Intravenous Conscious Sedation (aka “IV sedation”) is when a drug, usually of the anti-anxiety variety, is administered into the blood system during dental treatment.
What does it feel like? Will I be asleep?
A lot of dental offices and practices use terms such as “sleep dentistry” or “twilight sleep” when talking about IV sedation. This is confusing, because it suggests that IV sedation involves being put to sleep. These terms are more descriptive of deep sedation. Deep sedation isn’t commonly used (in the U.K. at least), and is classified as general anaesthesia (even though sedation occurs on a continuum).
In reality, you remain conscious during conscious IV sedation. You will also be able to understand and respond to requests from your dentist. However, you may not remember much (or anything at all) about what went on because of two things:
- IV sedation induces a state of deep relaxation and a feeling of not being bothered by what’s going on
- the drugs used for IV sedation produce either partial or full memory loss (amnesia) for the period of time when the drug first kicks in until it wears off. As a result, time will appear to pass very quickly and you will not recall much of what happened. Many people remember nothing at all. So it may, indeed, appear as if you were “asleep” during the procedure.
Is it still necessary to be numbed with local anaesthetic? Will my dentist numb my gums before or after I’m sedated?
The drugs which are usually used for IV sedation are not painkillers killing drugs are occasionally added, see below for more info), but anti-anxiety drugs. While they relax you and make you forget what happens, you will still need to be numbed. If you have a fear of injections, you will not be numbed until the IV sedation has fully kicked in. If you have a phobia of needles, you will very probably be relaxed enough not to care by this stage. Your dentist will then wait until the local anaesthetic has taken effect (i.e. until you’re numb) before starting on any procedure.
How is IV sedation given?
“Intravenous” means that the drug is put into a vein. An extremely thin needle is put into a vein close to the surface of the skin in either the arm or the back of your hand. This needle is wrapped up with a soft plastic tube. It makes the entry into the vein, then is slid out leaving the soft plastic tube in place. The drugs are put in through that tube (which is correctly referred to as an “indwelling catheter”, but more commonly known by the tradename of Venflon). The tube stays in place throughout the procedure.