Conscious sedation is defined as:
A technique in which the use of a drug or drugs produces a state of depression of the central nervous system enabling treatment to be carried out, but during which verbal contact with the patient is maintained throughout the period of sedation. The drugs and techniques used to provide conscious sedation for dental treatment should carry a margin of safety wide enough to render loss of consciousness unlikely.
The level of sedation must be such that the patient remains conscious, retains protective reflexes, and is able to respond to verbal commands.
Range of Techniques
sedation with midazolam
Inhalation sedation with nitrous oxide and oxygen
Oral sedation with benzodiazepines
The majority of anxious or phobic patients can be treated with these techniques or a combination of them. Others may respond better with alternative techniques such as:
Intravenous sedation with more than one drug
Intravenous sedation with propofol
Transmucosal sedation (nasal, sublingual)
Some reasons for prescribing sedation:
To treat anxious or phobic patients who would otherwise be denied access to dentistry.
To enable an unpleasant procedure to be carried out without distress to the patient.
To avoid general anaesthesia
Reasons for anxiety
Patients who cannot accept an injection in the mouth can often be persuaded to accept venepuncture. If not, inhalation sedation may be acceptable either to provide sedation for the treatment itself or to provide sufficient anxiolysis to enable venepuncture to be performed. Oral sedation may provide a satisfactory alternative.
Fear of "the drill", sharp instruments and the dental environment can be reduced with conscious sedation.
Pronounced Gag Reflex
This distressing condition is greatly reduced by inhalation sedation. Alternatively, intravenous sedation may be more effective.