatives, used in sedation dentistry are from a group of drugs called Benzodiazepines.

Benzodiazepines provide the sedative effect and an amnesic effect that prevents you from remembering painful sensations. In fact, you will remember little or nothing or your dental procedure or appointment.

Since the sedative is either in pill or liquid form the patient doesn’t have to be “awake” for any injections or needles. This form of sedation dentistry is best for patients that fear getting shots, are nervous around needles and/or have difficult to locate veins for I.V. sedation. Since no special training or certification is needed for oral sedation dentistry (unlike I.V. sedation), the cost is lower.

Unfortunately, since the drug must be absorbed through your digestive track it is not easy for the doctor to change your level of sedation in a timely manner. The delay in the time the medication is administered and the time it takes effect also means you must remember to take your sedative before your appointment and someone must drive and accompany you to and from your dental visit.

Remember that sedatives do not relieve pain, they only erase the memory of the pain. Fortunately, once you are relaxed and amnesic the doctor can then administer local anesthetic which will further increase comfort without raising your anxiety level.

Source by Eric Hackenberger

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