Conscious Sedation

What is sedation?

Conscious sedation is a commonly used, safe procedure which is defined as a technique in which the use of a drug or drugs produces a state of depression of the central nervous system enabling treatment to be carried out, but during which verbal contact with the patient is maintained throughout the period of sedation. The drugs and techniques used to provide conscious sedation for dental treatment should carry a margin of safety wide enough to render loss of consciousness unlikely.

Conscious sedation can be provided by tablets or intravenous injection, the main difference being the level of sedation achieved. The intention in providing sedation is to allow a patient to undergo more difficult procedures in comfort, without the worry normally associated with those treatments. It is a safe and effective procedure in common use for dentistry and dental surgery in particular.

Sedation is not sleep, but a drug induced state that reduces awareness and your ability to respond. The procedure still requires local anaesthetic and this will be given once your chosen method of sedation has been achieved. IV sedation has a strong amnesic effect, and it is unlikely that you will remember much at all about the surgery.

Sedation by tablets, usually Temazepam, is described as anxiolytic. It reduces anxiety, but is less profound than intravenous sedation, with the normal drug for the IV route being midazolam. The usual protocol for sedation by tablets is to take some the evening before the procedure to assist with sleeping, and a repeat dose an hour before the surgery. Recovery after oral sedation is slower than for IV sedation, and the normal precautions, such as avoiding driving or operating heavy machinery for 24 hours will need to be observed.

What to expect on the day

You will remain conscious during this kind of sedation.

You may experience a temporary loss of memory during the time that you are sedated. Many patients
have no memory of the procedure at all. You may feel unsteady on your feet for some hours after the
procedure. Your ability to think clearly and make judgements may be affected for the next 24 hours.
You may experience some forgetfulness.

Once you are sedated, the dentist can use local analgesia (pain relief that numbs the site of the dental
treatment). Local anaesthetic as a paste is sometimes used to numb the site of the treatment.

Any injections that you may need can be given through this numbed area to reduce the chance of any
discomfort.

You will spend some time in the recovery area following your treatment. You will be checked by the
dentist or the person giving you the sedation before you can go home.

You must be accompanied by an able-bodied adult who can take responsibility for you following your
treatment. This person must be able to stay with you overnight. If arrangements have not been made
for someone to accompany you after treatment, you will not be able to have the sedation.

If you have any questions or are unclear about having your sedation, then do not hesitate to ask the
dentist.

After the treatment

Your judgement may be affected by the drugs. This is similar to the effects of consuming alcohol. You should not drive a car, ride a bicycle or operate machinery until the following day. In some cases, this may be for as long as 24 hours.

You should also not take responsibility for the care of others, use sharp implements or cook. It would be unwise to make any irreversible decisions for 24 hours following your treatment. Owing to the effects of the drugs used, care should be taken when using the internet for personal communication.

Before you are discharged, the dentist or dental nurse will give you and the adult accompanying you (escort) important information about your care. You will be given information relating to any local analgesia and the treatment you have received. The dentist will also provide details of pain relief as well as how and when to take other prescription medicines.

You will be given a telephone number of who to contact if you have any problems as a result of your treatment.