An impending visit to the dentist is sufficient to put anyone through sleepless nights and mental trauma. Even the thought of getting a tooth extracted or root canal treatment can send shivers down the spine of some people, especially children. For these individuals, anesthesia or sedation might be an option.
The pain involved may be too much to handle. Making the patient unconscious by administering some medicines has increasingly been proposed as a possible way out.
Sedation and Anesthesia are two medical terms often used by people in a misinformed way. Most of them know that these are used for making a person unconscious but the scientific difference between the two is lesser known.
Let’s have a detailed look at these two terms and other aspects of the whole process of ‘making a person unconscious’.
WHAT EXACTLY IS SEDATION?
Wikipedia defines ‘Sedation’ as the reduction of irritability or agitation by administration of sedative drugs, generally to facilitate a medical procedure or diagnostic procedure.
In other words ‘Sedation’ is a state of partial unconsciousness. When under sedation, the patient may respond to stimulation but is unaware of the surroundings otherwise.
A patient under the effect of a sedative will open his eyes or move his hands when asked to. It is a form of a ‘light sleep’ employed to make the patient unconscious for various medical purposes including endoscopy, vasectomy, and dentistry.
It can be of various levels such as minimal sedation, moderate sedation, and deep sedation.
Sedation generally used for dental purposes is referred to as ‘Oral Sedation Dentistry’. For dental purposes, some oral sedative drugs are administered which reduce the patient’s fear and anxiety of the impending operation. Commonly used drugs for dental sedation are diazepam, zaleplon, and hydroxyzine.
Dental patients with a fear of needles and sharp instruments, commonly referred to as ‘Prior Dental Trauma’, are often given a dose of oral sedatives. The dose can be single or incremental depending on the patient and the type of dental operation to be performed. Removal of wisdom teeth is a common example where dental sedation is used.
WHAT IS ANESTHESIA THEN?
Anesthesia has been used in some form or the other for a long time. It’ll be interesting to note that in ancient times Belladonna flower plant was used as an anesthetic for surgery. This deadly nightshade is still used for mild sedation.
Under the effect of anesthesia, the patient is sent into a state of complete unconsciousness. He or she is completely unaware of the surroundings and does not respond to any external stimulus. It is a temporary state of induced loss of senses.
Dental anesthesia is a broad term. It is a sub-field of anesthesia and further includes local anesthetics, sedation and, general anesthesia. A patient is said to be under local anesthesia when only a specific part of the mouth is under the effect of the drug used for anesthetizing the patient.
The mouth tissues are made numb in this process blocking the nerves which transmit the pain signals to the brain. For dental purposes such as filling cavities or preparing the tooth for a crown, injectable anesthetics are used.
General anesthesia, on the other hand, completely suppresses the activity of the central nervous system and sends the person to a state of complete unconsciousness. Some texts also refer to the most advanced level of sedation as ‘General Anesthesia’.
Even painful stimulus is not sufficient to arouse the patient. Although for a majority of dental purposes, local anesthesia is used and is quite sufficient, still many dentists tend to choose one out of sedation and general anesthesia.
HOW DO SEDATION AND GENERAL ANESTHESIA DIFFER?
Sedation generally relieves the patient of the anxiety of a dental operation. The medication reduces the memory, sight, and smell of the clinic thus preventing the patient from any possible trauma.
Anesthesia, on the other hand, is given with a goal to achieve hypnosis, analgesia and muscle relaxation. As opposed to sedation, one of the major goals of anesthesia is to make it impossible for the patient to move. The most common method used for sedation in dentistry is ODS (Oral Dental Sedation).
It is preferred because it is the easiest to administer, most effective, doesn’t involve any needles and has a lower cost. The patient wakes up gradually from the effect and is under medical examination till recovered fully.
Feeling tired or groggy is common among the patients. The other risks involved include apnea and hypotension. Anesthesia, on the other hand, involves the usage of a dental syringe.
The anesthetic solution is injected into the patient’s body. Nausea and vomiting may be witnessed in the patient.
WHICH ONE SHOULD YOU PREFER?
Whether you should go for sedation or anesthesia depends on a number of factors –
- Your medical history – The drugs used for sedation or anesthesia must not have any side effects on your body. The doctor must be completely aware of your medical history before proceeding further with the kind of drug to be used.
- Type of patient – Patients with hypertension, heart defects, kidney diseases or any other medical problem like latex allergy should avoid sedation under normal circumstances. Special procedures must be used to minimize the risks involved.
- Equipment – As anesthesia involves the use of a dental syringe, it may not be much recommended for those suffering from dental trauma or having high levels of anxiety. Oral dental sedation can be a better option here.
Hence, both sedation and anesthesia have their own prospects and consequences.
Choosing one out of the two involves a subjective approach and must be done after proper consultation with the dentist keeping in mind the medical history, mental state and age of the patient.
Both have their own risks and must be mitigated by experts in a professional manner.