The main reason that people seek out sedation dentistry is because they are afraid. Even if you are not a typically fearful person, the dentist’s office can very easily provoke feelings of anxiety, panic, and fight-or-flight responses. And it doesn’t have to have been this way from a very early age. Many people only begin to experience severe dental anxiety as they enter into adulthood. This may have to do with the way the brain consolidates memories during this period.

When you think about it, regular dental visits are a perfect setup for behavioral conditioning of a fear response, because they intermittently produce extremely painful, uncomfortable experiences and make people feel helpless. You lay down with your mouth wide open, you get pricked with needles and dug into with drill. The sounds and the smells become powerful triggers for those feelings of helplessness and discomfort. The more this happens, the more ingrained in your psyche these stimuli become, until, like Pavlov’s dogs, you simply begin to respond to them regardless of whether there is any immediate pain or discomfort. Over the years, this conditioning can really pile up on a person.

Of course, you can get psychotherapy to help you manage dental anxiety, but many people consider this too extreme. After all, you only go to the dentist’s office twice a year if all goes well, and so to have therapy to help you through this, it is likely the effects of the psychological treatment will have worn off by the time your next check-up with the dentist comes around. Therefore the emerging solution to this widespread problem has become pharmacological treatment.

Often patients are given a sedative prior to coming in for their appointment, and for many people this is a highly effective way of dealing with the problem. But sometimes dental anxiety can be too severe or too deeply embedded for this to be enough. For these patients, dental sedation is indicated.

Sedation dentists use full medical sedation in order to make their patients unconscious while their dental work is going on. This is the surest way to avoid the problem of dental anxiety during the time that the work is being done, but it also carries some risks. The medications used are powerful enough to make you lose consciousness and to keep you unconscious for a period of time. That means that if you experience side effects, they may also be fairly powerful. Some people experience a kind of “hangover” effect from the medicines as well.

“Conscious sedation dentistry,” also called “partial sedation dentistry,” or “relaxation dentistry,” is really just ordinary dentistry. These techniques have been used for many years, and they amount largely to what we have already talked about. If you take a benzodiazapene prior to treatment at the dentist, you are undergoing conscious dental sedation. The term applies even more readily to the use of nitrous oxide, or laughing gas. You inhale the gas and enter a partially sedated state in which you are relieved of much anxiety and pain.

Neither one of these approaches is adequate for very severe dental anxiety, but there are new drugs that offer step up from these traditional treatments. One of the most popular is known as Halcion, or triazolam. This medication offers not only some level of sedation, but also brings about amnesia. So you will not be likely to clearly remember exactly what happened at the dentist although you will technically have been conscious for it. The main disadvantage of this approach is that it is somewhat unpredictable how much an individual will be affected by the pill the first few times, so you may not receive adequate sedation, or you may receive too much and be a mess to deal with.

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