Dr. Sara S. Cummins has a long history of working with her hands and experimenting with color, symmetry and design. She began her college career studying fine arts with an emphasis in painting, but became drawn to the fusion of art and science she found in dentistry. As she neared graduation from the University of Louisville School of Dentistry in 2003, Dr. Cummins began construction of her first practice. She had a clear vision of her philosophy of care, which integrated clinical excellence, superior service, and an exceptional patient experience. Pursuing these core principles, Dr. Cummins’ practice has grown to two locations that focus on contemporary esthetic restoration, implant dentistry, 3-D CBCT imaging and analysis, and advanced periodontal therapies. Her knowledge, skill, and eye for aesthetics have created some of Louisville’s most beautiful smiles. 

Photo Credit: Shutterstock

Do you find it difficult to relax in the dentist’s chair? Meet, sedation dentistry which is oftentimes referred to as “sleep dentistry.” Sedation dentistry uses medication to aid in the relaxation of patients during a procedure. If you are not under anesthesia, you technically are awake – regardless, this process is extremely helpful. To understand the technique a bit better, Haute Beauty Smile Expert Dr. Sara Cummins explains all the details of sedation dentistry.

Haute Beauty: What exactly is sedation dentistry? When is it used and what are the benefits?

Sedation could be anything from taking medicine like Valium that relaxes you all the way up to IV sedation that requires airway management. We do IV sedation that requires intubation for bigger surgeries. We can also do mild, light sedation with a combination of nitrous oxide and medicine like Valium that is very relaxing and allows the patient to sleep in and out of the procedure. It also imparts some amnesia, so even if they are awake during the procedure throughout different periods, they do not remember anything later, which is a good benefit. If they are awake, not remembering goes a long way in reducing fear and sensitivity to the visits.

HB: How long does it usually take to kick in and how long does it last?

For oral medicine, patients take it an hour before the appointment begins. When they get here, we assess their level of sedation. If we need to administer another dose, we do and we titrate that medicine throughout the appointment. If the appointment is only an hour and a half, one or two doses is plenty, but recently I had an appointment six hours long and we had to give six doses throughout the procedure. It wears off fairly quickly, which is nice because it allows us to use it for shorter procedures. Even more, patients are not wiped out the entire day. Now with an IV, it is almost instantaneous, but setup and preparation for that kind of sedation is a totally different thing. Usually, within 30 minutes of arriving at the office, the patient is asleep.

Photo Credit: Shutterstock

HB: The medications are prescribed prior. What is that process like?

When somebody expresses interest in sedation, we do a sedation consult where we go over paperwork with them. There is a thorough review of their medical history. There is also an informed consent that is signed because treatment changes are on the day of sedation. We do not want them to have to make any decisions. We go through the procedure that is planned, but also any possible alternatives that might arise, so they can go ahead and give us consent to treat while they are under the influence of the medicine. We talk about risks, benefits, and anything of relevance. They sign the paperwork, then we go ahead and call that medication into the pharmacy so that they can pick it up and be prepared the morning of. Patients take it an hour before the appointment and bring the bottle to the appointment with them, so if needed, we can continue to administer it as needed.

HB: Outside this situation, do you provide any other aspects that can serve to ease anxious patients?

Nitrous oxide, we use this constantly. Laughing gas would be the layman’s term for that. It is super safe. People like that because it is just enough to reduce the anxiety, but they can still drive with all of the other sedation appointments. If you are taking any kind of medicine, you must have a driver. That is inconvenient for some people. Nitrous oxide is a great option to reduce milder anxiety and is easily administered. It is very quick onset and very quick to flush it out of their system. It takes about five minutes, then they can drive and function for the rest of the day normally.

HB: What is something patients should know about sedation dentistry?

Sometimes patients are embarrassed or scared to ask for it, but I encourage people to, especially on a larger cosmetic case. We want their experience to be pleasant. With IV sedation, sometimes we do not even have to give an anesthetic. If I am prepping 10 or 20 veneers and somebody has been sedated not having to use the anesthetic with the post-off is so much better. On a longer procedure, the recovery from that procedure, though you might be drowsy physically for not being anxious being able to rest and sleep throughout the procedure, people seem to bounce back and recover from it better. They have a pleasant association with it instead of being aware and awake for six hours tense in the chair. It is physically and emotionally exhausting. We really encourage it and do not want people to be afraid to ask. Sometimes it can enable the doctor to do their best work. If you are relaxed, we are relaxed.