Sedation
Several methods of sedation are available. The method of sedation that is chosen for or by a patient depends upon the nature of the surgical procedure and the patient’s level of apprehension.
Sedation Options
The following table illustrates the choices of sedation, a description of the sedation technique, and the usual indications for that technique.
| Method | Description of Technique | Usual Indications |
|---|---|---|
| Local Anesthetic | The patient remains totally conscious throughout the procedure. A local anesthetic (e.g. lidocaine) is administered in the area where the surgery is to be performed. Local anesthetic is used in conjunction with the other methods of sedation in all oral surgery procedures. | Simple oral surgery procedures such as minor soft tissue procedures and simple tooth extractions. |
| Office Based IV sedation with Local Anesthetic* | Medications are administered through an intravenous line (I.V.). The patient falls asleep and is completely unaware of the procedure being performed. Medications most commonly used are Versed (benzodiazepine), Ketamine, and Propofol. Supplemental oxygen is delivered through a nasal breathing apparatus and the patient’s vital signs are closely monitored. | IV sedation is available for all types of oral surgery. A patient may choose IV sedation for simple procedures depending on their level of anxiety. Most people having their wisdom teeth removed or having a dental implant placed will choose IV sedation. IV sedation may be necessary if local sedation fails to anesthetize the surgical site which often occurs in the presence of infection. |
To administer IV sedation in the office, an oral surgeon must have completed at least three months of hospital-based sedation training. Qualified applicants will then undergo an in-office evaluation by a state dental board-appointed examiner. The examiner observes an actual surgical procedure during which IV sedation is administered to the patient. The examiner also inspects all monitoring devices and emergency equipment and tests the doctor and the surgical staff on sedation-related emergencies.
If the examiner reports successful completion of the evaluation process, the state dental board will issue the doctor a license to perform IV sedation. The license is renewable every two years if the doctor maintains the required amount of continuing education units related to sedation.
Again, when it comes to sedation, our first priority is the patient’s comfort and safety. If you have any concerns regarding the type of sedation that will be administered during your oral surgery procedure, please do not hesitate to discuss your concerns with your doctor at the time of your consultation.
Intravenous Sedation
Our office offers our patients the option of Intravenous Sedation for their dental treatment. Intravenous Sedation helps you to be comfortable and calm when undergoing dental procedures. Your treatment can be completed under intravenous sedation.
Intravenous sedation or IV sedation is designed to better enable you to undergo your dental procedures while you are very relaxed; it will enable you to tolerate as well as not remember those procedures that may be very uncomfortable for you. IV sedation will essentially help alleviate the anxiety associated with your treatment. You may not always be asleep but you will be comfortable, calm and relaxed, drifting in and out of sleep.
If you choose the option of intravenous sedation your IV sedation is administered and monitored by the doctor, therefore, eliminating the costly expense of having your treatment carried out in an operating room or same-day surgical facility.
How is the IV sedation administered?
A thin needle will be introduced into a vein in your arm or hand. The needle will be attached to an intravenous tube through which medication will be given to help you relax and feel comfortable. At times a patient’s vein may not be maintainable, in these situations, the medications will be administered and the needle retrieved – both scenarios will achieve the same desired level of conscious sedation.
Once again some patients may be asleep while others will slip in and out of sleep. Some patients with medical conditions and/or on specific drug regimens may only be lightly sedated and may not sleep at all.
The goal of IV sedation is to use as little medication as possible to get the treatment completed. It is very safe, much safer than oral sedation. With IV sedation a constant “drip” is maintained via the intravenous tube. At any time an antidote can be administered to reverse the effects of the medications if necessary.