Relaxed?

Sedation allows dentists to create a state of relaxation and thus manage the fear and pain patients may experience during dental procedures. There are several different types of sedation in dentistry.

• Local anesthesia is administered by injecting medication into tissue or by applying a medication topically to an area to eliminate sensation.

• Minimal sedation is used most frequently in dentistry and usually involves taking medications orally. All bodily functions remain normal and the person is able to breathe on his or her own. The patient may respond normally to verbal commands and may experience some degree of amnesia about what happened during their dental appointment. Nitrous oxide or “laughing gas” may be used to achieve minimal sedation and in combination with a recommended dosage of oral medication.

• Moderate sedation is achieved by using medications that can be taken orally or intravenously (IV). Patients who undergo moderate sedation are awake and respond to touch and/or verbal commands. All bodily functions remain normal, and the patient does not need assistance breathing.

• Deep sedation can be achieved by injecting medication, giving oral medica- tions, and in combination with gases. Patients who are deeply sedated are not easily awakened but may respond to some stimulation. Patients may need some breathing assistance at deeper levels.

How does it work?

Patients who are minimally sedated inhale nitrous oxide through a mask during

their dental appointment and/or may take a recommended dosage of a single oral sedative medication. Moderately sedated patients generally have taken a

medication or a combination of medi- cations while in the dental office. The medication causes the patient to become sleepy and feel relaxed. The dentist will give the patient specific instructions and you will be asked to avoid driving while you are on the medications.

What kinds of medications are involved?

To reach a level of minimal sedation,

a mixture of nitrous oxide and oxygen (30-50 percent) may be used, possibly in combination with a minimal dose of an anti-anxiety (benzodiazepine) pill. In com- bination with nitrous gas, it is important that patients take only one type of drug under minimal sedation.

Moderately sedated patients also generally take benzodiazepines. The most common benzodiazepines prescribed by dentists include Valium®, Halcion, Xanax, and Ativan. Patients who are deeply sedated may receive benzodiazepines combined with opioids.

What are the advantages and disadvantages of sedation in dentistry?

Minimal and moderate sedation reduce anxiety that is typically associated with dentistry and allow the patient to relax. The amnesia usually associated with these methods also is a plus for many patients.

However, sedation in dentistry does have disadvantages. Minimal seda- tion usually cannot be administered to

patients with respiratory problems like emphysema or asthma or those who are sensitive to the class of drugs used for minimal sedation.

With moderate sedation, the level

of sedation cannot be adjusted without administering additional medications and sensitivity to certain medications can be

a factor. Also, the patient should be pre- pared for supervision after the dental visit until the effects of the medications have passed. This applies to sedation adminis- tered both orally and intravenously.

With intravenous deep sedation,

a needle has to be put in the arm or hand, so it may not be the most relaxing method if you are afraid of needles. It

is possible to experience complications, such as hematoma (a localized swelling filled with blood) at the site where the needle entered. In addition, recovery from IV-administered or oral medica- tions may not be complete at the end of dental treatment, so the patient should be prepared to be escorted home by a responsible adult.

Is it safe?

Sedation is safe although you should talk to your dentist and/or the specialist and gain a thorough understanding of how

it works and what is expected of you before the procedure. Your medical his- tory will be examined comprehensively to ensure safe sedation and your vital signs will be monitored throughout the entire procedure to confirm that your blood pressure, pulse rate, and blood oxygen levels are normal.

I Fact Sheet Sedation I

Resources

www.agd.org

At the AGD’s Web site, you can search more than 300 oral health topics, post dental questions, sign up for e-newsletters, find an AGD dentist, and more.

1.877.2X.A.YEAR

The AGD’s toll-free referral number. Call to locate an AGD member dentist in your area.

單張 鎮靜劑

輕輕鬆鬆？

鎮靜劑允許牙醫造成一個放鬆的狀態，因此管理病人可能在牙科治療過程體驗的恐懼和疼痛。牙科有幾種不同類型的鎮靜劑。

•局部麻醉: 注射藥物進入組織或外用局部麻醉

，以消除感覺。

•牙科最常用的輕微的鎮靜劑通常涉及口服藥物。所有身體功能維持正常，而病人是能夠自己呼吸的。病人可以正常回應口頭命令，並可能出現一定程度短期的失憶 (尤其是他們在看牙醫發生了什麼事。)

一氧化二氮或“笑氣”也可以被用來做到輕微的鎮靜劑還可以與口服藥物配合所需的劑量。

•中等鎮靜劑是由口服或靜脈(IV)的藥物。病人是清醒和正常回應觸摸或口頭命令。所有的身體功能維持正常，病人並不需要呼吸協助。

•深度鎮靜劑可以通過注射藥物，給予口服藥物，並結合笑氣。深度鎮靜劑的病人不容易叫醒，但可能對一定的刺激做出反應。病人可能需要一些呼吸援助。

鎮靜劑是如何做到功效？

輕微鎮靜劑通過面罩吸入一氧化二氮及/或可服一次口服鎮靜藥物。

中等鎮靜劑病人一般採取一種或多種類型的藥物。該藥物會導致病人變得昏昏欲睡，感覺輕鬆。牙醫會給病人的具體指示，你會被要求避免駕駛。

鎮靜劑包括何類型的藥物？

達到最輕微的鎮靜水平，可以混合一氧化二氮和氧（ 30％-50％ )，也有可能聯合用抗焦慮丸（苯二氮卓

 )。一起用，重要的是，病人只需要一種藥物。

[如果口服藥丸, 有很高的機會加入一氧化二氮漸漸地得到期望的結果] 

中等鎮靜劑病人也普遍採取苯二氮。牙醫規定的最常見的包括苯二氮安定® ，酣樂欣， Xanax等，和阿蒂凡。[英文名為準]  深度鎮靜劑病人可能接受苯二氮卓結合阿片類藥物。

鎮靜劑有什麼優點和缺點？

輕微的和中等鎮靜劑減少焦慮並讓病人放鬆。對很多病人, 相關的失憶也是一個優點。

然而，牙科鎮靜劑確實有缺點。有呼吸系統問題(如肺氣腫或哮喘或藥物敏感)的病人通常不能用最輕微的鎮靜劑.

中等鎮靜劑: 不能給予額外的藥物去加深鎮靜水平.  

藥物敏感是另一個缺點。此外，治療後, 病人需要別人照顧直至藥物的影響已經過去了。這包括口服和靜脈注射鎮靜劑。

靜脈深度鎮靜劑，需要在手臂或手使用一根針，所以如果你怕針, 它可能不會是最輕鬆的方法。

有可能遇到的並發症，如血腫（局部腫脹,充滿血液)。此外，從靜脈或口服藥物, 牙科治療結束後,  病人不能立即不完整的甦醒，因此病人應準備由一個負責任的成年人陪同回家恢復。

它是不是安全的？

鎮靜劑是安全的，雖然你應該向你的牙醫和/或專家談論 ，並深入了解如何做到功效和過程，還有你的期望。

您的醫療歷程記錄將被全面檢查，以確保安全地面

 鎮靜和會在整個過程進行監測你的生命體徵，以確認你的血壓，脈搏和血氧水平是正常的。

資源

www.agd.org

在AGD的網站，可以搜索超過300口腔健康的主題，張貼牙科問題，簽署了電子通訊，找到一個AGD牙醫，等等。

1.877.2X.A.YEAR

該AGD的免費轉介電話。打電話在您的區域找到一個AGD成員牙醫。