IV (Intravenous) Sedation for Nervous Dental Patients in Southampton
IV (Intravenous) Sedation
Intravenous Conscious Sedation (often known simply as “IV sedation”) is when an anti-anxiety drug is administered into the blood system during dental treatment.
This is an increasingly popular option for patients who suffer from dental phobia or extreme dental anxiety.
A lot of dental clinics and practices refer to IV sedation as “sleep dentistry” but this is not entirely accurate as it suggests that the patient is actually being put to sleep. Deep sedation would better describe sleeping during surgery but this form is seldom used in dentistry, particularly in the UK.
So for IV sedation you remain conscious and able to understand and respond to requests from your dentist.
However, you may not remember much about the procedure because of two things:
1.IV sedation induces a state of deep relaxation and the feeling that you are not really bothered by events surrounding you.
2. the drugs used for IV sedation produce either partial or full memory loss for the period of time when the drug first affects you until it wears off. Patients report that time passes quickly and in fact that they felt like they had been asleep.
The IV sedation drugs are not painkillers although some pain-killing drugs are occasionally added at the initial sedation. So whilst you will feel deeply relaxed, you will still need to be numbed.
Will this be done before or after I’m sedated?
However, if you fear injections, you will not be numbed until the IV sedation has taken full effect. Experience suggests that the IV sedation process is so effective that you will likely not care about the needle in any case. As you would expect, the dentist will not begin any procedure until it’s is certain that the numbing effect of the painkiller is fully established.
“You check the local anaesthetic has worked by asking the patient. Just coz they’re sedated doesn’t mean they can’t answer you… in fact they better be able to answer or they ain’t sedated, they’re anaesthetised! If they’re not numb enough they’ll soon tell you. But they won’t remember telling you of course because of the amnesia effect…” (answer courtesy of Gordon Laurie, BDS – yet again!)
The drugs used for IV sedation are administered intravenously using a very fine needle around which a thin plastic tube is wrapped. The needle punctures the vein, typically on the back of the hand and is then removed backwards through the plastic tube. The tube remains in place during the process and it is through this that the drugs make their way into your body.
To ensure patient safety your pulse and oxygen levels are measured throughout the procedure using a “pulse oximeter”. This device clips onto a finger or an earlobe and measures pulse rate and levels of oxygen in the blood. This is the safety “catch net” but an experienced dental team will be able to spot any issues with vital signs before the machine steps in. Blood pressure before and after the procedure is checked with a “sphygmomanometer” to ensure that it is within normal range.
A strong topical anaesthetic or numbing cream can be used to make the site where the needle goes completely numb.
IV sedation is extremely safe when carried out under the supervision of a trained dental team.
Statistically speaking, it is even safer than local anaesthetic on its own. However, there are some contraindications that include:
- allergy to benzodiazepines
- alcohol intoxication
- CNS depression, and
- some instances of glaucoma.
Its use is also cautioned for cases of psychosis, impaired lung, kidney or liver function, advanced age and sleep apnoea, however heart disease is generally not a contraindication.
Benzodiazepines tolerance cane increase if you have been taking them for long periods so please let your dentist know.