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Consumers Guide for Sleep and Sedation Dentistry

What You’ll Learn in This Guide

There is good news for even the most fearful, anxious and terror-stricken dental patient: You can receive dental care without:

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Pain,

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Repeated, unnecessary appointments, or

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Feeling self-conscious about the condition of your teeth

What you will find in this guide is the reassurance that you can:

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Find comfort,

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Have dental procedures done without bad tastes, sounds or memory,

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In a healthy, safe environment and in a way respectful of your wishes.

All of this is possible thanks in part to the latest trend in dentistry – the use of new sedation techniques. Sedation allows patients to receive care who might have otherwise been too fearful to go into the dentists’ office.

Many dentists advertise Sleep and Conscious Sedation Dentistry. This guide, however, will also show you they are not all meaning the same thing, and why that matters.

What is the Difference Between Sleep Dentistry and Sedation Dentistry?

If you think in terms of a continuum you’ll grasp the concept of Sedation and Sleep Dentistry. Some patients do well and are comfortable with being awake and aware of what is going on during a procedure while others would rather be completely unaware and asleep. In between these two extremes are several variations.

In short, Sedation Dentistry can be divided into two forms. Conscious Sedation Dentistry is the range of sedation during which you are awake and aware during a dental procedure. Sleep Dentistry refers to the use of sedation techniques where you are asleep and unaware of what is happening during the dental procedure.

Dentists who are able to offer the full, broad spectrum of what is known as “Sedation Dentistry” can help patients determine the best method for them in preparation for treatment. Those methods may range from some form of Conscious Sedation to total Sleep Sedation.

Important Distinction!
Many dentists use these terms interchangeably. “Sedation Dentistry” is unfortunately used by many to give the impression they offer “Sleep Dentistry”. Sleep Dentistry is a more narrowly defined discipline during which you are actually asleep during dental procedures. It requires rigorous certification and so very few dentists offer true Sleep Dentistry.

There are several methods of Sedation Dentistry on the continuum between Conscious Sedation Dentistry and Sleep Dentistry. Using the one that is right for you will be determined by many things:

  • The level of fear or anxiety you have when thinking about seeing a dentist or having a dental procedure completed.
    Example: If you have mild anxiety about seeing a dentist you probably will do well using Conscious Sedation Dentistry. However if you are gripped with fear thinking about drills, shots, bad tastes, noises or pain you’ll find comfort in using Sleep Dentistry.
  • Your personal health history.
    There can be prior health concerns or ongoing health risks which make some forms of Sedation Dentistry unwise. You’ll want to discuss your health history with your dentist.
  • The method best suited to the procedure you are considering.
    Not all procedures require full Sleep Dentistry. Not all people do well with Conscious Sedation. Somewhere you, in consultation with your dentist, will be able to determine what is best for you.

What This Means for You!
With modern sedation techniques offered by a dentist who is certified in Sleep Dentistry you can receive dental treatments despite your fear of:
Drills    Shots    Smells
Noises    Tastes
…or other unpleasant things you associate with dental visits. You can smile again!

 

The Four Basic Methods of Sedation and Sleep Dentistry

If you think back to that continuum of Sedation Dentistry which runs between Conscious Sedation Dentistry and Sleep Dentistry you’ll find four main forms of sedation:

Conscious Sedation Dentistry

Nitrous Oxide (Laughing Gas)
Nitrous oxide is a gas that is generally used to help you feel more relaxed during a dental procedure. It is inhaled through a small rubber inhaler placed over your nose. The effects of it wear off within minutes after use. It is best used for patients with mild anxiety in the dental office or/and for short, uncomplicated dental treatments.

Oral Conscious Sedation
Oral conscious sedation is accomplished with a pill and best taken on an empty stomach. While you’ll still be awake during this level of sedation you’ll feel very relaxed, almost sleepy, and be less aware of what is going on in the dentist’s office. It offers a deeper level of relaxation then nitrous oxide. Because people react differently to medications, however, the level of sedation is harder to control. Also, the effects of the pill do not take immediate effect so adjusting the level of sedation quickly during a procedure is almost impossible. Oral conscious sedation is best used with patients who have mild fear about dental appointments, have a mild gag reflex and when procedures are fairly short in duration.

A Point of Concern!
These first two levels of sedation dentistry are where many dentists stop! While they say they offer sedation dentistry they do not offer the following two levels of sedation which are important for many fearful patients!

 

Sleep Dentistry

Intravenous (I.V.) Sedation
I.V. Sedation is the greatest advancement for fearful dental patients in decades, perhaps ever. It produces sleep within about a minute so that the patient afraid of dental procedures can have treatment without having to get over their fear. They will receive treatment without feeling pain, remembering or experiencing the smells, tastes or noises of dental visits.

Administering I.V. Sedation is quick, predictable and can be adjusted during treatment so the procedure can be easily completed. In addition, because the patient is asleep, prolonged procedures are easily completed without the need for numerous visits.

I.V. Sedation is often the answer for people with moderate to severe fear of the dental office and dental procedures. It is also a useful method of sedation when the treatment is prolonged or complicated because it allows these treatments to be completed in one or two visits.

General Anesthesia
Like I.V. Sedation, General Anesthesia produces a sleep during which the patient will not hear, smell or taste the dental procedure. It is generally administered by a Certified Registered Nurse Anesthetist (CRNA) and is typically carried out in a hospital. It has many of the same benefits of I.V. Sedation; quick to administer and adjust during a procedure and provides a way for long or complicated procedures to be carried out in one visit. General anesthesia is called for with patients who are phobic, not able to physically or behaviorally cooperate with the dentist or have a special medical condition that could cause a risk using other methods.

What This Means for You!
If you are one of the 145,000,000 Americans who avoid the dentist, mostly out of fear, treatment is now a possibility! Experience no pain or none of the other things that typically hold people back from seeing the dentist!

Now you know that there are at least four forms of sedation dentistry; two whereby you are still awake during a procedure (nitrous oxide and conscious oral sedation) and two whereby you are asleep and unaware during a procedure (I.V. sedation and general anesthesia).

There still may be a few questions you have. Here are the most common ones:

1. Do all dentists offer all forms of sedation dentistry?

No! While many dentists advertise that they offer sedation dentistry the fact is very, very few are trained and certified to offer I.V. Sedation. Certification requires a lot of study, difficult testing and the purchase of special equipment. You may hear phrases like “Sleep through your procedure!” or “Wake up and be done!” implying you’ll be asleep during your dental appointment. The fact of the matter is most dentists can only offer laughing gas or pills. In their office you will still be awake, still be conscious of what is going on and still be able to hear and taste the things that many find objectionable or fearful.

If you are seeking Sleep Dentistry make sure the dentist you are working with actually offers it. If you are like many fearful patients, when you are promised comfort and unawareness and then only given conscious oral sedation it will probably not help you overcome your hesitation to receive treatment.

Points to Ponder…

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If you are afraid of dental visits…

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If you break out in a sweat just thinking about calling for an appointment…

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If you can’t stand the smells, drill noise, tastes, needles or have a severe gag reflex…
…then choose a dentist who has chosen to work with you through Sleep Dentistry!

2. My concern goes beyond what I’d call ‘anxiety’ about seeing a dentist. Does this matter? Will my dentist understand?

Depending on where you get your information or which article you read you’ll find that somewhere between 20% – 50% of Americans put off dental care because they are afraid of the dentist. You are not alone.

Understanding dentists know that what many patients call ‘fear’ can actually be divided into 3 groups, and your level of sedation will be highly influenced by which category you fall in to:

Fear – This is a normal reaction to an unpleasant, past experience. If you are fearful of seeing a dentist or of having a procedure it is probably due to a past, painful or unpleasant situation. It is a very common reaction.

Anxiety – Anxiety is a lot like fear with one major difference; it is based on the anticipation that something bad could happen, not on a real and present danger. The anxious patient will put off dental visits, sweat and stew about making the appointment or avoid having treatment all together.

Phobia – This is an intense, unreasonable fear of a situation. It leads to total avoidance of the situation the person fears.

The three distinctions call for differing approaches to sedation. A dentist who is certified in Sleep Dentistry has taken the time to study the major fear classifications and compassionately offers solutions to each one.

Points to Ponder…Fearful, anxious or phobic…all can be treated compassionately and understood by a dentist who is certified in sleep dentistry. Such a dentist will have a specific solution to a patient’s level of fear, understand that fear and in consultation with each patient develop a plan for sedation everyone can be comfortable with.

3. Will I have to overcome my fear, anxiety or phobia before seeking dental treatment?

No, not if your dentist can deliver the full range of sedation dentistry techniques. If he or she is certified in I.V. Sedation you’ll be able to be given a level of sedation which is right for you. You won’t have to wait for some sort of therapy to resolve your fear issues.

Why is this important? Simply because by putting off dental care you run the risk of several things:

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Lack of preventative care can mean more costly treatment down the road.

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The buildup of bacteria in your mouth can actually lead to serious health problems in other parts of your body. Long lasting infections and inflammation can lead to heart disease, make diabetes harder to control, increase the risk of pneumonia or respiratory problems and increase the risk of a stroke. For pregnant women it can also increase the risk of having a low birth weight or pre-term child.

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Those with unhealthy mouths can suffer from poor nutrition, low self-esteem and fear intimacy with others.

Points to Ponder…
You do not have to wait to receive dental care any longer. You do not have to:

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Be self-conscious about your appearance or breath.

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Suffer through painful chewing while eating or avoiding certain foods.

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Run the risk of other health problems realizing the mouth is the “window to the rest of your body”.

4. Can people with special needs that make understanding what is going on in a dentist’s office difficult, or can those with chronic health problems that make sitting still impossible, still receive dental care?

Yes they can. When the dentist is informed about the special needs or physical limitations about a patient a level of sedation can be chosen appropriate for their needs.

Example: Someone with autism may not understand why a stranger with a mask is peering down on them. It can be a scary situation for the patient and the dentist. In this case sleep dentistry is called for so that the procedure can be completed without endangering the patient, the dentist or adding more fear into the life of the person with special needs.

Example: A person with a condition such as cerebral palsy may not be able to sit still. Without I.V. Sedation sudden movements can be dangerous for the patient and lead to frustration on the part of the dentist.

Whatever the special consideration any person may have, I.V. Sedation will probably offer the safest, quickest and gentlest way for dental procedures to be completed.

Points to Ponder…When you are considering dental treatment for yourself or a loved one with a special need or health concern, find a dental office that offers I.V. Sedation.
You do not need to be forced into a conscious sedation technique that puts you or your loved one at risk because that is all the dentist can offer. Ask for I.V Sedation, and if your dentist doesn’t offer it go elsewhere.

5. I’ve put off dental care for so long I’m ashamed of the condition of my teeth and smile. How do I know I won’t get a lecture or feel berated when I finally do go in for treatment?

The truth is you won’t without doing a little research. It’s not hard to find out what others have to say, however.

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Ask friends, family and acquaintances what their experiences with the particular dentist you are considering have been like. You’ll get a straight answer.

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See if the dentist has a website and look for testimonials about how others have been treated. The law actually states that testimonials on websites have to be a representative sampling of all testimonials received. If on video, do the testimonials look forced? Does the person look like “they are just saying that”, or do they look genuine?

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See if you can talk to the dentist ahead of time and get a feel for his or her personality. Does it fit yours? Does it make you feel comfortable?

Points to Ponder…For whatever the reason, if you have put off dental care you do not need to be lectured, chastised or shouted at in a dental office. Your dentist should be compassionate enough to accept you, work with you and offer solutions and treatments that are comfortable for you. Lectures about how “you should take better care of your teeth” or “you should have been here sooner” are unnecessary. If a dentist or hygienist has a ‘holier than thou’ attitude you can always ask, “Who works for whom?”

 

What’s Next?

You now know a lot about Sedation Dentistry. You know that:

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    There are several levels of sedation along a continuum that is divided into two parts; conscious sedation and sleep dentistry.
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    Conscious sedation relaxes the patients but they are aware of their surroundings, noises, tastes and conversations. The two main forms of conscious sedation are nitrous oxide gas and oral sedation (pills).
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    Sleep dentistry actually puts the patients to sleep so they do not have to remember or be aware of things they consider unpleasant or are fearful of. The two main forms of sleep dentistry are I.V. Sedation and General Anesthesia.
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    Not all dentists offer the full range of sedation dentistry. Because dentists do not have to differentiate between ‘sedation’ and ‘sleep’ in their advertising many appear to offer patients sleep dentistry, but in fact they cannot.
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    Sleep dentistry is a major advancement for those with fears, anxiety or phobias regarding dental treatment. It is also an appropriate solution for those with health conditions or special needs who cannot sit still or understand the need for a dental treatment.
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    Those with fears, anxiety and phobias towards dentists or treatment do not have to wait to get over their level of fear before seeking treatment. There is a sedation level that is right for anyone.
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    With Sleep Sedation you can have procedures completed in one or two visits that might have required 6-8 visits in the past.
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    Regardless of your level of fear (fear, anxiety or phobia)…

1. There is a level of sedation appropriate for you.
2. You do not need to live with a self-conscious smile, bad breath or painful chewing any longer.

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    Regardless of the reason for a prior lapse in dental care you do not have to be berated, made to feel like a scolded child or lectured to by a dentist or hygienist regarding the condition of your teeth. Dentists that permit or do this are not understanding of your fears, nor are they appreciative of your trust.

 

What This Means for You!
1. You have a right to find a dentist who offers the full spectrum of sedation dentistry. Don’t settle for one that only offers conscious sedation.
2. You have a right to be treated in a compassionate, understanding manner and in accordance with your concerns and fears.
3. You have a right to discuss your fears, anxiety and phobias with your dentist, and he or she should not only understand them but offer treatment and sedation that is appropriate for you.
4. You have the right to completing your dental procedure or treatment with as few visits as possible. Sleep dentistry can ensure one to two visits versus multiple returns.
5. Despite fears, anxiety or phobias you have the right to a healthy mouth, comfortable eating, eating whatever you desire and a beautiful smile, all without:

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Pain

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Horrible Tastes

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Gagging

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Unpleasant Noises or Smells

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Unpleasant Memories of the Procedure

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Chastisement

Sedation Dentistry is a major breakthrough for those suffering from dental anxiety and fear. Now that you better understand the full range of sedation dentistry, talk to your dentist. Together you can discover the best course for going forward and the most appropriate level of sedation for you.

 

 

This guide has been provided by Dr. Ron Receveur. We hope it was helpful and educational.

Definitions and dental options covered in this material are for information only. This guide is not intended to replace a personal consultation with your dentist.

Dr. Receveur is dedicated to helping those with fears, anxieties and phobias overcome their avoidance of dental treatment. He also believes everyone, regardless of fears, past experiences or the current condition of their teeth has the right to a beautiful smile and comfortable bite. Because of this pledge to all of his patients he has taken the time and expense to become certified in I.V. Sedation Dentistry. He is the only restorative dentist in Southern Indiana to do so.

To learn more about Dr. Ron Receveur, sedation dentistry and his caring approach to your health and smile, please go to www.IndianaSmiles.com or www.NewAlbanySedation.com, or call his office at 888-469-3982. He is located at 819 Mount Tabor Road, New Albany, IN.