Oral Health Topics
Anesthesia & Sedation
Overview
Several medications are available to help create more relaxed, comfortable dental visits. Some drugs control pain, some help you relax, and others put you into a deep sleep during dental treatment. You and your dentist can discuss a number of factors when deciding which drugs to use for your treatment: the type of procedure, your overall health, history of allergies and your anxiety level are considered when determining which approach is best for your particular case. Working together you and your dentist can choose the most appropriate steps to make your dental visit as comfortable as possible.
Frequently Asked Questions
- What should every patient know about dental anesthesia?
- What are analgesics?
- What is local anesthesia?
- What is sedation and general anesthesia?
What should every patient know about dental anesthesia?
Providing you with high-quality, appropriate care and making your dental visit as comfortable as possible are top priorities for the more than 155,000 dentist members of the American Dental Association (ADA). Advances in dental techniques and medications can greatly reduce—even eliminate—discomfort during dental treatment, and your dentist and the ADA want you to know about them. The following explains options available to help alleviate anxiety or pain that may be associated with dental care.
What are analgesics?
Non-narcotic analgesics are the most commonly used drugs for relief of toothache or pain following dental treatment. This category includes aspirin, acetaminophen and non-steroidal anti-inflammatory drugs such as Ibuprofen.
Narcotic analgesics, such as those containing codeine, act on the central nervous system to relieve pain. They are used for more severe pain.
What is local anesthesia?
Topical anesthetics are applied to mouth tissues with a swab to prevent pain on the surface level. Your dentist may use a topical anesthetic to numb an area in preparation for administering an injectable local anesthetic. Topical anesthetics also may be used to soothe painful mouth sores.
Injectable local anesthetics prevent pain in a specific area of your mouth during treatment by blocking the nerves that sense or transmit pain and numbing mouth tissues. They cause the temporary numbness often referred to as a "fat lip" feeling. Injectable anesthetics may be used in such procedures as filling cavities, preparing teeth for crowns or treating periodontal (gum) disease.
What is sedation and general anesthesia?
Anti-anxiety agents, such as nitrous oxide, or sedatives may help you relax during dental visits and often may be used along with local anesthetics. Dentists also can use these agents to induce "minimal or moderate sedation," in which the patient achieves a relaxed state during treatment but can respond to speech or touch. Sedatives can be administered before, during or after dental procedures by mouth, inhalation or injection.
More complex treatments may require drugs that can induce "deep sedation," causing a loss of feeling and reducing consciousness in order to relieve both pain and anxiety. On occasion, patients undergo "general anesthesia," in which drugs cause a temporary loss of consciousness. Deep sedation and general anesthesia may be recommended in certain procedures for children or others who have severe anxiety or who have difficulty controlling their movements.
The ADA provides guidelines to help dentists administer pain controllers in the safest manner possible. Dentists use the pain and anxiety control techniques mentioned above to treat tens of millions of patients safely every year. Even so, taking any medication involves a certain amount of risk. That's why the ADA urges you to take an active role in your oral health care. This includes knowing your health status and telling your dentist about any illnesses or health conditions, whether you are taking any medications (prescription or non-prescription), and whether you’ve ever had any problems such as allergic reactions to any medications. It also includes understanding the risks and benefits involved in dental treatment, so that you and your dentist can make the best decisions about the treatment that is right for you.
Understanding the range of choices that are available to relieve anxiety and discomfort makes you a well-informed dental consumer. If you have questions or concerns about your oral health care, don't hesitate to talk to your dentist. If you still have concerns, consider getting a second opinion. Working together, you and your dentist can choose the appropriate steps to make your dental visit as safe and comfortable as possible, and to help you keep a healthy smile.
Additional Resources
ADA Dental Minute
- Novocaine—Who Invented It?
- Overcoming Dental Anxiety
For the Dental Patient
The Journal of the American Dental Association
- Balancing Efficacy and Safety in the Use of Oral Sedation in Dental Outpatients (April 2006)
- Effectiveness of Computerized Delivery of Intrasulcular Anesthetic in Primary Molars (October 2005)
- Techniques for Reducing Anesthetic Injection Pain: An Interdisciplinary Survey of Knowledge and Application (September 2004)
- Anesthetic Efficacy of the Palatal–Anterior Superior Alveolar Injection (September 2004)
- Computer-Controlled Delivery Versus Syringe Delivery of Local Anesthetic Injections for Therapeutic Scaling and Root Planing (March 2004)
- Avoiding Complications in Local Anesthesia Induction: Anatomical Considerations (July 2003)
- The Key to Profound Local Anesthesia: Neuroanatomy (June 2003)
- Intraosseous Anesthesia: Implications, Instrumentation and Techniques (April 2003)
- Dental Local Anesthetics: Alternative Delivery Methods (February 2003)
- Local Anesthesia System for Intraosseous Injection (July 2002)
- Effectiveness of Local Anesthesia in Pediatric Dental Practice (December 2000)
- Assessing the Need for Anesthesia and Sedation in the General Population (February 1998)
Additional Resources
Current Guidelines and Policy Statement
- ADA Policy Statement: The Use of Sedation and General Anesthesia by Dentists (PDF)
- Guidelines for the Use of Sedation and General Anesthesia by Dentists (PDF)
- Guidelines for Teaching Pain Control and Sedation to Dentists and Dental Students (PDF)
