Conscious sedation

Today conscious sedation is gaining an increasing foothold in dentistry and other medical disciplines. This service is increasingly popular at our clinic with patients fearing dental interventions, the environment and the dentist (aka dentophobia). Although today most dental interventions can be performed painlessly with state-of-the-art anaesthetics, there are a number of instances requiring conscious sedation to stave off further angst.

A few points about dentophobia

Dentophobia is not as rare as one would imagine: it afflicts over 5 % of people. Anxious distress can present with the following symptoms:

  • rapid heartbeat
  • asphyxiation
  • fear of death
  • trembling
  • perspiration
  • abdominal discomfort
  • vertigo

About 75 % of people demonstrate some extent of fear from dental interventions. This fear and trepidation can manifest in different degrees of severity, with vegetative symptoms occurring only in the severest instances, where cognitive therapy will fail and medical therapy is recommended for a more thorough sedation of the patient. Sometimes the fear is so intense that the patient keeps a wide berth of the dentist for decades, and only consults one when the problem is severe enough. Regular check-ups and prevention could forestall the development of severe tooth issues.

What kind of dental treatments indicate conscious sedation?

  • oral surgeries, wisdom tooth extraction, multiple tooth extractions in a single sitting, etc.
  • tooth implant (insertion of an implant)
  • abnormal dentophobia

What contraindicates the application of conscious sedation?

  • on-going respiratory tract infection
  • decompensated organ dysfunction
  • 3 months after a heart attack
  • pregnancy

What will happen to me at the clinic?

You will be given a sedative by means of venipuncture administered into your arm, which will relieve your angst and make you feel relaxed and eased into a slumber. During the treatment you will be able to react when spoken to and communicate with your doctor but will not recall the treatment itself. During the treatment your vital functions will be monitored with appropriate instruments (blood pressure meter, heart rate monitor, etc.). During the treatment you will feel no pain but will feel relaxed. Following treatment you will receive a wake-up injection which will suspend the effect of the sedative and you will regain consciousness within a couple of minutes.

Important information before conscious sedation:

No drinking is allowed 4 hours prior to the intervention. If you take medications on a regular basis for another disease, take it in the morning with less water.
Make sure you report for the intervention with an escort as you are not allowed to leave the clinic on your own.

Important information following conscious sedation:

  • following the intervention, having regained full consciousness (in about 30 minutes’ time) you will be discharged with your escort.
  • on the day of the intervention no alcohol consumption is allowed as it may lead to hazardous alcohol intoxication
  • refrain from driving, handling dangerous equipment and machinery on the day of the sedation
  • schedule the execution of contracts and the conduct of negotiations for a different day
  • following the intervention you will have a sound sleep
  • do not stay alone
  • you will have pleasant recollections of the treatment

Potential complications:

  • multiple needle insertion, arm pain, bruises and venous inflammation may occur due to cannulation issues
  • Temporary deterioration of existing diseases (e.g. diabetes, hypertension, asthma, etc.)
  • oversensitivity to the medications applied, medicine-induced venous inflammation
  • Post treatment dizziness and headache

It is important to emphasise that the incidence of severe complications is extremely low even in patients in a poor general condition. The tried and tested methods, state-of-the-art medications and our qualified anaesthesiologist’s expertise and decades-long experience all see to that your safety is guaranteed.

Keywords: conscious sedation, oral surgery, tooth implantation, implantation, tooth extraction, relaxation