Keeping you safe before, during and after dental sedation

On the day of your operation

Nothing to eat or drink from midnight the day before including sweets and chewing gum

The reason for this is that if there is food or liquid in your stomach during your sedation, it could come up into the back of your throat and then go into your lungs. This would cause choking, or serious damage to your lungs. 

Normal medicines

If you are asked to take your normal medicines, you can do so with a small sip of water, not milky drinks or yogurt. Check with the dentist as some medications should be stopped before dental procedures. 

If you feel unwell on the day of your operation

Please phone the dental clinic that is expecting you and ask for their advice.  

Jewellery/watches/facial piercings

Please leave jewellery, watches and facial piercings at home.  

Clothing

Please wear loose clothing and no nail varnish. 

Checks

When you arrive in the department, dental staff will check your name, and what dental procedure you are having, complete prechecks, ask about your last meal, and give you a chance to ask questions. You will also be checked by the dentist and the anaesthetist. 

Weight

You will be asked to stand on scales, if possible, or asked for your last weight. 

Toilet

You will be asked to visit the toilet before the sedation. 

Monitor

The team will attach you to monitoring equipment, which allows them to closely follow your wellbeing during your operation. 

Blood pressure

A cuff may be placed around your arm  to read your blood pressure. 

Oxygen levels

A peg with a red light inside it is placed on your finger . This records your pulse and oxygen level continuously. 

All this information is passed to the screen so the anaesthetist can quickly see that you are responding well to the sedation. 

Other care you will receive

Protecting pressure points 

The team will also make sure that you are supported and positioned as comfortably as possible.  

Manual handling and clinical holding 

We will discuss with you how best to transfer you into and out of the dental chair for the procedure. Any aids such as hoists and pillows will be discussed and assessed. We will also discuss how to keep you safe during your dental procedure. This may involve members of the dental team supporting arms and head whilst a member of the dental team supports your arm to achieve venous access during certain parts of the procedure to ensure your safety and that of staff.  

Additionally, some support and holding may be required to ensure that you are not left in a worse position than prior to starting the procedure e.g. to allow a tooth to be filled after drilling. Part of the best interest decision will outline the possible need for clinical holding during the procedure.  If minimal clinical holding is insufficient then consideration must be given to abandoning the procedure and choosing a different approach, such as using a general anaesthetic, or rescheduling or re-planning the procedure to achieve the necessary treatment.  

Intranasal sedation 

Anxiety can be reduced by sedative drugs (medicines), which also make the patient drowsy. The sedative agents used in this technique will be administered by a medically trained consultant anaesthetist. 

Intranasal sedation is generally given through a fine spray, which is squirted into the nose. The sedation drugs are absorbed through the lining of the nose and enter the bloodstream. It can take 5–10 minutes for the the drug to work. 

Intravenous sedation

Your anaesthetist will need to give you drugs into a vein. They will do this through a small plastic tube placed in the vein. This is called a cannula. A needle is used to put the cannula into a vein on the back of your hand or in your arm. The nurse will need to hold or squeeze the appropriate arm, to make the vein more obvious and keep the arm still. 

The anaesthetist will use the smallest cannula suitable for you. 

Sometimes, it can take more than one attempt to insert the cannula. Occasionally this may not be possible and so another appointment would need to be arranged for a general anaesthetic in hospital. 

Recovering from sedation 

Before and after 

A responsible adult escort must accompany you both to and from the appointment, and a second adult should be available to drive you home  

Eating and drinking 

Eat light easily digestible food for the rest of the day and avoid alcohol. 

Medication 

Take regular medication as prescribed unless you have been told not to. 

Pain relief at home 

Your anaesthetist and dental team will make a plan for your pain relief at home and let you know. You may be asked about pain-relief drugs that you already have at home, such as paracetamol.  

Take it easy 

Do not operate machinery, or make any major decisions on the same day as treatment, as your reflexes and judgement may be affected. 

Who can give me advice when I am at home? 

Before you leave you should make sure you know how and who to contact if you develop significant pain or other problems at home:  

How did it all go? 

Occasionally, problems happen during sedation. For example, you may have had an allergic reaction to a drug. Your anaesthetist will tell you about anything significant that has happened. It is important to keep a note of this so you can tell an anaesthetist in the future. 

After sedation 

How you feel afterwards depends mainly on the dental procedure you have had, and on the pain-relief medicine that you need to treat any pain that you have. 

Very common and common risks 

• Aches, pains and backache 

During your operation you may lie in the same position on a firm dental chair for a long time. You will be positioned with care, but some people still feel uncomfortable afterwards. 

• Bruising and soreness  

This can happen around injection. It may be caused by a vein leaking blood around the cannula or by an infection developing. It normally settles without treatment. Less common bruising may happen around the arm where this was squeezed when placing the cannula  

• Memory loss  

This is common among people who have had sedation almost all patients will have no memory of the procedure   

• Sneezing and sore nose 

This is a common side effect of nasal midazolam 

• Sore cracked lips 

This can happen after extensive dental treatment and usually lips will be given a covering to help prevent this. 

• Dribbling onto clothing 

This commonly occurs after dental treatment especially if local anaesthetic is involved. Please wear old loose clothing