by Charles Simmins

Created on: November 23, 2009   Last Updated: November 25, 2009

Sedation dentistry may be the most important innovation in dental care since, well, forever. Millions of Americans forgo a visit to the dentist because of anxiety and fear. Despite numbing agents, dental procedures still create pain. That pain, the fear of pain, prevents many people from receiving the dental treatment they need.

Dental care is not just about pretty smiles. Infection and disease accompany neglect, and the infection can turn life threatening.

Conscious sedation dentistry uses medication to quell the fear and anxiety of a patient before and during the procedure. Numbing agents are still used. The greatest benefit to this type of dentistry - amnesia. The medications used in sedation dentistry inhibit short term memory so the patient does not remember the dental visit. There are no memories to replay, no moments that are seared into the brain.

In the past, sedation dentistry used gases such as nitrous oxide or IV drug administration. Both are effective but require a patient comfortable with that type of procedure. They also require additional monitoring and carry a greater risk to the patient than the current methods.

During conscious sedation dentistry, the patient is awake and able to cooperate with the dentist. The combination of medications used will often allow the patient to nap through much of the visit yet still be able to move, open their mouth and walk from the procedure room.

One recent procedure that took about three hours replaced five traditional visits. The patient needed a detailed cleaning and laser treatment for periodontal disease.

The night before, the patient took two diazepam, also known by the brand name Valium. This allowed the patient to receive a good night's sleep, without anxiety and free from worry.

An hour before his appointment, the patient took a dose of triazolam, also known by the brand name Halcion. This disolves under the tongue and is the amnesia inducing agent. On arrival at the dentist, he was given a second dose of triazolam.

The appointment was for 8 a.m. His designated driver picked him up shortly after 11. In this condition, the patient needs someone to watch them and to transport them because they are sedated.

His next memories would be of the following morning. He recalls nothing of the dental visit, the trip home or the afternoon and evening at home. He slept much of the time, but was able to use the bathroom and to eat soft foods during that period of time.

The time spent in sedation feels like nothing. It is as if time stopped, then resumed. There is no intervening feeling that time passed.

For patients who are prevented from receiving dental care due to fear and anxiety, conscious sedation dentistry represents a breakthrough. Poor dental care affects a patient's nutrition and the infections can cause pain and spread to other parts of the body including the heart. Sedation dentistry is also a Godsend for children and patients with special needs such as autism. It is widely practiced and the local dental society can provide a list of those doing so.

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