Root canal treatment is one of the most common and widely performed dental procedures for oral health performed around the world. Most people undergo a root canal procedure when there is an infected dental pulp or a chronic non-vital tooth.
The primary purpose of root canal therapy is always to save the tooth’s integrity, remove the factors causing pain, and strengthen the tooth to bear the occlusal load. In the case of a non-vital tooth, dentists usually do not prefer general anesthesia or sedation techniques during root canal procedure.
However, most active infection cases of the root canal system are performed under sedation. Sometimes, patients with anxiety may require sedation therapy to be able to undergo root canal treatment. Three types of sedation techniques are commonly used for root canal therapy, such as IV anesthesia, oral, and inhalation sedatives.
Today’s article will highlight the purpose and types of sedation techniques used in a root canal therapy appointment. Furthermore, we will discuss the criteria for sedation in root canal therapy.
What is sedation dentistry?
Sedation is a technique where the dentist uses medications or another sedation method to help the patient feel more comfortable and relaxed, especially during the procedure. In some cases, the sedation technique is also referred to as Sleep Dentistry because, during this time, the patient tends to feel drowsy.
Unlike general anaesthesia like laughing gas, sedation dentistry uses medications that act locally in the area of interest. Patients with anxiety usually remain awake throughout the procedure. Several dental procedures use sedation dentistry, such as pediatric treatments, problematic tooth extractions, and root canal treatments.
Is sedation required in root canal treatment?
Root canal treatment is a dental care procedure that involves removing the infected tooth nerve, connective tissue, and bacteria from the tooth’s root canal. It is performed by drilling in the tooth to access the root canal and using dental files to clean and shape the channel’s inner walls.
Once the dentist is sure that all the infection has been removed, the root canals are filled with a plastic or rubber-like material called gutta-percha. With many patients root canal treatments are performed under local anesthesia.
Root canal treatment is an incredibly comfortable procedure, especially with the advancement in dental care technologies. Most dentists try to comfort their patients by explaining the process and assuring them that they will not feel any pain.
Although not all root canal treatment cases may be ideal for sedation therapy, it is undoubtedly possible to ease a nervous patient with severe dental anxiety by using this technique before starting the potentially long procedure on root canals.
What types of sedation can be used for root canal treatment?
Typically, there are three types techniques of sedation options used by dentists during root canal therapy and other dental services –
Conscious/ inhalation sedation
Most patients usually feel comfortable with conscious sedation during their dental work appointment. This minimal sedation technique numbs the area around the tooth with medications like Novocain or any other topical anesthetic. During this time, the patient with anxiety remains fully awake. Moreover, the patient is responsive and able to follow the instructions.
Nitrous oxide (commonly known as laughing gas) is an effective inhalation sedative for patients with mild dental anxiety and nervousness. Nitrous oxide is typically a gas that is sweet-smelling, colourless, and odourless. Inhalation sedation in dentistry uses a combination of nitrous oxide and oxygen. The patient inhales this nitrous oxide mixture through a mask.
During inhalation sedation with a small mask, the patient remains fully conscious of total control over all bodily functions.
Extremely anxious patients may feel comfortable with oral sedatives that are prescribed before or during the dental procedure for moderate sedation. Some of the common sedatives include valium or Xanax. Usually, oral sedatives are prescribed to take the night before the procedure.
Usually, oral sedatives can make the patient feel drowsy. Therefore, it is advised not to drive independently; instead, ask someone you trust to accompany you to the dental office.
IV sedation may not be the first line of choice for sedating a patient. However, in some cases, a safe amount of IV sedative may be delivered for deep sedation. During this time, the patient often remains awake when a light dose of anesthesia is provided. However, the patient may fall asleep or find themselves in a twilight sleep when a more massive dose of anesthesia is given before the procedure.
Who is an ideal candidate to receive sedation for root canal treatment?
Some of the ideal criteria for assessing the suitability of the patients for sedation technique are as follows
- patients who do not like the sound or smell of the dental office or deal with dental anxiety
- patients with a severe gag reflex
- patients who have difficulty in keeping their mouths open for long periods
- patients with special needs
- dementia or patients with Alzheimer’s
- sensitive teeth
- patients undergoing multiple procedures during one dental visit
The dentist carefully assesses the patient’s condition, medical history, and the factors that may make him suitable for receiving sedation therapy to tolerate dental treatment.
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