Treatments - Sedative options

Sedative options

I offer a range options for having sedative medication to help you have your dental treatment. The option which is decided between us will be matched to your anxiety level and the type of treatment to be done at any visit. You may have different options for different appointments.

Oral Sedation

 5 or 10 mgm of Diazepam (Valium) tablets.
Tablets are taken from 1 hour before the appointment time. The level of anxiety control does vary between individuals.
The sedative has a muscle relaxant effect as well as damping down the level of anxiety that you feel. You may not need an escort.

Oral Temazepam.
This is a deeper level of Oral Sedation, given in syrup form.
It is taken about 40 minutes before the planned procedure. You have to have an escort with you during this time, who is there to take you home afterwards.
It works well for most people, but it is less predictable than intra- venous sedation.

Relative Analgesia (RA)

This is a mixture of Nitrous Oxide and Oxygen. It is given through a small nosepiece, and the percentage needed to achieve conscious sedation is titrated for each individual.
It is very good for gagging problems as it suppresses the retching reflex. Our patients have had crowns prepared and impressions taken without difficulty.
It also has a place for people who are needle phobic. You can be sedated enough to accept an injection in the mouth.
It is also good for children and teenagers.

Intra- Nasal Midazolam

This is a newer option, which may be suitable for needle phobia sufferers.
The solution is inhaled through a special nasal device attached to the midazolam delivery system.
It does take about 15 minutes to be effective, you need an escort and it can be unpredictable in its effects.

Intra- Venous Sedations

There are two levels of IV sedation available. The first is Intra- venous Midazolam , I carry out the sedation myself accompanied by my trained dental nurse.
You need an escort for this, and if this is chosen there are a number of conditions that have to be met by us, and by you.
This method is suitable for procedures, which last for 1-2 hours.
If you have a history of difficulty with access to veins then I will suggest that the anaesthetist does the sedation for you.

Level 2 Sedation 

This is carried out by our experienced anaesthetists, and is a deeper level of sedation. A cocktail of different drugs is given which achieves a deep sedative effect.
It is suitable for those who have very severe dental phobias. This is also offered to the small percentage of patients who have a history of ‘ failed ‘ sedation with intravenous midazolam
It is also more suitable for sessions where lengthier or more complex treatment is needed.

Expectations

‘I want to be knocked out ‘ is a frequent plea from dental phobics. The Intra- venous techniques I have available will not make you lose consciousness completely, that would be General Anaesthesia and is not safe or legal in practice. However the majority of patients are unaware of what is happening, can maintain verbal contact with us, and remember very little afterwards

General Anaesthesia

This can’t be done in a General Dental Practice. For Surgical procedures I have links with Private Oral Surgeons. I also have the facility to refer to two Dental Hospitals in the London area on the NHS (there are waiting times) .

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