Cleland Periodontics offers sedation dentistry both orally and intravenously. This is our means of treating those patients who otherwise might not seek the care they truly need. We assess each individual and together determine the best treatment modality to provide the most comfortable experience possible, an experience without pain and anxiety.

Dental Sedation Modalities

Local Anesthesia-the most frequently used type of anesthesia. Used to numb the area being treated, it is given by injection (although dentists often swab a topical anesthetic gel on the injection site for the patient’s comfort). The numbing effects can last from five minutes to three hours after treatment.

Inhalation Anesthesia- the most commonly used inhalation agent is nitrous oxide or “laughing gas.” Nitrous oxide is a sedation gas combined with oxygen to make patients feel more comfortable during dental care. A small rubber inhaler is placed over the patient’s nose and adjusted so that the patient breathes through it. With nitrous oxide, most patients experience an initial feeling of light-headedness, which gradually leads to an overall feeling of well-being.

The advantages of inhalation sedation are its rapid onset, lack of lingering effects, the ability of the patient to engage in conversation while under its influence, and the ability of the patient to drive home unassisted.

Other more potent anesthetic gases are available and can be used for general anesthesia, usually in a hospital setting.

Oral Conscious Sedation- The patient takes a pill before treatment, becomes sleepy, and develops a diminished awareness of sounds and smell. The effects can last for up to four hours. A patient is monitored for his or her individual response. Commonly administered oral sedatives include: Valium, Halcion, Zanax, and Ativan.

Advantages of oral conscious sedation include: its easy administration (no needles), a generally low incidence of side effects, the patient’s ability to breathe independently and to interact with and respond to the dentist

This mode of "sedation" or "sleep" dentistry is gaining popularity; however, oral medication does not and should not put a patient to sleep. Therefore, patients using this method who wish to be "asleep" may be more aware of dental treatment than they want to be.

Intravenous Sedation- Also known as IV or “conscious sedation.” Patients often think they are asleep and have no memory of the procedure, but can respond to the dentist when necessary. During the procedure, devices are attached to the patient to monitor breathing, blood pressure and heart rate.

IV sedation is a safe, precise, and highly effective technique for management of moderate to more severe levels of dental fear. This method may also be used for patients who are not physically or behaviorally able to cooperate with dentistry. Commonly used drugs, that are either administered alone or in combinations selected by a doctor, include Valium, Versed, Fentanyl, Propofol, and Demerol. For patients who want to be completely asleep, the modality can become "total intravenous anesthesia", administered by a specialist while the dentist works.

Amnesia is a major benefit of some of these IV drugs. The patient will have no memory of most, or even all, of the dental treatment. Another benefit is the comparatively quick recovery time. Most patients are relaxed and able to have a light meal the evening following treatment.

Intramuscular Sedation- Sedative drugs are injected into the muscle of the upper arm or the thigh, producing sedation in approximately 2 to 30 minutes depending on the medication used. Intramuscular conscious sedation is rarely used to sedate adults, but is commonly employed in the management of fearful children.

General Anesthesia- The most uniformly dependable of all the sleep sedation modalities, because medication can be accurately dosed and the patient response can be appropriately monitored. It can be a combination of injected or inhaled sedation. While the effect can last for hours, many patients safely return home within 2 to 4 hours after treatment is completed. Most people resume normal activity on the day following treatment.

Because the patient is deeply asleep, general anesthesia is the most controlled, effective and predictable method for highly anxious and fearful patients. General anesthesia is also often used for patients who are not physically or behaviorally able to cooperate with dentistry, for patients with special needs and for patients whose medical conditions place them at risk. It can also be the ideal method when multiple procedures need to be accomplished in one visit.