Dentists performing IV sedations must have received specialized advanced training and must be certified by the provincial licensing board before they can offer intravenous sedation to their patients. IV sedation dentists should also have formal training in ACLS (Advanced Cardiac Life Support), airway management, and their dental office must be equipped with the necessary monitoring and resuscitative equipment. Their team members are also trained to assist during these procedures.

The benefits of IV (intra venous) sedation:

§ Higher controlled level of sedation. The level of sedation which can be achieved with IV administration is deeper and can be reached more quickly than with oral or inhalation (nitrous oxide) sedation. Drugs used for IV sedation (tranquilizers, anxiolytics, narcotics, etc.) are much more effective when given intravenously than when taken orally.

§ Beneficial for patients with moderate to severe anxiety. Because the drugs are titrated to effect, the adequate sedation levels required for an individual, even a patient with severe anxiety, can be reached quickly and effectively and maintained throughout the procedure.

§ Speed of onset of sedation. The intravenous administration of sedative drugs allows them to reach the brain and start taking effect within a few seconds, as opposed to oral sedation. Oral sedatives may take over an hour to act; the fast onset and the ability to titrate to effect gives a significant advantage to IV sedation. Nitrous oxide has a fast onset but it can only provide a light sedation level.

§ Adjustable dosage and sedation level. The dose of sedative drugs is titrated by administering small incremental doses until the patient reaches the desired sedation level (titrated to effect) that provides adequate comfort and relaxation. If the patient is not sedated enough during the treatment, the dentist can simply administer more medication. The ability to easily and quickly adjust the level of sedation is considered the main advantage of IV sedation dentistry over oral sedation where the effects and duration on each patient are not accurately predictable.

§ Recovery. Recovery time is generally shorter than that required after oral sedation. This is due to the more controlled dosage of sedatives administered, the route of administration, and types and quantities of sedative agents used on the patient. When the dental treatment is completed, the patient is given enough time to recover from the effects of IV sedation, either in the same room where treatment occurred, or in a designated recovery area. The patient remains under supervision, until they have been assessed to be discharge under the supervision of the patients escort. The patient is normally in a condition to be discharged approximately one hour after the last dose of sedative drug was given. They are not permitted to leave the dental office unescorted after the procedure. Postoperative instructions and contact phone are given to the patient’s companion. Although they will have received all this information prior to the procedure, the patient may not remember them after the sedation.

§ Amnesia. The most popular medicines used in IV sedation belong to the family of benzodiazepines, (midazolam, triazolam, lorazopam) that have amnesia as a side effect. Due to this amnesic effect, the patient will usually have little or no memory of any unpleasant dental procedures. Amnesia can be especially useful for patients with dental anxiety who have to undergo long and invasive dental treatments.

§ Faster more effective treatment in fewer appointments. Dental treatments under IV sedation can be performed much faster and in fewer appointments. During IV sedation procedures, a team of professionals not only monitor the patient’s vital signs, but also others are free to focus on the dental treatments without distractions and without the patient feeling discomfort. Time saving is an important benefit of IV sedation for busy patients with a strict schedule. More complex procedures and longer appointments are tolerated extremely well with the patient having little or no recollection of the appointment.

§ Alternative to General Anesthesia (GA). IV conscious sedation provides an effective alternative to General Anesthesia for patients who wish to have high level of sedation but they want to avoid a general anesthesia, either because they want to avoid the higher cost, or avoid the risk of complications associated with GA. The fact that the patient remains conscious throughout the procedure makes IV conscious sedation a much safer alternative to General Anesthesia.