Do you experience high levels of anxiety when visiting the dentist? You may be a candidate for Sedation Dentistry. Dr. Tummala is Board Certified to administer (oral conscious) sedation, commonly referred to as “SLEEP DENTISTRY.”
Sedation Dentistry
Advantages to patients include:
- Treatment is completed when you are in a more relaxed mood.
- You will have less difficulty sitting through a lengthy procedure.
- Multiple treatments and full mouth restorations can occur at during the same visit.
- Less discomfort after treatment.
Anti-Anxiety Pills
The most commonly prescribed dental related drugs that treat anxiety belong to the “benzodiazepine” family. Drugs such as Valium, Halcion, Xanax, or Ativan. These drugs decrease anxiety by binding and toning down activity within “fear” receptors in the brain.
There are two different types of Benzodiazepines:
- Sedative-Hypnotics: These drugs induce calm, including drowsiness and even sleep. This sleep state is actually a form of hypnosis which is a form of physiological sleep.
- Anti-Anxiety Drugs: These are drugs which relieve anxiety and induce a state of calm and relaxation.
While benzodiazepines act as sedatives AND anti-anxiety drugs, some are highly targeted at areas within the brain which focus on sleep. Others act in a more specific way and target fear centers in the brain. In most cases, higher doses act as sedatives and induce sleep, while in lower doses, they reduce anxiety without sedation. Benzodiazepines are also Central Nervous System (CNS) depressants (i.e. there can be a decline in blood pressure and breathing). It is important to note that they shouldn’t be mixed with other CNS depressants such as alcohol. Its important that you utilize the dose your dentist or doctor recommends. It is possible to overdose, and overdoses could lower your breathing to dangerously low levels, which could result in coma or death. Please note that you shouldn’t travel on your own after you’ve taken any of these drugs. Make sure you have an escort, even if you traveled by bus or foot! It’s easy to become disorientated.
When not to take benzodiazepines:
Some of these drugs can affect your liver and heart. It’s important to check with your practitioner and/or pharmacist. You should be sure to inform your doctor or dentist if any of the following apply: known allergy to the drug, narrow-angle glaucoma, pregnancy, severe respiratory disease (COPD), congestive heart failure (CHF), impaired kidney or liver function, depression/bipolar disorder/psychoses, chronic bronchitis and some other conditions. It’s also important to let us know if you are taking other medications. There could be possible drug interactions.
Frequently Asked Questions
What is the difference between oral sedation and nitrous oxide?
Depth and duration, mainly. Nitrous oxide is a gas you breathe during treatment, it works within minutes, and it clears almost as fast, so you can usually drive home. Oral sedation is medication taken beforehand, it produces a deeper level of relaxation, and it stays in your system for hours afterward, which means you cannot drive and need someone with you. Nitrous suits mild anxiety. Oral sedation suits stronger anxiety or longer appointments.
Will I actually be asleep?
Not truly asleep, despite the term "sleep dentistry" that gets used for it. This is conscious sedation: you remain able to respond and to breathe on your own, and you can be roused. What most people experience is deep relaxation and a hazy sense of time, and many remember very little about the appointment afterward. That is different from general anesthesia, which is not what this is.
Do I need someone to drive me home?
Yes, and this is not negotiable. The medication affects your judgment and coordination for hours after your appointment, well beyond the point where you feel fine. You will need a responsible adult to bring you, take you home and stay with you for a while. Plan not to drive, not to work and not to make any important decisions for the rest of the day.
How long do the effects last?
Longer than most people expect, often the better part of a day depending on the medication and dose. You may feel drowsy well into the evening. Clear your schedule for the whole day rather than planning to go back to work, and follow the specific instructions we give you about eating beforehand and afterward.
Who is not a suitable candidate?
It depends on your medical history, so this is decided case by case rather than by a rule. Certain medical conditions, some medications that interact with sedatives, pregnancy and some allergies can all rule it out or change the approach. Dr. Tummala will review your full medical history and current medications before recommending it, and will tell you plainly if something safer would suit you better.