Anesthesia

Dentistry has advanced to the point in which pain is almost a thing of the past.

Powerful pain-killing medications known as anesthetics not only help a patient avoid discomfort during a procedure, but post-operatively as well.

Some patients, especially children, may require higher doses of anesthetic than others.

Types of pain-killing medications include:

• Analgesics - These are also called pain relievers and include common non-narcotic medications such as ibuprofen and aspirin. Analgesics are usually used for mild cases of discomfort, and are typically prescribed following such procedures as a root canal or tooth extraction.
• Anesthetics - Anesthetics can either be topically applied, injected or swallowed. Dentists often apply topical anesthetics with a cotton swab to an area of the mouth where a procedure such as a restoration will be performed. This numbs the affected area. Topical anesthetics are used in many dental procedures such as tooth restoration. Topical anesthetics also are used to prepare an area for injection of an anesthetic. Novocaine and Lidocaine are the most common kind of injectable anesthetics. Such medications block the nerves from transmitting signals and are used for more major types of procedures, such as fillings and root canals.
• Sedatives - Sedatives are medications designed to help a patient relax. This can be a powerful tool in avoiding pain. Sedatives are sometimes used in combination with other types of pain relievers and pain-killers. Nitrous oxide, or laughing gas, is a form of sedative. Conscious sedation involves administering a sedative while the patient is alert and awake. Deep sedation or general anesthesia involves administering a medication that places a patient in a state of monitored and controlled unconsciousness.

Types of sedatives include:

• Intravenous (IV) sedation - Usually in the form of a tranquilizing agent); patients given IV sedation are often awake, but very relaxed.
• Inhalation sedation - a form of sedation in which a medication (such as nitrous oxide) is administered through a special mask.

Sedation

Sedatives are agents to aid in relaxation. They work by reducing your anxiety level and are often given when basic relaxation techniques fail. Sedatives may be used in tandem with anesthetics and analgesics. These kinds of sedatives (such as nitrous oxide and tranquilizers) can be administered before, during or after dental procedures. Patients normally receive sedation orally by inhaling nitrous oxide or swallowing a tranquilizer.

Here are some basic kinds of sedation:

• Conscious sedation is sense of calmness while awake. Analgesics, anti-anxiety agents, and sedatives are used in some combination in order to make the patient more comfortable and relaxed, thereby making pain more manageable. Patients who have received this kind of sedation typically feel as though they have been asleep throughout their appointment. Patients who are faced with a greater degree of fear or anxiety, or are experiencing root canals or tooth extractions sometimes ask to be sedated for their treatment.

Types of sedation

Intravenous (IV) sedation

Intravenous sedation is the administration of a tranquillizer drug into the blood system in order to facilitate dental surgery in the highly anxious patient. An IV sedative produces a very strong sensation of deep relaxation and well-being in the vast majority of patients.

Most patients who have IV sedation report remembering very little or nothing from their dental surgery. IV sedation is administered by injecting a sedative agent into one of the superficial veins of your arm or hand. As the vein is usually just under the skin and the needles used these days are extremely thin, this is usually quite painless. Most people are good candidates for this kind of sedation. Some medical conditions such as severe lung diseases, some heart problems, obesity or anorexia rule it out as an option, however.

Unlike general anesthesia, IV sedation allows you to remain medically conscious yet deeply relaxed throughout your surgery.

Inhalation sedation, Nitrous Oxide

Inhalation sedation uses combinations of nitrous oxide and oxygen gases, which are inhaled by the patient through a rubber nose mask. Nitrous oxide is a very benign, safe and simple drug to use. The strength of the sedative effect depends upon the concentration of nitrous oxide that is inhaled. The effects of nitrous oxide are easily controlled by the patient simply by breathing more or less room air through the mouth.

The effects of the gas wear off quite quickly upon removal. This gas does produce a feeling of well-being and euphoria combined with a feeling of good self-control while the treatment is being performed.

Children tend to respond better to nitrous oxide as apposed to other techniques, although some are fearful of having a mask placed on their nose.