Going to the dentist can be a nerve-wracking experience for many people. The thought of someone poking around in your mouth with sharp instruments is enough to make anyone anxious. However, modern dentistry has many methods to help patients feel more relaxed and comfortable during dental procedures. One of the most common ways dentists help patients feel at ease is by administering sedation medication. Sedation causes you to feel calm, relaxed, and even sleepy during your dental appointment. There are different levels of sedation offered by dentists depending on the invasiveness of the procedure and your anxiety level. Let’s explore the different sedation options available and why they make you feel “loopy.”
What is Sedation Dentistry?
Sedation dentistry refers to the use of medications to induce a relaxed, calm state in patients undergoing dental procedures. The goals of sedation include:
- Reducing anxiety and fear
- Blocking pain sensations
- Inducing relaxation and drowsiness
- Causing some short-term memory loss
- Allowing patients to undergo dental procedures while awake but in a calmer state of mind
The level of sedation can range from minimal to moderate to deep, depending on the specific medication and dosage used. Minimal sedation helps take the edge off anxiety while allowing you to remain awake and conversant. Moderate sedation causes drowsiness and foggy memory. Deep sedation is very close to general anesthesia in that you are in a sleep-like state without awareness.
Types of Sedation Offered by Dentists
There are several different types of sedation that may be used by your dentist depending on your needs:
Nitrous Oxide
Nitrous oxide, sometimes called “laughing gas,” provides a mild sedation effect and pain relief. You inhale nitrous oxide through a mask placed over your nose. This type of sedation helps you relax but you remain awake and aware during the procedure. Nitrous oxide starts working within a few minutes and wears off quickly after the mask is removed. It is a popular option for people with mild to moderate anxiety about dental work.
Oral Sedation
Oral sedation involves taking anti-anxiety medications by mouth. Common oral sedatives prescribed by dentists include Valium, Halcion, Xanax, and Ativan. These medications cause drowsiness, relaxation, and some short-term memory loss. You take the pill about an hour before your dental appointment so it can start working before your procedure. Oral sedation is useful for longer appointments to keep you relaxed.
IV Sedation
Intravenous (IV) sedation involves injecting sedative medications into your bloodstream through an IV line in your arm or hand. IV sedation works more quickly and predictably than oral sedatives. Common IV sedatives include Versed, fentanyl, and propofol. These drugs cause relaxation, pain relief, amnesia, and in higher doses can induce total unconsciousness. IV sedation allows you to undergo extensive dental work while in a deeply relaxed state.
General Anesthesia
General anesthesia provides the deepest level of sedation. With general anesthesia you are completely unconscious and unaware, as in a deep sleep. General anesthesia is administered by an anesthesiologist or nurse anesthetist through an IV line or breathing mask. It is generally only used for extensive surgical procedures or for patients with severe anxiety or medical conditions that prevent other forms of sedation from working.
What are the Stages of Sedation?
Sedation occurs along a spectrum ranging from minimal effects to full unconsciousness. The stages of sedation include:
| Stage | Level of Awareness/Responsiveness |
|---|---|
| Minimal Sedation | Fully awake and responsive, lowered anxiety |
| Moderate Sedation | Drowsy, clouded thinking, respond to stimuli |
| Deep Sedation | Sleep-like state, difficult to rouse, no awareness |
| General Anesthesia | Completely unconscious, no reflexes or recall |
Your dentist will determine which level of sedation is appropriate for your procedure based on several factors including your dental health, anxiety level, age, medical history, and more. The goal is to give you just enough sedation to help you feel relaxed but not so much that it negatively affects your breathing, blood pressure, or heart rate.
Why Does Sedation Make You Feel Loopy?
The “loopy” feeling induced by dental sedation is a side effect of the medications used. Sedatives like benzodiazepines, opioids, nitrous oxide, and propofol work by depressing activity in the central nervous system. This causes:
- Muscle relaxation
- Drowsiness
- Disorientation and cognitive impairment
- Detachment from surroundings
- Euphoria and mood alterations
In higher doses used for deep sedation or general anesthesia, these effects become even more pronounced. Patients report sensations of floating, spinning, fuzziness, giddiness and even mild hallucinations while under the influence of these medications.
After the procedure while the sedation drugs are wearing off, you may say or do things you would not normally say or do. Your inhibitions and mental sharpness are lowered. You may find everything hilariously funny and say silly nonsensical things. This is all a typical side effect profile of sedative medications that depress central nervous system functioning.
Who is a Good Candidate for Sedation Dentistry?
Sedation dentistry is appropriate for the following patients:
- People with dental phobia or high anxiety about dental procedures
- Patients undergoing long, complex treatments like wisdom tooth extraction or dental implants
- People with sensitive gag reflexes that are triggered by dental instruments
- Children and patients with special needs who have difficulty sitting still and tolerating procedures while awake
- Patients needing extensive dental rehabilitation work done at once rather than multiple visits
Sedation allows these patients to get the dental care they need in a safe, comfortable manner. It may be an option if your regular numbing and anesthetic is not enough to allow you to relax in the dental chair.
What Should I Expect During Sedated Dental Procedures?
If you and your dentist decide sedation is right for you, here is a typical timeline for what to expect:
- Your dentist will review your medical history and may request lab work to ensure you are healthy enough for sedation.
- You will be given instructions to fast for 6-12 hours before your appointment to prevent nausea and vomiting.
- Upon arrival at your appointment, you will be hooked up to monitors to track vital signs like blood pressure, oxygen levels, and heart rate.
- Sedative medications will be administered through an IV, pill, or inhaled gas.
- As the sedation takes effect, you will become very relaxed and drowsy but still rousable if the dentist needs you to open your mouth.
- Local anesthetic will be administered to numb any pain once you are sedated.
- The dental procedures will be performed while you are in a comfortable, sedation-induced haze.
- After the work is complete, you will move to a recovery area while the sedation wears off.
- You may feel groggy, sleepy, or dizzy as the medications leave your system.
- You will need a ride home from a responsible adult and should rest for the remainder of the day.
Full recovery takes about 24 hours as the sedation clears your body. Let your dentist know if you experience any concerning side effects afterward.
Are There Risks With Sedation?
Sedation dentistry is very safe when administered by a trained professional. However, as with any medication, there are some minor risks including:
- Nausea and vomiting
- Headaches, dizziness, prolonged drowsiness
- Respiratory depression if given too much sedative
- Allergic reaction in rare cases
- Minor heart rhythm disturbances
Your dentist will monitor you closely and take all necessary precautions to minimize risks. Serious complications are extremely rare when proper protocols are followed. The benefits of sedation typically far outweigh the small risks for most dental patients.
Conclusion
Being anxious about going to the dentist is very common. Fortunately, sedation dentistry can help you feel peaceful and relaxed for even extensive procedures. Oral sedatives, nitrous oxide, IV medications, and general anesthesia can induce a range of sedation from minimal to deep.
The loopy, dizzy, floating sensation you may experience results from depressant effects on the central nervous system. While you may not remember much of your dental visit, sedation allows you to undergo procedures with less pain, anxiety, and stress. Consult your dentist to see if some level of sedation could benefit you on your next dental appointment.