CONSCIOUS SEDATION
Relaxed, still responsive
UK guidance defines conscious sedation as a drug-induced state in which verbal contact is maintained throughout, with a wide margin of safety from losing consciousness.
Compare the typesAN INDEPENDENT GUIDE
Not asleep,
just calmer.
"Sleep dentistry" rarely means sleep.
AWAKE but relaxed
≈ 200,000 Dental general anaesthetics a year, then
- Verbal contact kept
- Several ways to give it
- General anaesthetic in hospital
- Informational only, sources linked
In UK dental surgeries the usual option for anxious patients is conscious sedation: you feel relaxed and drowsy, but stay able to talk and respond. A general anaesthetic, where you are fully unconscious, is only given in hospital settings. This independent guide sets out what UK guidance says.
THE SHORT ANSWER
Sedation keeps you
conscious.
UK guidance draws a firm line
between sedation and anaesthetic.
GAS AND AIR
Through a nasal mask
Inhalation sedation uses nitrous oxide and oxygen through a small nose mask. One NHS dental hospital leaflet compares it to Entonox used in childbirth.
How practice changed
AFTERWARDS
An adult to take you home
Guidance says a responsible adult escort should take the patient home after sedation, although adults having gas and air do not usually need one.
Questions to askGeneral information only, not medical advice. For advice about your own health, speak to a doctor, pharmacist or other qualified health professional.
THE MAIN TYPES
How far from
fully awake?
Pick a type to see how UK guidance and an NHS dental hospital leaflet describe it. The bar shows how far each moves from being fully awake.
Descriptions quoted from SDCEP guidance and a Liverpool University Dental Hospital patient leaflet. General information only, not medical or dental advice: which option suits a person is decided with their dental team.
QUESTIONS PEOPLE ASK
Useful things
to ask about.
This is not advice on whether sedation is right for anyone. These are questions that follow from what the guidance and patient leaflets cover.
Which type is being offered?
Inhalation, oral, intranasal and intravenous sedation work differently and take different times to act.
Will I still need a numbing injection?
The NHS leaflet says a local anaesthetic is still needed for extractions, oral surgery and most fillings.
Who will take me home?
Guidance expects a responsible adult escort after most sedation; the leaflet says they should stay until the next morning.
What can't I do afterwards?
The leaflet lists not driving, not drinking alcohol and not signing important documents until the next day.
HOW PRACTICE CHANGED
From the dentist's chair
to the hospital.
General anaesthetic was once routine for extractions.
A 2001 Scottish Executive letter set out the change.
≈ 200,000
Dental general anaesthetics a year, then
The 2001 letter says that in the 1960s and 1970s general anaesthesia was the main method for extracting teeth, with an estimated 200,000 a year, mainly in general dental practice.
1960s–70s · SCOTTISH EXECUTIVE
20–25k
Estimated a year by 2001
By 1997 the estimate had fallen to 45,000–50,000, and the letter put it at around 20,000–25,000 a year in 2001. From 1 April 2001 dental general anaesthesia in Scotland had to be in a hospital setting.
2001 · SCOTTISH EXECUTIVE
SDCEP guidance says the 2000 report A Conscious Decision led to general anaesthesia for dentistry ending in the primary care setting, with more emphasis on safe conscious sedation.
WHY IT IS OFFERED
Anxiety control is
part of dentistry.
SDCEP guidance says adequate anxiety control is an integral part of dentistry, and that the General Dental Council treats it as both a right for the patient and a duty for the dentist. It also says a one-size-fits-all approach is inappropriate, and non-drug methods can be used instead of or alongside sedation.
The NHS dental hospital leaflet lists reasons sedation may be considered: anxiety about treatment, involuntary movement disorders, severe gagging, or a medical condition that stress could make worse. UK standards for dental sedation are set by the Intercollegiate Advisory Committee for Sedation in Dentistry.
Questions
Questions people ask
Will I be asleep during 'sleep dentistry'?
Usually not. In the UK the common option is conscious sedation, where verbal contact is maintained throughout. Being fully unconscious is a general anaesthetic, which UK guidance says is not permitted in primary dental care.
What is the difference between sedation and a general anaesthetic?
SDCEP guidance says that in conscious sedation verbal contact and protective reflexes are kept, while in deep sedation and general anaesthesia they are lost. Any technique that causes loss of consciousness counts as general anaesthesia.
Is gas and air the same as other sedation?
It is one type. Inhalation sedation uses nitrous oxide and oxygen through a nasal mask. SDCEP says adults having it do not usually need an escort, unlike other forms of sedation.
Do I still need an injection with sedation?
An NHS dental hospital leaflet says a local anaesthetic injection is still needed for extractions, oral surgery and most fillings. Sedation helps with anxiety; the local anaesthetic numbs the area.
Is this site a dental practice?
No. mydentalnap is an independent informational guide, not a dentist, clinic or health service, and does not offer treatment. It quotes UK guidance and NHS leaflets and links to them.
Where the facts come from
Updated
- SDCEP: Conscious Sedation in Dentistry, dental clinical guidance (3rd edition, 2017)
- Royal College of Surgeons of England: Standards for Conscious Sedation in the Provision of Dental Care (IACSD)
- Liverpool University Hospitals NHS: Conscious sedation for adults (patient leaflet PIF 641)
- Scottish Executive Health Department HDL(2001)29: General anaesthesia and sedation for dental treatment
- NHS: General anaesthetic