Unbiased oral health information

Procedures

General anesthesia/sedation

Talk to your dentist about...

Only a dentist can diagnose or recommend treatment for your specific needs. Web-based research by a patient is no substitute for the extensive training and clinical experience of a dentist—but it can empower you to ask intelligent questions that can result in the best treatment for your unique needs. This page lists some things to keep in mind and offers some suggested questions you can ask your dentist about this topic.

  • What complications of the dental procedure might occur, and how will they be dealt with? Knowing in advance what may happen while you are sedated avoids unpleasant surprises later.
  • Does the office have the necessary emergency protocols, medications, and monitoring equipment in place? At a minimum, your heart rate, respiratory rate, blood pressure and oxygen saturation should be monitored during an oral sedation. Oxygen saturation is measured with a pulse oximeter. The office should also have oxygen and an automated external defibrillator (AED) in place and ready to be used. Staff should be trained in the use of these devices, and should have current certifications in CPR for healthcare providers. Dentists administering intravenous sedation are required to be certified in advanced cardiac life support (ACLS).
  • Will pain medication be prescribed for after the procedure? Will it have an additive sedation effect to the sedative medication? When will it be safe to begin taking these pain relievers? Narcotic pain relievers have a sedative effect that, when added to those of a sedative medication can produce unsafe levels of sedation. When in doubt, ask your doctor, or a pharmacist.
  • How soon after the sedation will it be safe to return to work? to operate a motor vehicle or machinery?

If you are going to be sedated with oral medications (pills)

  • Since oral medications make prediction of the level of sedation difficult, ask which medication would be used for you and why. Do your homework on the medication you would be prescribed.
  • Some oral sedatives have a higher safety factor than others, measured by the drug's LD50 number. This is a ratio between the dose that would be lethal for 50% of people, to the effective dose. The higher the number, the better. Drugs whose lethal dose is only a small multiple of the effective dose can be used carefully, but if a safer drug exists, it should be considered. When in doubt, ask your doctor, or a pharmacist.
  • What happens if you are under-sedated for the appointment? In general, you should be re-appointed on another day, instead of being given more oral sedatives that day.
  • Will other sedatives be given in conjunction with the pills (e.g. nitrous oxide)? Your safety is the primary factor, and risk of over-sedation should be avoided.

If you are going to be sedated intravenously

  • Will other sedatives be given in conjunction with the IV medication (e.g. nitrous oxide)? Your safety is the primary factor, and risk of over-sedation should be avoided. Be sure you understand the purpose of all medications that may be used to control your level of sedation. In general, IV sedation is a safer and more effective method of controlling the level of sedation than orally administered drugs.
  • Does the office have the required reversal drugs in case complications arise from the sedation?
  • Is the doctor's ACLS certification current? Is the staff trained to handle any medical emergencies that may arise?

If nitrous oxide is used

Will pure oxygen be administered at the end of the procedure to avoid the nausea associated with diffusion hypoxia?