Local anesthetic is used most procedures. When a patient specifically requests otherwise because he/she does not feel (any) discomfort during tooth preparation, this is acceptable. However, if the patient doesn't want a local anesthetic "because he/she" doesn't like injections and would rather put up with the pain, we usually give the patient the choice of either having the local anesthetic first, or having the treatment without under the agreement that "they do not move at all when the tooth is being treated". If neither of those can be agreed, and the offer of IV is declined as well, we decline treatment. This is because Dental treatment is usually carried out with a high-speed drill -if the patient 'jumps' at a bit they can 'feel' an injury could easily occur - that is unacceptable in this practice. Sedation techniques for adults have been practiced and perfected by the dentist for over 30 years.
Intravenous Sedation (IV) for adults is an injection (of Midazolam) in a vein in the arm. The patient is heavily sedated but is still conscious. The effect is prolonged sedation (1 hour) and the patient is much more relaxed. We still use injections in the gum (local anesthetic) but the patient has had the IV injection in the arm first so is little affected by these. Large amounts of treatment - fillings, crowns, extractions, extensive deep cleaning, an implant or other oral surgery - can be carried out at one visit. Afterwards the patient often cannot remember much of the treatment they know they must have had.
IV sedation is useful for nervous patients and for those people requiring a lot of work where holding the mouth apart for a long time would be difficult and uncomfortable. General anesthetic is not available in the practice. There is a referral system if the dentist decides this to be the right course of action.
IV sedation is useful for nervous patients and for those people requiring a lot of work where holding the mouth apart for a long time would be difficult and uncomfortable. General anesthetic is not available in the practice. There is a referral system if the dentist decides this to be the right course of action.
Anaesthesia and Sedation