What is Midazolam and how is it used?

What is Midazolam and how is it used? 

You are about to be given a drug called Midazolam to stop you feeling worried and relax you enough for your dentist to help you. 

The way you will be given Midazolam today means you will first breathe it in as a spray up your nose. This is to help you relax. Once you are relaxed you will have an injection in your arm that will make you even more relaxed, but still conscious. 

Breathing Midazolam spray up through your nose is a tried and safe way of taking away any worries you might have. Using Midazolam this way is what is known as unlicensed. Before we use it this way we must make sure patients know this and that they are happy for us to use it this way. That's another reason why you or your carer has been given this leaflet. 

Normally Midazolam is only given by injection, but some people find that breathing it in through the nose first is better for them. 

We want to ensure your care is gentle and comfortable. 

What should I know? 

Although you will not be fully asleep during your procedure, afterwards you are unlikely to remember what happened. 

If you are not feeling well, have a cold or a sore throat just before your appointment, it is important you or your carer contact us before coming for your treatment. 

Side effects from Midazolam nose spray are usually very mild but sometimes it can make the inside of your nose sting, give you a bitter taste at the back of your throat and very occasionally, cause small nose bleeds. 

If you do not understand any of this information, are not clear about what you must do before and after having midazolam, speak to the dentist, the person giving you the Midazolam (the anaesthetist) or the nurse helping them. 

Before you can be given Midazolam you must be accompanied by an adult who will take responsibility for you. They must be able to take you by car or by taxi to and from the hospital. You must not use public transport. This person must be able to take you home and stay with you for at least 12 hours, or overnight if possible. 

Things to remember before having Midazolam 

• do not eat or drink, including alcohol, for at least 6 hours before your appointment – and nothing after midnight before your appointment
• do not wear contact lenses, make-up, lipstick, jewellery or nail varnish before your appointment
• do continue to take your usual medication unless your dentist or the anaesthetist advises otherwise
• do tell your dentist or the anaesthetist if you have been to see your family doctor or been to hospital since your appointment was made
• do wear loose comfortable clothes. There is a chance they may get dirty
• do wear a short sleeved top as we may need to insert a cannula tube into your arm

After you have had Midazolam

You can go home as soon as you are assessed as fit and well by the anaesthetist and the dentist. When you get home rest for a while – take it easy for the rest of the day.

• do rest for a few hours and the rest of the day quietly
• arrangements need to be made to drive the you to and from the clinic. Public transport is not suitable
• do eat light and easily digestible food for the rest of the day
• do take medicines, tablets or pills, which have been prescribed for you, unless you have been told not to
• do not drink anything very hot or cold or alcohol for at least 24 hours after
• do not drive, operate machinery, or make any business decision on the same day of your treatment, as your reflexes and judgement may have been affected

After care 

After a tooth is removed, the space left behind is filled with blood, which clots and heals over. Do not disturb the blood clot, as there is nothing better you can put in its place. Do not rinse it out, or poke it out with the tongue, finger or handkerchief. 

Rinsing 

No rinsing on the day of your treatment, but start the day after with salt water (1 teaspoon of salt to a glass of warm water). The next day and every day thereafter, rinse with warm salt water. This speeds up the healing.  

Pain 

If you have any pain, take regular painkiller tablets (except aspirin). There should be nothing more than a dull ache present when the injection wears off. If you get severe pain or you develop a nasty taste and or pain after 3 days, contact the dentist. 

Bleeding 

When you leave the surgery you will have stopped bleeding. If you disturb the wound it may start bleeding again. If this happens do not be alarmed, but take a clean piece of tissue / kitchen towel, roll it up in a ball, place it over the wound and bite on it hard for fifteen minutes by the clock. Whatever you do, do not rinse your mouth with water, as this will dislodge the clot. If it still bleeds afterwards, contact the dentist.