Sedatives and anesthetics are used before dental surgery to reduce sensitivity to pain.
- Sedatives are the substances that relieves the patient’s anxiety and helps to relax and sleep.
- Anesthetics are the agents which reduces sensitivity to pain by blocking the nerves.
Classification of dental anesthetics:
Dental anesthetics are based on level of sedation and based on the route of administration. They are classified into two types; local anesthetics and general anesthetics.
- Local anesthetics: Local anesthetics are used to numb a particular area with out any loss of consciousness. Agents used as local anesthetics are lignocaine and novocaine.
- General anesthetics: In general anesthetics the entire body will have temporary loss of consciousness. Agents used as general anesthetics are halothane, desflurane, isoflurane, and propofol.
Classification of dental sedation:
Dental sedation is based on the level of sedation, and are classified into; minimal sedation, moderate sedation and deep sedation.
- Minimal sedation: Less amount of sedatives is given. Patients remain awake and communicate verbally.
- Moderate sedation: In this state, patient remains conscious during surgery. In this state patient can not communicate. In some cases, patient may fall into sleep.
- Deep sedation: In this type of sedation, patient is in unconscious condition during surgery and patient will not remember anything.
Classification based on route of administration:
Based on the route of administration, anesthetics used in dental surgery are classified into; inhalation sedatives, IV sedatives, oral sedatives and topical sedatives.
- Inhalation sedatives: Sedatives are administered through nose. Dentist will place an anesthetic agent on the mask and ask you to inhale through nose and expel through the mouth. This route of administration provides less sedation effect. Nitrous oxide is the inhaled sedative.
- IV sedatives: Sedatives are administered by injecting into intravenous nerves. Onset of action is faster as it is injecting into the vein. Duration of action depends on the amount of sedative given. Benzodiazepam and methohexital are used as IV sedatives.
- Oral sedatives: Sedatives administered through oral route. In this a pill is taken to sleep. The pill should be taken 30 minutes before the surgery as the onset of action is slow and duration of action depends on the amount of sedative taken. Diazepam, triazolam, lorazepam are available in the form of pills.
- Topical sedatives: Topical sedative agent is applied over the area where surgery is going to be done. It anesthetizes the mucous membrane. Now a days, patches are available. Patches contain anesthetic agent that are applied over the surface and slowly the area gets anesthetized. Benzocaine and eugenol are used as topical sedatives.