Intravenous sedation:
In reality, you remain conscious during IV sedation. You will also be able to understand and respond to requests from your dentist.
However, you may not remember much about what went on because of two factors: firstly, in most people, IV sedation induces a state of deep relaxation and a feeling of not being bothered by what's going on. Secondly, the drugs used for IV sedation can 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, or perhaps even nothing at all, of what happened. So it may, indeed, appear as if you were "asleep" during the procedure.
With this type of sedation, medications (midazolam) are administered directly into the blood stream by iv. cannula. 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. The tube stays in place throughout the procedure.
After iv. sedation you need to be escorted by a responsible adult and don't perform any strenuous or hazardous activities and don't drive the rest of the day.
Do not eat and drink anything for at least 2 hours prior to the sedation.
Sedation is performed by trained anaesthetist.
Why is General Anaesthesia not used very much for dental work?
Apart from the risk of serious complications (which, while very small, is still significantly higher than for conscious IV sedation), general anesthesia has a few major disadvantages:
- Complications are more likely with GA compared with conscious sedation both during and after the procedure. GA depresses the cardiovascular and respiratory systems.
- It's not recommended for routine dental work. The potential risk involved is too high to warrant the use of GA. A breathing tube must be inserted, because otherwise, little bits of tooth, other debris or saliva could enter the airway and produce airway obstruction or cause illnesses like pneumonia.
- Laboratory tests, chest x-rays and ECG are often required before having GA, because of the greater risks involved.
- You can't drink or eat for 6 hours before the procedure (otherwise, vomiting is possible and this would be extremely dangerous during GA).
- It's expensive.