WHAT IS INTRAVENOUS SEDATION AND WHAT ARE THE BENEFITS
Intravenous sedation in dentistry is very safe and highly effective and will make your dental visit a
relaxing, sleepy and comfortable experience. It is also known as twilight sedation, sleep dentistry
or twilight anaesthesia. A combination of intravenous anaesthetic, sedative and pain relieving
medications is administered to create a very sleepy and pleasant dream-like state for the whole
procedure so that you will be relaxed, comfortable and unaware of your surroundings while still
maintaining the ability to breathe on your own, move and able to obey commands. The vast
majority of people have no memory of the procedure. Memory before and after IV sedation is
usually not affected. Patients often comment that the whole procedure has passed in only a few
minutes when in reality it may have been several hours. Intravenous sedation also allows patients
to avoid the risks, cost and time involved with having a general anaesthetic. It allows your dentist to
care for you at their clinic and is safer, allows you to recover quickly and has minimal side effects
compared to undergoing a general anaesthetic.
WHO CAN HAVE IV SEDATION?
Intravenous sedation is available and very effective for any dental procedure. It is suitable and
extremely safe for most people. No procedure is too small for IV sedation.
Intravenous sedation is beneficial for patients who:
• Have anxiety or fear/phobia or are nervous about dental procedures or avoid going to the
dentist.
• Have had traumatic or negative dental experiences in the past.
• Require complex, multiple, extensive or long dental treatments.
• Dislike needles, drills, pain/discomfort, sights, sounds/noises, tastes or smells associated with
their dental procedures.
• Have sensitive teeth or gums.
• Require removal of wisdom teeth, teeth extractions, dental surgery/oral surgery, dental
implants, root canal treatment, fillings, periodontal or gum treatments, crowns and bridges, full
mouth restorations, bone grafts, All on 4, emergency procedures, and so forth.
• Have limited time and wish to undertake their dental procedures in one appointment instead of
multiple appointments.
• Are uncomfortable with dental treatments.
• Have difficulty feeling numb with local anaesthetic injections.
• Have a strong gag reflex.
• Find it difficult to keep their mouth open or have jaw problems.
• Feel embarrassed about the condition of their teeth.
• Find it difficult to sit still in the dental chair.
• Are anxious, fearful or nervous about injections/needles or who have a low-pain threshold.
Prior to your dental treatment you will complete a patient anaesthetic and medical history
questionnaire, attached at the end of this document, which should be completed and submitted to
your dentist/dental clinic who will then email it to me for review. I will contact you earlier if required,
otherwise we will have the pre-anaesthetic consultation on the day of your dental procedure
HOW IS IV SEDATION PERFORMED?
You will be continuously monitored with all the Australian and New Zealand College of
Anaesthetists(ANZCA) recommended standard hospital grade full monitoring along with
intravenous fluids as well as 100% oxygen therapy available via nasal prongs during the entire
intravenous sedation and dental procedure. An advanced programmable syringe driver, routinely
used in all hospital theatres in Australia, will administer an accurate and continuous infusion of
intravenous anaesthetic, sedative and pain relieving medications via a small IV cannula/drip placed
in your arm or hand. The intravenous medications work quickly and are very effective and you will
drift off into a relaxed, sleepy and pleasant dream-like state and you will be comfortable and
unaware of your surroundings and the vast majority usually have no recollection of the procedure.
Local anaesthetic and/or any nerve blocks(for intra-operative and post-operative pain relief) are
only administered once intravenous sedation is working so that there is no awareness and no
memory of the needles or dental procedure in the vast majority of patients. The comprehensive
continuous patient monitoring performed (which includes end tidal CO2 levels(EtCO2), respiratory
rate and pattern, oxygen saturation(SaO2), blood pressure, pulse/heart rate and rhythm,
electrocardiogram(ECG) as well as anaesthetic medication levels monitoring) allows me to
accurately adjust and titrate the intravenous medications to the appropriate level required
throughout the dental procedure. Although intravenous sedation is extremely safe, there will still be
emergency and resuscitation medications and equipment available in the clinic in accordance with
the Australian and New Zealand College of Anaesthetists(ANZCA) recommended guidelines.
ARE THERE SIDE EFFECTS?
Side effects and complications are rare with IV sedation. A very small minority of patients have
dream-like recollections of the experience and can recall features of the clinic or verbal
conversations but these are not distressing.
IV sedation is generally very well tolerated and side effects/complications are rare and are more
infrequent than compared with general anaesthesia.
Transient minor side-effects can include dizziness and nausea. Intravenous anti-nausea
medications are also given prophylactically so the risk of nausea is extremely low.
ARE THERE ANY CONTRAINDICATIONS TO IV SEDATION?
The relative contraindications or conditions where intravenous sedation should be ideally
performed in a hospital setting instead of in a dental clinic include the following:
• Paediatric patients younger than 15 years old.
• Pregnant women.
• Significant/Severe Obstructive Sleep Apnoea(OSA).
• Morbid Obesity with BMI > 40.
• Diabetic patients on Insulin.
• Unstable severe medical conditions.
• Symptomatic, severe or unstable cardiac or respiratory conditions.
Intravenous sedation is extremely safe for most people and is suitable for any dental procedure.
