Oral Sedation Dentistry

General dentists and many other dentists now offer adult oral sedation to their fearful patients.  This offers many advantages to the fearful patients including getting the much needed dental care without stress and depending on the medication used to achieve sedation, patients often do not even remember.  Patients get more dentistry done in one single visit instead of requiring several returns to the dentist’s office. 

Some of the common medications used by dentists to achieve conscious sedation include valium (diazepam) which was first introduced in 1963, it is a benzodiazepines.  It has a half-life of between 20 and 100 hrs.  The problem is patient may not be able to return to regular routines after 24 hrs. such as driving.  Sonata (zaleplon) is a non-benzodiazepine but acts as if it were.  It has a most rapid onset and a half-life of just one hour so if you are planning to have extensive dental work done at one visit, this may not be for you.  Ativan (lorazepam), it has a half-life of 12-14 hours and it is widely accepted in the dental circle because it is safe and effective as an anxiolytic agent.  Xanax (alprazolam) is a moderate benzodiazepine with two active metabolites that extend the half-life to 11-12 hrs. in adults.  Interestingly, the half-life doubles in obese patients.  Halcion (triazolam), the blue pill is considered by many in the dental community as the “ideal” oral sedative because it has a fast onset, short-acting, anxiolytic, amnesic; half-life of 2-3 hrs., large margin of safety, and reversal agent is readily available.

So the millions of patients avoiding recommended and needed dental treatment due to fear, can now relax and look forward to relaxation dentistry.  With availability of safe and effective oral sedation dentistry protocols, the dental team can help these patients get care they need and deserve.  Dentists often consider patient variability as an important risk factor in deciding which anxiety-free protocol to use.  Indidivudal variables such as weight, anxiety level, age, and underlying disease states are often considered by the treating dentist.