In-Office Sedation Options at Winchester Dental

Dr. Gio Iuculano, DDS outside with plants in background

In-office dental sedation is a good option for patients with dental anxiety or a history of difficult dental experiences. At Winchester Dental, we offer conscious and IV sedation options. We work with patients to customize their individual plans, taking into account their medical history, their anxiety level, and the extent of the dental work they need. In this interview, Dr. Gio discusses each option.

How does conscious sedation work?

For patients who choose this option, we ideally schedule these appointments in the morning. Patients take a sedative pill the night before their appointment, and then another pill the morning of the appointment. This takes the edge off things and relaxes patients to a level equivalent to having drunk three to four cocktails; their anxiety minimizes greatly. Patients breathe on their own, but they’re in a state where they cannot drive and should not make major decisions (we strongly advise against making major decisions on these days). After the appointment, patients usually go home, nap the rest of the day, wake up for dinner, and typically get a great night’s sleep.

What other types of sedation dentistry does Winchester Dental offer?

We also offer IV sedation, which sedates patients more deeply. It erases all memory of the office visit, but the patients are never fully asleep, and they are still breathing on their own. With this option, we have firm control of the sedation level. Patients still hear, smell, and feel, but their brains don’t interpret it and they are unresponsive.

How do you administer the IV sedation?

We work with an anesthesiologist to administer the sedative. Of course, this involves planning and scheduling. Before patients can choose this option, we review their medical history thoroughly, because not everyone is a candidate. During IV sedation, the anesthesiologist is present the entire time. He or she starts the IV and administers the sedative.

Are conscious sedation and IV sedation available to adults only, or also to children?

Both options are available to children, but if our young patients require either of these, we refer them to pediatric dentists who are best trained for performing these procedures with children. Our local referral partners include Valley Pediatric Dental and Shenandoah Smiles in Winchester.

What can patients expect during their procedures while they are consciously sedated? Will they be aware of what is happening? Are there any side effects?

They don’t remember much of the visit—they maintain deep relaxation and their stress level is minimal. The anesthetic works well, the procedures go quicker, patients tend to feel better the next day than they might without conscious sedation, and they remember very little.

Does conscious sedation help patients with a sensitive gag reflex?

Yes, it can help in these cases, and we’re always glad to discuss this concern with individual patients.

How does sedation dentistry help reduce pain after dental procedures?

Because patients are so much more relaxed, their adrenaline and endorphins remain low, so they feel less pain after the visit, when they are home. We see that consistently within our practice.

What can patients expect if they elect these types of sedation? For instance, would they be able to eat, drive, or go back to work immediately after their appointment?

After either type of sedation, patients can eat, but cannot drive or work. We always recommend that for these appointments, patients bring someone to drive them home and look after them for the rest of the day.

What are the risks associated with these types of sedation?

Overall, conscious sedation has a broad safety margin and very little risk. IV sedation is also tremendously safe because the sedative works almost instantly, and the anesthesiologist maintains strict control over how much the patient receives.