What is conscious sedation?

Conscious sedation is a very safe, very efficient and very effective way of providing anxiety relief and pain control during dental procedures. There are 2 groups of patients who benefit from this technique:

• Patients undergoing relatively unpleasant or lengthy procedures such as removal of wisdom teeth or other complex procedures.
• Patients who fear most forms of dental treatment and who often avoid going to the dentist.

As the name implies, conscious sedation is not a general anaesthesia. The aim of conscious sedation is to reach a state of calm relaxation and drowsiness, so that you:

• know very little of what is going on;
• do not care about what is going on; and
• remember very little, if anything, of what goes on.

Other options?

• Conscious sedation is not a replacement for good basic dental care - it simply provides a means of making some procedures less of an ordeal.
• Conscious sedation is not usually for children.
• Hospitalisation and general anaesthesia is also a very safe treatment option. However, with the simplicity of conscious sedation and the excellent drugs we have available today, it is only on rare occasions that we recommend this option for fit, healthy adolescents and adults.

• Modern methods of sedation are low risk and very safe.
• Throughout the procedure you are under the care of 2 clinicians. The first provides the actual dental/surgical treatment. The other (i.e. the sedationist) is fully involved with administering the sedation and monitoring your breathing, blood pressure, heart rate and rhythm, and oxygen saturation with the aid of specialised monitoring devices.

• You will be drowsy for several hours after having conscious sedation. It is therefore important that you follow the postoperative instructions given to you.
• Postoperative nausea and/or vomiting are rare but can occur. If such symptoms persist the day after the procedure, you should contact the dental centre for further advice.
• Tenderness or bruising around the intravenous injection site is also rare. If it does occur, it will normally resolve within a few days.

• As alluded to above, conscious sedation is not general anaesthesia. You may hear us talking and be vaguely aware that something is being done - but it won't worry you.
• On very rare occasions a patient may not respond to the drugs/dosage that we use in conscious sedation. On these rare occasions it may be necessary to stop the procedure and resort to alternative treatment methods.
• The most important thing for you to do on the day of your operation is to arrive relaxed, confident and trusting your dentist.

• Limited solid food may be taken up to 6 hours prior to your procedure. If your appointment is not until the afternoon, you may have light breakfast - but this must be at least 6 hours prior to your appointment.
• Routine medications (e.g. blood pressure tablets) are to be taken as normal but with just a sip of water.
• Otherwise only medications ordered by the sedationist may be taken less than 24 hours prior to your procedure.
• Smoking affects your blood's ability to transport oxygen. Therefore, to ensure you are in the best physical state to undergo sedation, smoking should be ceased at least one week prior to the procedure.
• As a bare minimum, smoking should cease or be significantly reduced at least 24 hours before your procedure.
• For your own comfort and to allow us to readily attach our monitors, please wear loose fitting clothes. We ask that you wear short sleeves and either long pants or shorts.
• Veins are sometimes harder to find in cold weather - please wear warm clothes if it is cold.
• As our monitoring equipment is very sensitive and subject to interference, please refrain from wearing neck and wrist jewellery/watches and please remove finger nail polish.
• Contact lenses should not be worn.
• You will be unable to drive following your procedure.
• You will need to arrange suitable transport home.
• A responsible adult who can take you home must accompany you.
• To help minimise the risk of postoperative infection, please brush your teeth thoroughly before coming to the dental centre.
• Remember to rinse only - do not swallow the water.
• Upon your arrival, you will be asked to sign a consent form for conscious sedation, confirming that you understood and complied with the preoperative instructions.
• During the procedure, you may be given some fluids intravenously. For your personal comfort in the immediate postoperative period it is recommended that you use the toilet immediately prior to coming through for your procedure.

It is important that both you and the person accompanying you understand that for at least 12 hours following your conscious sedation:

• No alcohol may be consumed.
• Your concentration and memory will be poor. You should therefore avoid potentially dangerous activities such as driving, operating machinery, climbing ladders, or crossing roads unescorted.
• Avoid making important decisions or commitments.

Dion Kramer is managing director of NobleDentist. NobleDentist is a dental plan for the people of Australia. Dion Kramer collaborates with a NobleDentist so that his writings are topical and up-to-date. You can visit the website to learn more about NobleDentist and each Noble Dentist http://www.nobledentist.com.au