Conscious Dental Sedation–Sedation Dentist & Sedation Dentistry

Here’s a question I’ve been asked form a patient from Wheaton looking for a sedation—“What is dental conscious sedation?” Valid question as the 2 words seem to be contradictory as if you are sedated how you could be conscious!
The dictionary defines sedation as the “reduction of anxiety, stress, irritability, or excitement by administration of a sedative agent or drug.” It does not specify the degree of reduction. In the dental setting there are a number of levels provided by the sedation dentist . Light sedation can be achieved with nitrous oxide gas (Laughing gas), or oral conscious sedation. For more information of the different levels see our blog site on sedation dentistry, or dedicated website on conscious sedation.
But why do we say conscious sedation? Done properly with conscious sedation, the patient may not be aware of what is going on in the dental office, but the patient is still able to respond to verbal commands such as to “open their mouth.” Most important, they are completely comfortable and have no memory of their dental visit (just what they were hoping for!). Done improperly they can remain alert and remember everything.
This can often be accomplished with oral conscious sedation. However very often the level of dental sedation is not predicable with oral sedation. Most states prevent the dentist from giving incremental doses of medication without the dentist having their IV sedation license. Because oral sedation medications require 30 to 60 minutes to take effect, the scheduled procedure is not often able to be completed if additional oral sedation medication is needed for patient comfort. IV medications require just minutes to take effect and patient comfort and can be adjusted maintained throughout the distist visit.
So what is the conclusion? If sedation is simply by “a reduction of anxiety…” most drug regiments will satisfy the definition. My experience is the “Patient’s definition” of sedation is that they are completely comfortable and amnesic (no memory) of the dental procedure. This can sometimes be accomplished with nitrous oxide sedation or dental oral sedation, but is much more predicable with IV dental sedation. Also, some patients want different levels of sedation depending on the procedures–for exmaple nitrous may be sufficient for one hour tooth whitening, but they want IV sedation for more difficult procedures like dental implants.