Managing Dental Anxiety:
The Benefits of Sedation Dentistry

Dental fear is also called dental phobia or odontophobia. Patients who have this condition experience immobilizing fear of visiting a dentist and obtain oral care. Addressing the issue of dental care would prevent delay in seeking oral care and thus prevent life-threatening emergencies. There are many causes of dental fear like the fear of pain, drilling sound, the smell of the dental office, fear of dental tools, fear of needles, fear of being helpless, gagging, and many more.

Sedation will reduce your awareness, making you will feel more relaxed. Your memory, responsiveness, and consciousness during the procedure would vary based on the type of sedation used. You would not be losing total consciousness unless it is general anesthesia. Since you feel relaxed during and after the procedure, you would positively react to the treatment performed, and dental fear would gradually start reducing.

Studies have found that 30-50% of the population avoid going to a dentist regularly because of their anxiety and fear of visiting a dental clinic or sit in a dental chair.

In sedation, your dentist will give you anti-anxiety drugs or nitrous oxide gas, or anesthesia. These will help in calming you by decreasing your cognition (awareness and memory). As a result, you would be less intimidated during and after the treatment. You would be encouraged to get treated for your dental problems without procrastination due to dental fear. Moreover, you can get more procedures done in a single appointment. Sedation would reduce your number of visits to the dental office and reduce the hassle of scheduling multiple appointments.

One of the significant differences between both the procedure is the patient’s breathing. In IV sedation, the patient breathes on his/her own. However, in general anesthesia, the patient would lose control of his respiratory muscles, so the respiration has to be supported by special medical equipment.

No, you will not experience any pain during sedation. Sedation helps in dulling your senses, and you would be less conscious. You would experience less pain, less fear, less anxiety, and less memory of the procedure. Sedation dentistry is becoming popular. More and more people opt to make their dental visits less painful and, thus, more pleasant.

Dr. Adatrow is a highly qualified and indiana university-trained healthcare professional. You can openly talk about your fears and concerns regarding your dental treatments with him during your first dental visit. He will take the utmost care of you and address all your problems. Providing details about your medications (including supplements), medical history, habits like alcohol or smoking to your dentist is crucial. All these factors would alter your response to sedation medication. Based on your medical history, medications, preferences (cultural or personal), and treatment needed, your dentist would advise you on appropriate sedation techniques without any judgment.

The type of sedation is best to decide by your doctor. Dr. Adatrow will assess your medical history, medications, anxiety level, and treatments required and determine the type of sedation that will give you the best results.

Your dentist would prescribe medication types for sedation dentistry based on your treatment procedure and your medical history. The most commonly used medicines are a group of drugs called benzodiazepines (valium) and nitrous oxide gas. They help in reducing dental anxiety.

We at Advanced Dental & TMJ Center thrive for providing world-class care to our patients. We make sure that all our patients are comfortable and satisfied with their treatment. Dr. Adatrow is passionate about providing personalized care. He spends time with the patients, understands his patient’s condition, and recommends the best possible treatment. He has intensively trained in the Indiana University hospital for administering sedation to his patients. He is the only practicing board-certified periodontist and prosthodontist in the southern United States. He has experience of more than 17 years.

You will be awake during your dental procedure but will not feel any discomfort thanks to IV conscious sedation. You are wholly unconscious during general anesthesia and cannot be woken — not even by painful stimuli. Furthermore, general anesthesia necessitates additional breathing assistance. It can affect heart rate and other life-sustaining activities, requiring an anesthesiologist to monitor vital indicators like blood pressure, heart rate, and pulse. With IV sedation, you will be safer and more comfortable “semi-awake” state with reduced anxiety. Because of the amnesic impact of the drugs used to deliver sedation, you will most likely have little or no recall of the procedure afterward. While sedated, you can respond to verbal directions and light physical touch. You do not require medical aid to maintain proper breathing and heart function when under IV conscious sedation.

In inhalation sedation, we sedate the patients by asking them to inhale nitrous oxide and oxygen gas mixture through a mask device. This is a light type of sedation. It is a blend breathed into a nosepiece of nitrous oxide and oxygen. It encourages the child to feel comfortable and welcome therapy.

Inhalation sedation is not recommended in the following conditions –

• Chronic obstructive pulmonary diseases.
• Current respiratory tract infections.
• Recent middle ear disturbance/surgery.
• Severe emotional disturbances or mental health issues
• Drug-related dependencies
• The first trimester of pregnancy
• Cobalamin (vitamin B12) deficiency

• Works very rapidly
• No “hangover” effect
• Faster recovery
• Easy to administer
• No needles required

Nitrous oxide sedation requires minimal preparation before administration. Recovery is also immediate for nitrous oxide sedation.

The effects of nitrous oxide would be similar to the consumption of one to five beers. 1-5 Beers = nitrous oxide sedation.

You might feel euphoric within two to three minutes of inhaling the nitrous oxide, maybe a few giggles too.

Inhalation sedation comprises a nosepiece. The nosepiece releases a blend of nitrous oxide and oxygen gases.

Intriguingly, N2O’s exact mechanism of action is still unclear (there seem to be quite a few distinct mechanisms at work)! However, it has been noted that N2O depresses almost all types of sensation, specifically hearing, touch, and pain. It decreases anxiety, as well. It only minimally impairs the capacity to focus, execute intelligent actions, and short term memory.Providing details about your medications (including supplements), medical history, habits like alcohol or smoking to your dentist is crucial. All these factors would alter your response to sedation medication. Based on your medical history, medications, preferences (cultural or personal), and treatment needed, your dentist would advise you on appropriate sedation techniques without any judgment.

IV sedation is also known as ‘twilight sleep.’ In this procedure, Dr. Adatrow would be sedating you by administering a drug into your body through one of your veins, using an IV. Dr. Adatrow controls the amount of drug delivered into your body and, with his dental team, continuously monitors you during the entire procedure.

The experience of undergoing IV sedation could be comparable to the consumption of ten to fifteen beers at a time.

10 – 15 beers = IV Sedation

To understand IV sedation, remember outpatient procedures like LASIK surgeries. The patient would not be aware during the process, and they might not remember the procedure done. The patient would gradually regain awareness after the procedure, so it might take a few hours to recover.

Your surgery will be performed for your comfort, utilizing a combination of local anesthetics and intravenously administered conscious sedation. Please follow the instructions below for your safety:

IV sedation has the following side-effects or disadvantages. However, these are rare.

• Longer recovery time
• Need constant monitoring to avoid complications like oversedation and respiratory distress
• Dry mouth
• Drowsiness that can last for a couple of days
• Nausea and vomiting

Your surgery will be performed for your comfort, utilizing a combination of local anesthetics and intravenously administered conscious sedation. Please follow the instructions below for your safety:

1. Take your usual prescribed medications and those that have been prescribed for you in preparation for your periodontal surgery. Do not take aspirin or other aspirin-containing medicines for one week before your surgical date.
2. Advise us of any medications you are taking, even supplements or over the counter drugs. Please do not take any medicines without your surgeon’s knowledge and approval.
3. Please do not have anything to eat for at least 8 hours before your appointment. It is O.K to have small amounts of clear liquids (water, lemon-lime soda) up to 2 hours before, but refrain from drinks with sugar or cream.
4. Do not drink any alcoholic beverages on the day of your appointment or for twenty-four hours after your sedation.
5. Wear loose, comfortable clothing with sleeves that can quickly be drawn above your elbow. You may find it more comfortable to wear flat shoes as, after your sedation, you may be a little unsteady on your feet.
6. To monitor you properly during your sedation, it is best not to wear any nail polish, lipstick, or make-up the morning of surgery. If you wear acrylic nails, please remove them from at least two fingers on your right hand.
7. For all surgical procedures, please brush your teeth just before coming for your appointment to reduce bacteria and prevent infection.
8. Please arrive promptly for your appointment so that our staff has time to go through our pre-operative
9. questionnaire and prepare you for your surgery. Late arrival may necessitate rescheduling of your procedure.
10. You MUST be accompanied home by an adult who will drive and arrange for responsible supervision for the remainder of the day. We are sorry, but we cannot allow you to take public transportation, taxi, or drive yourself home.
11. Please notify your surgeon if you develop a cold, sore throat, cough, stuffy nose, fever, or any other illness during the days before your surgical appointment. If rescheduling your appointment becomes necessary, we would like to have as much advance notice as possible.

Your surgery will be performed for your comfort, utilizing a combination of local anesthetics and intravenously administered conscious sedation. For your safety, please follow the instructions below:

1. The after-effects of sedation are often predictable but may vary slightly between individuals. Following treatment and after your clinic’s discharge, it is likely that you will not remember the actual dental procedure and often your trip home. It is normal to feel a little disoriented and tired after sedation. It usually takes 12 to 24 hours to feel completely normal about your ‘hangover*.
2. Restrict your activities on the day of surgery. Return home immediately following discharge from the office. Rest. Lie down with your head elevated as much as possible that first day.
3. Because you have not had anything to eat or drink for 8 hours before surgery, you are calorie depleted and dehydrated. Drink ‘sugary’ liquids (juice, milkshakes) when you return home. This will help you regain your energy more quickly and treat your dehydration. You should consume at least 5 to 6 glasses of liquid daily for the first few days. Also, eat bland, soft foods (soup, pasta, rice) if possible. Heavy foods and fatty foods on an empty stomach sometimes cause nausea and vomiting and should be avoided if possible. Try to resume a regular diet as soon as possible.
4. Avoid alcohol, sleeping pills, and any illicit drugs for at least 24 hours after your sedation. These medicaments can interact with medications remaining in your body following the sedation, which can cause a severe reaction and harmful result.
5. You should not drive a vehicle, operate dangerous equipment make any crucial decisions, or sign any legal documents for at least 24 hours after receiving intravenous sedation.
6. If your IV site becomes red, swollen, and warm to the touch, you should call us as soon as possible.

Yes, IV sedation is safe if all the necessary measures are taken appropriately. It is of utmost importance that you select a dentist with the right sedation dentistry expertise to have optimum results. Dr. Adatrow has trained intensively in Indiana University hospital in administering sedation dentistry to patients and has more than 17 years of experience in doing the same. Hence, you can trust him in the process and enjoy your dental experience with us.

Oral sedation, also called pill sedation, is one of the sedation dentistry strategies and calms down the patients during dental treatment. In this strategy, Dr. Adatrow would prescribe you a sedative pill to be consumed hours before the dental procedure. The oral sedative would be a Benzodiazepine (i.e., Valium, Xanax, or Halcion). The sedative would reduce brain activity, especially the areas controlling fear and anxiety, making the patient calmer and relaxed.

You have to adhere to the instructions provided to you by our dental team. Recovery from oral sedation is not instantaneous as inhalation sedation but is faster than general anesthesia. However, we would recommend you ask someone to accompany you on the day of the procedure. You might still be a little drowsy after the procedure for a couple of hours, so we recommend that you not drive home or operate heavy machinery after the procedure.

The purpose of oral sedation is for you to feel secure and fully relaxed. The sedative can make you feel drowsy and utterly pain-free so that within just one office visit, the dentist would be able to conduct several dental procedures.

During oral conscious sedation, you will feel drowsy, but you would remain alert. You will respond to verbal commands, and you can be woken with a gentle shake. You will feel relaxed and react well to the doctor’s instructions. You will recollect very little about the procedure like it all happened in the dream.

• Comfort
• Fewer appointments
• Enhanced quality of treatment
• No needles

Undergoing Oral Sedation would be similar to the consumption of 5-7 beers.

5-7 beers = Oral Sedation

The various strategies used to relax or relax patients prior to and during dental treatments are covered by oral sedation. You’ve certainly heard of laughing gas, which is commonly used before dental treatments like crowns or root canals. Oral sedation, on the other hand, is a far broader and more complex field than just laughing gas, with a wide range of choices for patients who are anxious or even afraid of going to the dentist. Your dentist will not provide you oral sedation as part of your pain management plan. That phase of the process is covered by numbing drugs and injections. If the thought of getting a shot in your gums makes you nervous, dental sedation can help you relax to the point where you can tolerate it. Even though you’re awake during the treatment, you could not remember it if you’re given certain types of sedation.

Prior to your dental appointment, discuss your fears and concerns with your dentist. When it comes to sedation, your dentist will help you find a solution that’s customized to your unique needs. People who have tender nerves or smaller mouths, however, may benefit from sedation as operations result in increased pain and suffering for these patients. Other people may require sedation to assist them in overcoming their anxiety and phobias while they are going to the dentist or getting any kind of medical procedure done. Involuntary sleep induction, sometimes referred to as oral sedation, is a typical approach for people to face their fear or pain during dental visits. Anxiety may lead you to put off your next appointment, so if you have an upcoming dental appointment, it’s always a good idea to discuss sedation with your dentist.