More than 15 percent of adult Americans avoid going to the dentist because of "misconceptions and fears." Here are a few strategies to help combat dental anxiety and phobia.
Sedation Dentistry Modalities
The sedative methods used for sedation dentistry vary in strength and purpose. Your dentist will select the sedation dentistry option that is best for you based on the treatments performed, how long these procedures will take and your level of anxiety. Although your dentist will ultimately determine what sedatives will be used, you can request stronger sedatives if you suffer from severe anxiety.
Levels of sedation range from mild, to moderate, to deep and are achieved through different types of sedatives. According to the Academy of General Dentistry, sedation is safe, but it is important for patients to talk to their dentist about what is involved and expected before the procedure. In order to ensure that the appropriate sedatives are used, your sedation dentist will require a medical history and list of all medications you are taking including over the counter products and herbal supplements.
Anxiolysis: Anxiolysis is defined by minimal or mild sedation and is associated with relieving anxiety. Inhalation analgesia (also known as nitrous oxide or "laughing gas") is one of the more commonly requested types of anesthesia from people who have anxieties about their procedure. It is administered via a small nose-hood placed over the nose through which nitrous oxide is delivered prior to and throughout treatment. In addition to some tingling and numbness, nitrous oxide typically evokes an overall feeling of well-being. Pills can also be used to create a feeling of anxiolysis. It is important for you to be open and honest with your dentist about any past drug use or current medical conditions so that an appropriate medication may be selected. The cost for anxiolysis (inhalation of nitrous oxide) ranges from $50 to $60.
Moderate Sedation: Moderate sedation is defined by a depressed level of consciousness, meaning you can breathe independently, retain your reflexes and respond to verbal/physical stimulation. Oral sedation or oral conscious sedation (OCS) most often associated with sedation dentistry produces moderate sedation via oral medication dispensed to the patient before the appointment to diminish awareness of pain, sounds and smells. The patient is instructed to take the medication prior to being driven to the appointment by a responsible caregiver and, once at the appointment, may receive additional medication as needed to ensure comfort.
- Intravenous Sedation: Intravenous sedation can also make people feel as if they are actually asleep, much like oral sedation. The difference between oral and intravenous sedation is the route of administration. Administered via injection, intravenous sedation has an almost instantaneous effect and is best used for shorter dental procedures. Amnesia is a common side effect of intravenous sedation and oral sedation, often leading people to believe that their procedure lasted mere minutes. The cost for intravenous sedation ranges from $290 to $340 for the first 30 minutes, and $100 for each additional 15 minutes. The cost for non-intravenous conscious sedation is approximately $175.
- Intramuscular Sedation: Intramuscular sedation, which involves an injection of sedative drugs into the muscles of the upper arm or upper thigh, can result in sedation within five minutes. Its use in dentistry is less common.
Deep sedation: Deep sedation, which is not considered a sedation dentistry modality, involves depressed consciousness in which a patient may not breath independently, loses some of his/her reflexes and is unable to respond to verbal/physical stimulation. This level of sedation is typically achieved with IV sedation or general anesthesia medications, the effects of which may linger for hours after the procedure is completed. The cost for deep sedation is approximately $180 for the first 30 minutes, and $115 for each additional 15 minutes.
General Anesthesia: General anesthesia is commonly used for surgery and a small percentage of people who are not good candidates for sedation dentistry.
Patients receiving sedation dentistry treatments must be accompanied by a responsible driver/caregiver who will drive them home. After the appointment this individual should stay with the patient until the effects of the sedation have worn off.