Sleep Dentistry involves any sort of dental care performed while a person is fully or partially asleep. Using Nitrous Oxide Gas, drugs given in pill form or through an I.V. (tube connected directly into a blood vessel through a special needle), anesthetic gasses or a combination of these, a person can sleep through treatment.

2. What is anesthesia and what are my options of anesthesia for dental work?

Anesthesia (from the Greek; not feeling) refers to any method used to eliminate feeling or pain. There are two main classes of anesthesia in medicine and dentistry: general and local.

General anesthesia refers to not only the elimination of feeling but also the loss of consciousness. By the administration of drugs, the person receiving the general anesthesia essentially goes to sleep -- a deep sleep. During the procedures, their health and breathing are monitored by special doctors to assure safety. While the person "sleeps" procedures are done without any pain or discomfort.

Local anesthesia concerns the loss of feeling in a specific area of the body. The drugs for local anesthesia are placed at or near the site of the work and eliminate any feeling just in that area. In dentistry, these are often referred to as Novocain injections. With local anesthesia the person is awake and aware yet feels no discomfort.

3. What is the difference between anesthesia and sedation?

Anesthesia specifically deals with the elimination of feeling or pain. Sedation refers to consciousness or awareness. It is an altering of perception that allows a person to be calmer and more relaxed which often reduces the perception of discomfort.

In dentistry, sedation is used to calm a person and used with a local anesthetic to eliminate the feeling of pain.

4. What is the difference between sedation and general anesthesia?

Sedation involves the use (administration) of drugs that calm and put a person in a drowsy, sleep-like state. When a person is sedated, they still have their reflexes and can be somewhat responsive to questions and commands. Sedation can be achieved using pills or drugs introduced in an I.V. Sedation is often used in the dentist's office

General anesthesia uses drugs to produce a deep, unconscious sleep state. While under general anesthesia, a person is fully asleep and unresponsive to questions and commands. General anesthesia is used primarily in hospital or surgical center environments and is administered (provided) by Anesthesiologists (Doctors) or specially trained Anesthetists under a doctors supervision.

5. Who can benefit from sleep dentistry?

Anyone with the following can benefit from some form of sleep dentistry:

People with severe fears or phobias about dental work; People with uncontrollable or severe gag reflexes that cannot receive care in the traditional manner; People with medical conditions that make dental care in the traditional manner unsafe or uncomfortable; People who are unable to use local anesthetics (lidocaine, mepivicaine, articaine, bupivicaine, prilocaine, etc.) to get numb; People who cannot get numb; People who wish a great deal of care to be done at a single visit.

6. What is dental phobia?

The word phobia means "fear" or "dread." It is an extreme, and often debilitating, fear. Dental phobia indicates a fear of dentistry so strong that it prevents a person from even visiting a dentist.

The fear itself can have many causes. In its simplest form, the fear is based on unpleasant or painful experiences with dental care in the past. Most often these experiences occur when a person is very young and highly impressionable, leaving them uncontrollably fearful as an adult.

In many people, this fear and dread is made worse by the embarrassment and shame they feel. Either because they are ashamed of the condition of their teeth and mouth or because they think that they "shouldn't be like this," their embarrassment further prevents them from visiting a dentist. There is the fear that they may be blamed, ridiculed or harshly judged by the dentist and staff.

7. What can be done about dental phobia?

What many phobic people want is to be able to have their dental work done without pain, fear or awareness. In dentistry this can be accomplished in two ways. For the dental phobic with a milder fear, sedation or the use of anxiety reducing drugs can be used to calm them. While in this calm state, dental work can be accomplished.

For those with a more severe and debilitating fear, general anesthesia (that is, being completely asleep in the hospital) is effective. The fearful person can have most or all of their dental work done while being totally asleep and unconscious.

In some instances a severely phobic person will become less fearful after the bulk of work is done in the hospital. These people can then have cleanings and, sometimes, minor work done in a regular dental office or with mild sedation.

8. What are the benefits of having dental work done in the hospital under general anesthesia?

When a person is fully asleep, the dentist can work very quickly and for long periods of time without the interruptions of going to the bathroom, stretching, resting the jaws, etc. Because of this a great deal of work can be done in a single visit. Often, an entire set of teeth can be fixed or restored in a single trip to the hospital.

In addition, the hospital provides a great measure of safety. Physicians are on hand to supervise and administer the use of anesthetics and other drugs and the full resources of the hospital are right there should problems arise.

Postoperative core is provided by trained nurses and the person receiving care is monitored and cared for before they return home.

9. Are there any drawbacks to having care provided in the hospital under general anesthesia?

Going into the hospital is not something to take lightly. Before your treatment, you must have an examination by your doctor to make sure it is safe for you. Since a great deal of dental work will be done at one time, people are often tired and uncomfortable for several days afterward. As in any situation where drugs are used to create sleep, general anesthesia presents a small yet significant risk to some people's health. The hospital and anesthesiologist, while providing the great benefits of this sort of care, effect additional expense.

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