What is IV Sedation in Dentistry?

For patients who are desperately afraid of injections, going to the dentist or getting a wisdom tooth pulled or a root canal is agony in more than just the obvious ways. You laugh at laughing gas, and there’s not enough pills to help you calm down before the procedure. Instead of giving up on having healthy teeth and visiting your dentist, maybe it’s time to consider IV sedation.

What is IV Sedation?

IV or intravenous sedation is a procedure that allows your dentist or oral surgeon to provide anti-anxiety medications, like those used in oral sedation, directly into your bloodstream. You may sometimes see this referred to as “sleep” or “twilight” dentistry which may make you think you’ll be completely unconscious during your procedure. In fact, you remain awake the entire time and will be able to respond to your dentist’s questions. You may not, however, remember much or anything once the medication wears off.

Because of the nature of IV sedation, you must have an adult come with you to your procedure and drive you home. They will also need to take note of what you have to do in the hours and days after your procedure and help you until the sedation wears off. While it’s an effective form of sedation, it’s not one to be taken lightly.

How IV Sedation Works

IV sedation puts you in a state of deep relaxation, much more than laughing gas or oral sedation. While the drugs are being administered, you generally won’t care at all about anything going on around you. Time will seem to pass very quickly, and you will likely experience partial or even full memory loss of the procedure when it’s over.

To receive IV sedation, a needle is used to insert a tube into a vein, usually on the top of your hand.  The sedation drug is administered through this tube so it goes directly to your bloodstream. The IV stays in your vein for the entire procedure. While you’re under sedation, your pulse and oxygen levels will be monitored to make sure you don’t have a bad reaction. Before and after sedation, your blood pressure will be checked, too.

What Medication is Used

Like oral sedation, IV sedation uses benzodiazepines to reduce anxiety and fear during the procedure. The most common drugs used are Midazolam and Diazepam. This is in a different dosage than the oral sedation method. As anti-anxiety medications, they’re designed to relax you and make you sleepy. At this dosage, it can result in amnesia.

Pain medications like opioids are sometimes added to the IV sedation. This isn’t typical for everyone because the area being worked on will be numbed and pain should be minimal. Pain meds are most often used when a procedure will last a long time or if the postoperative pain will be unbearable. Even with the addition of pain medication, IV sedation is considered extremely safe for the vast majority of patients.

Why Choose IV Sedation

For patients with a fear of needles, the dentist, or medical procedures in general, IV sedation can be an excellent option. You may be thinking, “But I’m afraid of needles (or pain)! How will this help?” A topical numbing cream can be used on the spot where the needle goes in or your can use laughing gas to feel calmer. Either way while the needle is going in, you likely won’t notice.

IV sedation is a good option for a few reasons:

• You won’t know what’s going on around you during the procedure, and you won’t care, either.
• You’re still able to respond to your dentist’s requests and questions.
• The sedation takes effect quickly and can be adjusted to suit your specific needs.
• Any issues you may normally have with gagging are greatly reduced while you’re sedated.
• You’re more deeply sedated than with oral or inhalation sedation. This is good if you have extreme phobias or anxiety.

Who Should Not Use IV Sedation

No option is perfect for everyone. In some instances, IV sedation may not be the right choice for you.

If any of the following apply to you, you cannot have IV sedation:

• Pregnancy
• Known allergies to benzodiazepines
• Intoxication
• CNS depression
• Certain types of glaucoma diagnoses

Other patients should be cautioned against IV sedation but may still be able to use it, depending on your specific circumstances:

• Psychosis
• Lung, kidney, or liver problems
• Sleep apnea – even if you haven’t been diagnosed; Being overweight and snoring are indications of sleep apnea
• Advanced age

Conclusion

Ideally, patients with severe anxiety or fears can work with a patient, caring dentist to overcome the stress they feel. But sometimes people need more help than kind words and reassurances can provide. If you’ve tried every noninvasive technique without positive results, IV sedation is a safe alternative designed to help you get through big procedures and overcome your fears.