Drs. Morse, Cwiklinski, and Achille all have permits from the state of Maine to administer oral moderate sedation, commonly referred to as oral conscious sedation or “Sleep Dentistry.” This is a technique where a patient is given a sedative pill to take before the appointment to make them sedated and relaxed. Additional sedative pills can be administered in conjunction with nitrous oxide for a deeper sedation. Sometimes a single pill is all that is needed to make someone comfortable enough to move ahead with treatment.
The advantage of this technique is that a deeper level of sedation can be achieved than with nitrous oxide alone. The effects vary depending on the person. Some people will be relatively awake but relaxed, and other people will be falling asleep once they get comfortable in the dental chair.
The most commonly prescribed dental related drugs that treat anxiety belong to the “benzodiazepine” family. Some examples are Valium, Halcion, Xanax, or Ativan.
There are two different types of Benzodiazepines:
- Sedative-Hypnotics: These drugs induce calmness, including drowsiness and even sleep. This sleep state is actually a form of hypnosis, which is a form of physiological sleep.
- Anti-Anxiety Drugs: These drugs relieve anxiety and induce a state of calmness and relaxation.
While benzodiazepines act as sedatives AND anti-anxiety drugs, some are highly targeted at areas within the brain which focus on sleep. Others act in a more specific way and target fear centers in the brain. In most cases, higher doses act as sedatives and induce sleep, while in lower doses, they reduce anxiety without sedation.
Benzodiazepines are also Central Nervous System (CNS) depressants (i.e. there can be a decline in blood pressure and breathing). It is important to note that they shouldn’t be mixed with other CNS depressants such as alcohol. It’s important that you utilize the dose your dentist or doctor recommends. It is possible to overdose, and overdoses could lower your breathing to dangerously low levels, which could result in coma or death.
Please note that you shouldn’t travel on your own after you’ve taken any of these drugs! Make sure you have an escort bring you to the appointment, wait at the office during the entire appointment, and escort you home. Even if you traveled by bus or foot, it’s easy to become disorientated!
When not to take benzodiazepines:
Some of these drugs can affect your liver and heart. It’s important to check with your practitioner and/or pharmacist. You should be sure to inform your doctor or dentist if any of the following apply: known allergy to the drug; narrow-angle glaucoma; pregnancy; severe respiratory disease, such as chronic obstructive pulmonary disease (COPD); congestive heart failure (CHF); impaired kidney or liver function; depression/bipolar disorder/psychoses; or chronic bronchitis. It’s also important to let us know if you are taking other medications. There could be possible drug interactions.