Sedation Dentistry

Intravenous (IV) Sedation

Intravenous sedation is a widely accepted method of achieving a deeper level of relaxation during your dental procedure. In a well-controlled environment in which all of your vital signs are closely monitored, your sedation medication will be gently delivered into your blood stream. Dr. Almasri and his staff have received extensive training in the administration of these medications, as well as annual First Aid and Basic life Support certifications. Dr. Almasri has chosen to offer IV sedation in order to enable you to feel more relaxed and comfortable during your treatment. Many of the patients who choose this form of sedation can report a significant reduction in anxiety, resulting in a more positive dental experience.

Nitrous Oxide Relaxation Gas

Nitrous oxide (N2O) is simply a gas which you can breathe in. It has no color, smell, and doesn’t irritate. Nitrous oxide is mixed with oxygen – about 70% oxygen to 30% nitrous oxide and is then called N20-02. The desired N2O-O2 mix is fed through a tube to which a nasal hood or cannula is attached. This hood is put over your nose.

Sensations you can expect:

Depending on the concentration and length of administration of laughing gas, four levels of sedation can be experienced (after an initial feeling of light-headedness):

1. a tingling sensation, especially in the arms and legs, or a feeling of vibration (“parasthesia”), quickly followed by


2. warm sensations, and


3. a feeling of well-being, euphoria and/or floating. During heavier sedation, hearing may dissolve into a constant, electronic-like throbbing.


4. At a deeper level of sedation again, sleepiness, difficulty to keep one’s eyes open or speak (“dream”) can occur.

If you experience any unpleasant symptoms, let your dentist know so that they can adjust the percentage of N2O. Alternatively, just take the mask off.

What are the advantages of nitrous oxide?

• Nitrous oxide works very rapidly – it reaches the brain within 20 seconds, and relaxation and pain-killing properties develop after 2 or 3 minutes.


• The depth of sedation can be altered from moment to moment, allowing the person who administers the gas to increase or decrease the depth of sedation. Other sedation techniques don’t allow for this. For example, with IV sedation, it’s easy to deepen the level of sedation, but difficult to lessen it. Whereas with gas, the effects are almost instant.


• Other sedation techniques have a fixed duration of action (because the effects of pills or intravenous drugs last for a specific time span), whereas gas can be given for the exact time span it’s needed for. It can also be switched off when not needed and then switched on again.


• There’s no “hangover” effect – the gas is eliminated from the body within 3 to 5 minutes after the gas supply is stopped. You can safely drive home and don’t need an escort.


• With nitrous oxide, it’s easy to give incremental doses until the desired action is obtained (this is called “titration”). So the administrator has virtually absolute control over the action of the drug, preventing the possibility of accidental overdoses. While giving incremental doses is possible with IV sedation, it’s not possible with oral sedation (as a result, oral sedation can be a bit of a hit-and-miss affair).


• For certain procedures – those involving gums rather than teeth (e. g. deep cleaning) – it may be possible to use nitrous instead of local anaesthesia. N2O acts as a painkiller on soft tissues such as gums. However, its pain-relieving effects vary a lot from person to person and can’t be relied upon.


• No injection is required. In cases of very severe needle phobia, getting laughing gas first can help you feel relaxed enough to allow the needle required for IV sedation to be inserted in your arm or hand. The very deep state of sedation achievable through IV sedation will then allow you to accept local anaesthetic.

Inhalation sedation is very safe. It has very few side effects and the drugs used have no ill effects on the heart, lungs, liver, kidneys, or brain. Inhalation sedation has been found to be very effective in eliminating or at least minimizing severe gagging.