Sedation Dentistry Vancouver Burnaby BC

IV sedation Vancouver Periodontist IMPrESS Perio

Dental fear & anxiety is the result of several factors such as previous traumatic dental experiences, fear of needles, aversion to sights, sounds and smells of the dental office. Sleep dentistry may be the solution to help you overcome your fear and anxiety when it comes to receiving oral care. Our Specialists are certified by College of Dental Surgeons to provide oral conscious and intravenous sedation.

Oral Conscious Sedation

We also provide oral conscious sedation, also referred to as sedation dentistry. Patients who suffer from anxiety in the face of dental work, as well as patients who require multiple procedures within a single visit, can benefit from conscious sedation. Oral conscious sedation involves having an oral sedative before your visit. Your vital signs and comfort level are closely monitored during the operation. 

Intravenous Sedation (IV Sedation)  Burnaby Vancouver BC Periodontist

Intravenous Conscious Sedation (aka “IV sedation”) is when a drug, usually of the anti-anxiety variety, is administered into the blood system during dental treatment. This type of sedation brings about an altered state of consciousness, known as a “twilight” state, which is an unsteady state of mind and a relaxed body.  This mode of sedation reduces pain and discomfort with the use of pain relievers and sedatives. Patients who undergo treatments using conscious sedation generally are able to speak to verbal cues while the procedure is underway, conveying any discomfort being felt to the dentist. Once the procedure ends, a small period of amnesia could negate any recollection of the treatment. Following your treatment(s), you will require a drive back to your home from the dental office. The sedative will wear off completely within 24 hours, so that you can resume day-to-day activities. You remain conscious during IV sedation. You will also be able to understand and respond to requests from your dentist. However, you may not remember much (or anything at all) about what went on because of two things:

  • IV sedation induces a state of deep relaxation and a feeling of not being bothered by what’s going on
  • The drugs used for IV sedation produce either partial or full memory loss (amnesia) for the period of time when the drug first kicks in until it wears off. As a result, time will appear to pass very quickly and you will not recall much of what happened. Many people remember nothing at all.

The most commonly used drugs for IV sedation are benzodiazepines, or “benzos” for short. These are anti-anxiety sedative drugs. By far the most commonly used drug for IV sedation is Midazolam (Versed).

How is IV sedation given?

“Intravenous” means that the drug is put into a vein. An extremely thin needle is put into a vein close to the surface of the skin in either the arm or the back of your hand. This needle is wrapped up with a soft plastic tube. It makes the entry into the vein, then is slid out leaving the soft plastic tube in place. The drugs are put in through that tube which is correctly referred to as an “indwelling catheter”, The tube stays in place throughout the procedure.

Throughout the procedure, your pulse and oxygen levels are measured using a “pulse oximeter”. This gadget clips onto a finger or an earlobe and measures pulse and oxygen saturation. It gives a useful early warning sign if you’re getting too low on oxygen, although if your dentist and the nurses are paying attention they should see it way before the machine does grin. Blood pressure before and after the procedure should be checked with a blood pressure measuring machine.

Is it safe? Are there any contraindications?

IV sedation is extremely safe when carried out under the supervision of a specially-trained dentist.

 However, contraindications include

  •      Pregnancy
  •      Known allergy to benzodiazepines
  •     Alcohol intoxication
  •     CNS depression
  •     Some instances of glaucoma.

 Cautions (relative contraindications) include psychosis, impaired lung or kidney or liver function, advanced age, and sleep apnea. Many people who have sleep apnea haven’t been officially diagnosed – if you are overweight and you snore, do mention this. Heart disease is generally not a contraindication.

 If you have been taking benzodiazepines for many years, your tolerance may be very high – so let your dentist know that you’ve been taking them!

What are the main advantages of IV sedation?

  • IV sedation tends to be the method of choice if you don’t want to be aware of the procedure – you “don’t want to know”. The alternative is oral sedation using Halcion, but oral sedation is not as reliably effective as IV sedation.
  • The onset of action is very rapid, and drug dosage and level of sedation can be tailored to meet the individual’s needs. This is a huge advantage compared to oral sedation, where the effects can be very unreliable. IV sedation, on the other hand, is both highly effective and highly reliable.
  • The maximum level of sedation which can be reached with IV is deeper than with oral or inhalation sedation.
  •  Benzodiazepines produce amnesia for the procedure.
  • The gag reflex is hugely diminished – people receiving IV sedation rarely experience difficulties with gagging.

Unlike General Anaesthesia or Deep Sedation, conscious IV sedation doesn’t really introduce any compromises per se in terms of carrying out the actual procedures, because people are conscious and they can cooperate with instructions, and there is no airway tube involved.

Contact us today to book your consultation appointment.