Root canal treatment is one of the most common and widely performed dental procedures around the world. Most people undergo this therapy when there is an active pulp infection or a chronic non-vital tooth.
The primary purpose of a root canal therapy is always to save the integrity of the tooth, remove the pain-causing factors, and strengthen the tooth to bear the occlusal load. In the case of a non-vital tooth, dentists usually do not prefer anesthesia or sedation techniques.
However, most active infection cases of a root canal are performed under sedation. Sometimes, anxious patients may require sedation therapy to be able to undergo root canal treatment. Typically, 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 root canal therapy. 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 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 anesthesia, sedation dentistry uses medications that act locally in the area of interest. The patient is usually awake throughout the procedure. Several dental procedures, such as pediatric treatments, tooth extractions, and root canal treatments, use sedation dentistry. (1)
Is sedation required in root canal treatment?
Root canal treatment is a dental procedure that involves removing the infected tooth nerve, connective tissue, and bacteria from the root canal of the tooth. It is performed by drilling in the tooth to get access to 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. Usually, root canal treatments are performed under local anesthesia.
Root canal treatment is an incredibly painless procedure, especially with the advancement in dental technologies. Most dentists try to comfort their patients by explaining to them about 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 an anxious or nervous patient by using this technique before starting the procedure.
What types of sedation can be used for root canal treatment?
Typically, there are three types of sedation techniques used by dentists during root canal therapy –
Conscious/ inhalation sedation
Most patients usually feel comfortable with conscious sedation. This technique numbs the area around the tooth with medications like Novocain or any other topical anesthetic. During this time, the patient remains fully awake. Moreover, the patient is responsive and able to follow the instructions.
Nitrous oxide is an effective inhalation sedative for patients with mild dental anxiety and nervousness. Nitrous oxide is typically a gas that is sweet-smelling, colorless, and odorless. Inhalation sedation in dentistry uses a combination of nitrous oxide and oxygen. The patient inhales this mixture through a mask. (2)
During inhalation sedation, 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. Some of the common sedatives include valium or Xanax. Usually, oral sedatives are prescribed to take the night before the procedure. (3)
Usually, oral sedatives can make the patient feel drowsy. Therefore, it is advised not to drive on your own; 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. During this time, the patient often remains awake when a light dose of anesthesia is provided. However, the patient may fall asleep when a more massive dose of anesthesia is given before the procedure. (4)
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 are afraid of the dentist
- patients with a severe gag reflex
- patients who have difficulty in keeping their mouths open for long periods
- patients with special needs (5)
- dementia or patients with Alzheimer’s
- sensitive teeth
- patients undergoing multiple procedures during one dental visit
the dentist carefully assesses the patient’s condition and the factors that may make him suitable for receiving sedation therapy.
Take away message
The sedation technique is a boon to dentistry as it helps the patient feel more relaxed and comfortable before any procedure. Moreover, it makes the process easier for the dentist. Usually, the sedation technique is used for several dental procedures; one is root canal treatment.
Typically, conscious sedation with topical anesthetics, inhalation sedatives like nitrous oxide and IV sedatives may be used to make the patient feel comfortable. Additionally, oral sedatives like Xanax and valium may also be prescribed. However, the use of sedatives depends on the condition of the patient.
It is best to ask your dentist and discuss your anxiety and nervousness before the dental procedure.