IV Sedation & Anesthesia

Dental BLU has several methods of anesthesia available.  The method of anesthesia that is chosen for or by a patient depends upon the nature of the procedure and the patient's level of apprehension.  The following table illustrates the choices of anesthesia, a description of the anesthetic technique, and the usual indications for that technique.  The patient should discuss with Dr. Depp or Dr. Arlinghaus if they are a candidate for any of these options. 

Method of Anesthesia Description of Technique Usual Indications
Local Anesthetic The patient remains totally conscious throughout the procedure. A local anesthetic is administered in the area where treatment is to be performed. All procedures including fillings, crowns, root canals, extractions, etc.
Nitrous Oxide Sedation with Local Anesthetic A mixture of nitrous oxide (laughing gas) and oxygen is administered through a nasal breathing apparatus. The patient remains conscious in a relaxed condition. Nitrous oxide has a sedative and analgesic (pain-controlling) effect. Can be used during any procedure. Great for children, anyone experiencing mild anxiety or gag reflex.
Non-Intravenous Mild Conscious Sedation A combination of nitrous oxide (laughing gas) and Triazolam pill (oral pill given in-office; temporary anti-anxiety medicine lasting 4-6 hours). *Driver will be required after treatment. Can be used during any procedure. Great for anyone experiencing mild to moderate anxiety.
Moderate IV Sedation Medications are administered through an intravenous line (I.V.). The patient falls asleep and is completely unaware of the procedure being performed. Medications most commonly used are Fentanyl (opiate), Versed (benzodiazepine), Ketamine, and Diprivan. Supplemental oxygen is delivered through a nasal breathing apparatus and the patient's vital signs are closely monitored. Patient is responsive to commands. Moderate "conscious" sedation is available for all types of dental treatment. A patient may choose this for simple procedures depending on their level of anxiety. This is a drug-induced depression of consciousness during which the patient responds to verbal commands. No interventions are required to maintain a patent airway, and spontaneous ventilation is adequate. Cardiovascular function is usually maintained.
Deep IV Sedation Sedation is performed in office by a certified nurse anesthetist. The patient is on the edge of consciousness. A drug-induced depression of consciousness during which patients cannot be easily aroused but respond following repeated stimulation. The ability to independently maintain ventilatory function may be impaired. Patients may require assistance in maintaining a patent airway, and spontaneous ventilation may be inadequate. Cardiovascular function is usually maintained.

 

How is the IV Sedation Administered?

A thin needle will be introduced into a vein in your arm or hand. The needle will be attached to an intravenous tube through which medication will be given to help you relax and feel comfortable. At times a patient's vein may not be maintainable, in these situations the medications will be administered and the needle retrieved - both scenarios will achieve the same desired level of conscious sedation. Once again some patients may be asleep while others will slip in and out of sleep. Some patients with medical conditions and/or on specific drug regimens may only be lightly sedated and may not sleep at all.

The goal of IV sedation is to use a little medication as possible to get the treatment completed. It is very safe. With IV sedation a constant "drip" is maintained via the intravenous tube. At any time an antidote can be administered to reverse the effects of the medications if necessary. Along with IV sedation there are also other different "levels" of sedation available to you in our office. 

 

Nitrous Oxide (Laughing Gas)

Nitrous oxide is a sweet smelling, non-irritating, colorless gas which you can breathe. Nitrous oxide has been the primary means of sedation in dentistry for many years. Nitrous oxide is safe; the patient receives 50-70% oxygen with no less than 40% nitrous oxide. Patients are able to breathe on their own and remain in control of all bodily functions. The patient may experience mild amnesia and may fall asleep not remembering all of what happened during their appointment.

There are many advantages to using Nitrous Oxide 

  • The depth of sedation can be altered at any time to increase or decrease sedation.
  • There is no after effect such as a "hangover".
  • Inhalation sedation is safe with no side effects on your heart and lungs, etc.
  • Inhalation sedation is very effective in minimizing gagging.
  • It works rapidly as it reaches the brain within 20 seconds. In as few as 2-3 minutes its relaxation and pain killing properties develop.
  • Once dental treatment has been completed, 100% oxygen is administered to flush the nitrous oxide from your system.
  • You are able to function normally after nitrous, including driving your vehicle.

 

Again, when it comes to anesthesia, our first priority is the patient's comfort and safety. If you have any concerns regarding the type of anesthesia that will be administered during your dental treatment, please do not hesitate to discuss your concerns with your doctor at the time of your visit.