Is sedation dentistry different from sleep dentistry?
“There can be some confusion around these dentistry terms because many practitioners use them interchangeably,” explains Dr David Kerr, partner dentist at Today’s Dentistry. “If a practitioner calls themselves a sleep dentist, it can be hard to tell what’s what.”
In Australia, we generally see sedation dentistry and sleep dentistry as two different forms of dentistry.
“To me, sedation dentistry refers to people who want to have their dentistry done while they’re medically relaxed or asleep, whereas sleep dentistry deals with the whole area surrounding sleep disorders – a patient may want dentistry to help them with their snoring or sleep apnea.”
In which patient cases can sedation dentistry be useful?
When someone who’s nervous comes in, the words they often use about having treatment are:
“Can you knock me out to do that?”
“I don’t want to feel a thing or be awake.”
“Can you put me to sleep?”
“We can use sedation for a range of dental treatments and will discuss this option with patients to deal with the fear of pain, a long procedure, a specific issue like needle phobia, or more extensive and difficult procedures such as a wisdom tooth extraction or dental implant surgery,” says Dr Kerr.
So what exactly is sedation dentistry?
Sedation dentistry uses medication to help you become either:
- Almost unconscious – you’re awake but deeply relaxed
- Totally unconscious – you’re asleep and completely unaware
There are several levels of sedation and which one we use will depend on the severity of your dental anxiety:
Minimal sedation includes:
- Oral sedation – anti-anxiety medication such as Valium. Taking this pill before you come in will make you feel very relaxed and a little buzzed (our dentists can prescribe this tranquiliser)
- Inhalation sedation – while you’re in the dental chair, you breathe nitrous oxide or ‘laughing gas’ through a mask over your nose to help you feel drowsy and relaxed
Moderate sedation includes:
- Intravenous (IV) sedation – also known as twilight sedation, conscious sedation or IV sedation dentistry. A sedative drug called Midazolam is administered through a vein by an anaesthetist in a medical theatre. You’re on the edge of consciousness
Deep sedation includes:
- General anaesthetic – an anaesthetist will ‘put you under’ with medication while you’re on a ventilator in a medical theatre, making you totally unconscious during the procedure
And what is sleep dentistry?
“In Australia, sleep dentistry is an emerging area of dentistry,” says Dr Kerr.
Your dentist can now screen and treat you for the two most common sleep-related breathing disorders – snoring and obstructive sleep apnea (OSA).
While snoring can disrupt your sleep (and your bed partner’s!), sleep apnea can cause more significant physical and psychological issues such as extreme daytime fatigue, slow reaction times (work accidents or nodding off while driving), depression, diabetes and an increased risk of heart attack or stroke.
With sleep apnea, you typically gasp or choke for air, make snorting sounds, snore loudly, suffer headaches or dry mouth, or feel irritable. This is because you actually stop breathing for a few seconds while sleeping, up to hundreds of times a night, and this constant waking deprives your brain of oxygen.
How do we use sleep dentistry at Today’s Dentistry?
During consultation with your dentist, if your snoring is a worry or you’re showing up with sleep apnea symptoms, we’ll assess you for further screening or treatment (the Sleep Health Foundation’s new national sleep study highlights how important it is to get help).
Snoring may be treated by your dentist with an oral appliance called Oventus. This device looks like a mouthguard and helps to open the narrowed breathing passages during sleeping.
If we suspect you have sleep apnea, we’ll refer you to a specialist sleep clinic for a sleep study. Once you’ve been diagnosed, your sleep specialist can discuss a range of treatment options with you, including your suitability for using an oral appliance.
Our dentists are here to help
Should I have dental anesthesia at a sedation clinic or a hospital?
Usually, your general dentist would send you to hospital if you required dental surgery such as a difficult tooth extraction, impacted teeth or dental implants. You’d normally be referred to a surgeon who specialises in oral and maxillofacial surgery, and they’d perform dental anesthesia in a hospital.
Here the procedure would be carried out as day surgery under intravenous (IV) sedation or general anaesthetic, safely monitored by a qualified specialist anaesthetist and theatre nurses.
While a hospital theatre room is set up with the medical facilities and registered staff required to perform an operation, it isn’t equipped with a dental chair.
“Oral surgeons work in a private hospital where they take teeth out, put implants in and fix people’s broken jaws,” explains Dr David Kerr, partner dentist at Today’s Dentistry. “They don’t do general dental procedures because a hospital isn’t suitable for routine dentistry.
“At our specialised sedation clinic, however, the purpose-built theatre room has a conventional dental set-up with a dental chair and all the equipment we need to perform general dental treatments, as well as minor oral surgery such as tooth removal and dental implants.”
Why would a patient choose treatment at a sedation clinic instead?
“A patient can opt to undergo their treatment under dental anesthesia at our sedation clinic if they have a complicated series of procedures on their treatment plan, require a lot of fillings or suffer from dental phobia,” says Dr Kerr.
“For example, one of our patients needed dental implants, so while she was at the sedation clinic we also did some fillings and cleaned her teeth – we did it all together. We can’t do this in a hospital because it doesn’t have the drills and all the equipment we use in our dental office.”
Of course, a full assessment of your individual situation will be needed before your dentist can treat you at our sedation clinic.
How can this help an anxious patient?
“Because people who have dental fears often avoid going to the dentist, they can end up with problems that involve a lot of work,” says Dr Kerr.
“We’ll look at the complexity and enormity of their case, and whether they’d feel more comfortable being put to sleep. Then we’ll consider having it all done in one go under sedation or general anaesthetic, rather than coming in for several appointments.”
The added advantage is that your own dentist from Today’s Dentistry can treat you at our sedation clinic under dental anesthesia, so you don’t need to be referred to an oral surgeon.
If you’re a nervous patient, it can be reassuring to be with a familiar dentist who understands your worries, plus you won’t have to deal with different practitioners.
When would you recommend a patient go to a hospital?
“We still do take some patients to a hospital for their dental procedure, particularly children or those with a complicated medical history,” says Dr Kerr.
An anaesthetist will assess your case and determine whether a sedation clinic or a hospital is the safest location for you.
At Today’s Dentistry, we believe dentistry shouldn’t be painful
“If you’re worried about pain or don’t think you’re up to sitting in the dental chair, we can talk with you about going to our specialised sedation clinic to have your treatment under dental anesthesia,” says Dr Kerr.