Sedation for anxious patients

Start with a conversation

Many people feel some anxiety about seeing the dentist, and the first step is talking with your dentist about it.¹ Small things can help on their own: raising your hand when you need a break, asking questions so you know what to expect, and telling us about any bad experiences in the past.¹

Ontario's standard says sedation should be used only when it's needed, as an addition to non-drug approaches, not a replacement for them.²

The sedation we offer: nitrous oxide

The sedation we offer is nitrous oxide, which you breathe in mixed with oxygen. We don't provide sedative pills or deeper levels of sedation.

In Ontario, nitrous oxide with oxygen is a form of minimal sedation, the lightest level.³ Ontario's dental regulator, the Royal College of Dental Surgeons of Ontario, describes minimal sedation this way:²

• You stay awake and breathe on your own.
• You respond normally when someone speaks to you or touches you.
• Your thinking and coordination may be a little slower, but your breathing and heart are unaffected.

All sedation carries some risk, and people respond differently.² Ask us whether nitrous oxide suits you and your treatment.

Deeper levels of sedation and general anesthesia come with stricter requirements, including a special permit for the office.⁴ Dental anesthesiologists and oral and maxillofacial surgeons are among the specialists who provide deeper sedation.⁶

Who sedation may help

Ontario's standard lists several reasons a dentist may use sedation: fear or anxiety about dental treatment, conditions that make it hard to stay still or cooperate with care, and difficult or extensive procedures.² Sedation in a dental office is generally best suited to healthy people or those with mild, well-controlled conditions. People with more serious medical conditions may be referred to a dentist with more advanced sedation training.²

Safety rules in Ontario

• A dentist needs the College's authorization to give any level of sedation, including minimal. You can check any dentist's sedation authorization on the College's public register.⁴
• A patient breathing nitrous oxide must never be left unattended, and the equipment must have a safety feature so it never delivers less than 30% oxygen.²

Before your appointment

• Tell us about your health, any allergies, and every medication you take, including over-the-counter medicines, vitamins and herbal supplements.^2,5 Ontario's standard requires your health history to be reviewed again at each sedation visit.²
• Don't take any extra sedating medicine before your appointment unless your dentist tells you to, and tell us if you take medicine for anxiety or sleep, or opioids.^2,7
• Ontario's standard says patients should not eat or drink for two hours before nitrous oxide sedation.² We'll give you instructions for your own appointment. Ask us about taking your usual medicines that day.

After your appointment

Before you leave, the dentist checks that you've fully recovered.² Once you have, you can drive yourself home. If any effects remain, you'll need a responsible adult with you.²