Information For Patients Undergoing Intravenous Conscious Sedation
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Educational Information
What is intravenous (IV) conscious sedation?
Intravenous conscious sedation is sometimes referred to as sleep dentistry, twilight sedation or procedural sedation. A small plastic tube (IV cannula) is placed in your hand or arm, and sedatives and pain-relieving medication are given directly into your bloodstream. The medications make you sleepy so you can go for a light nap. For most procedures, local anaesthetic will also be given inside your mouth so that your teeth and gums are numb and you will not feel pain. The sedative medication will take effect first so that by the time injections for local anaesthetic occur in the mouth, you will not be bothered or notice them. Your memory and ability to keep track of time will become blurred. You may remember a little at the beginning or at the end of the appointment but generally not in the middle, unless your cooperation is required. You will be connected to monitoring equipment throughout your sedation appointment. You will be given supplementary oxygen through a small plastic tube that sits in your nostrils (nasal cannula).
Who normally considers conscious sedation?
Many patients are anxious or fearful about dentistry (dental phobia). Others have a strong gag reflex. Patients may have had unpleasant dental experiences including difficulty achieving anaesthesia. Often, it is more comfortable to be sedated for surgical procedures such as wisdom teeth extractions or dental implants. Sedation makes long procedures such as root canal treatment and crowns feel shorter and minimises multiple dental visits.
What are the benefits?
Patients who are otherwise anxious or fearful about dentistry can have their dental treatment completed in a comfortable and relaxed manner. Having dental treatment completed earlier rather than avoiding or postponing treatment, can result in easier and less costly treatment.
What are the risks?
Risks and complications regarding IV conscious sedation vary with each individual patient. For healthy patients, the risks and complications associated with sedation are minimal, but not zero. You need to inform us about any medical conditions, any medications or allergies to ensure you have a safe sedation. Common risks and complications include bruising, tenderness or swelling, near the site of the cannulation. You may also experience nausea, vomiting, dizziness, shivering, headache, sore or dry throat and lips, or feeling faint. Uncommon risks and complications include an allergic reaction to medication or exacerbation of an existing medical condition, which may require transfer to a hospital. Rare risks and complications include a severe allergic reaction (anaphylaxis), heart attack, stroke, seizure, brain damage or death.
What are my alternatives?
Most dental procedures are performed under local anaesthetic alone; that is, you will be numb and will not feel pain, but you will be completely awake and alert. Nitrous (happy gas) or oral sedation may be available at your dentist and will make you feel relaxed and lightheaded; however, it is a lighter form of sedation compared with IV conscious sedation. General anaesthesia can only be done in a hospital setting. This option is often necessary for special needs patients, young children or elderly patients with complex medical conditions.
Before & After Sedation Instructions
Before Sedation Instructions
- Responsible adult: You must have a responsible adult to accompany you after your sedation appointment.
- Transport: Private car or taxi transport must be organised; patients cannot travel home after sedation via public transport.
- Solid food: May be taken up to 6 hours prior to your sedation appointment.
- Clear fluids: Between 6 hours and 2 hours prior to your sedation appointment.
NOT clear fluids: cloudy apple juice, orange juice, milk-based drinks, jelly
- Your appointment may be cancelled if you fail to follow the fasting instructions.
- Do not smoke or drink alcohol for at least 24 hours before your appointment.
- If you feel unwell, have a cough or runny nose, notify your dentist and sedationist as soon as possible.
- Remove contact lenses before your appointment and wear regular prescription glasses.
- Take any prescription medicines with a small sip of water in the morning as normal, unless otherwise told by your sedationist.
- Notify your dentist and sedationist if there are any changes to your medications, medical history or general health.
- Wear warm comfortable clothing that allows easy access to your arms (e.g. short sleeved t-shirt).
- Wear flat-heeled shoes as you will be unsteady on your feet for a couple of hours following the sedation visit.
- Remove all makeup, jewellery and nail polish (one finger) before your appointment.
After Sedation Instructions
- Do not drive a vehicle or operate machinery for at least 24 hours.
- Do not make any important decisions or sign any legal documents for at least 24 hours.
- Do not consume alcohol or sleeping tablets for 24 hours following sedation as these may interact with sedatives that may still be in your body.
- Have a responsible adult accompany you for the next 24 hours.
- Be careful with stairs and getting in and out of a car.
- Do not drink any hot liquids or eat any solid foods until local anaesthetic has worn off (about 2-3 hours afterwards). Appropriate food and drinks include ice cream, yoghurt, smoothie or other cold drinks.
- Take pain relief medication (Panadol and/or Nurofen) before local anaesthetic has worn off.
- You will be provided with separate post-operative instructions regarding your dental procedure.