What Is IV Sedation in Dentistry?
For patients who are desperately afraid of injections, going to the dentist or getting a wisdom tooth pulled, or a root canal is agony in more than just the obvious ways. You laugh at laughing gas, and there are not enough pills to help you calm down before the procedure. Instead of giving up on having healthy teeth and visiting our dentist, maybe it is time to consider IV sedation.
What Is IV Sedation?
IV or intravenous sedation is a procedure that allows our dentist to provide anti-anxiety medications, like those used in oral sedation, directly into your bloodstream. You may sometimes see this referred to as “sleep” or “twilight” dentistry, which may make you think you will be completely unconscious during your procedure. In fact, you remain awake the entire time and will be able to respond to questions. You may not, however, remember much or anything once the medication wears off.
Because of the nature of IV sedation, you must have an adult come with you to your procedure and drive you home. They will also need to take note of what you have to do in the hours and days after your procedure and help you until the sedation wears off. While it is an effective form of sedation, it is not one to be taken lightly.
How IV Sedation Works:
IV sedation puts you in a state of deep relaxation, much more than laughing gas or oral sedation. While the drugs are being administered, you generally may not care at all about anything going on around you. Time may seem to pass very quickly, and you may likely experience partial or even full memory loss of the procedure when it is over.
To receive IV sedation, a needle is used to insert a tube into a vein, usually on the top of your hand. The sedation drug is administered through this tube, so it goes directly to your bloodstream. The IV stays in your vein for the entire procedure. While you are under sedation, your pulse and oxygen levels will be monitored to make sure you do not have a bad reaction. Before and after sedation, your blood pressure will be checked, too.
What Medication Is Used?
Like oral sedation, IV sedation uses benzodiazepines to reduce anxiety and fear during the procedure. The most common drugs used are midazolam and diazepam. This is in a different dosage than the oral sedation method. As anti-anxiety medications, they are designed to relax you and make you sleepy. At this dosage, it can result in amnesia.
Pain medications like opioids are sometimes added to the IV sedation. This is not typical for everyone because the area being worked on will be numbed and pain should be minimal. Pain meds are most often used when a procedure will last a long time or if the postoperative pain will be unbearable. Even with the addition of pain medication, IV sedation is considered extremely safe for the vast majority of patients.
Why Choose IV Sedation?
For patients with a fear of needles, the dentist or medical procedures in general, IV sedation can be an excellent option. You may be thinking, “But I amafraid of needles (or pain)! How will this help?” A topical numbing cream can be used on the spot where the needle goes in or you can use laughing gas to feel calmer. Either way, while the needle is going in, you likely will not notice.
IV sedation is a good option for a few reasons:
- You may not know what is going on around you during the procedure, and you may not care either.
- You are still able to respond to requests and questions.
- The sedation takes effect quickly and can be adjusted to suit your specific needs.
- Any issues you may normally have with gagging are greatly reduced while you are sedated.
- You are more deeply sedated than with oral or inhalation sedation. This is good if you have extreme phobias or anxiety.
Who Should Not Use IV Sedation?
No option is perfect for everyone. In some instances, IV sedation may not be the right choice for you.
If any of the following apply to you, you cannot have IV sedation:
- Known allergies to benzodiazepines
- CNS depression
- Certain types of glaucoma diagnoses
Other patients should be cautioned against IV sedation but may still be able to use it, depending on your specific circumstances:
- Lung, kidney or liver problems
- Sleep apnea — even if you have not been diagnosed; being overweight and snoring are indications of sleep apnea
- Advanced age
Ideally, patients with severe anxiety or fears can work with a patient, caring dentist to overcome the stress they feel. But sometimes, people need more help than kind words and reassurances can provide. If you have tried every noninvasive technique without positive results, IV sedation is a safe alternative designed to help you get through big procedures and overcome your fears.