- Given by an anaesthetist who monitors you throughout
- Used alongside local anaesthetic, never instead of it
- Fasting beforehand and an adult escort afterwards are essential
Sedation means using medication to bring on deep relaxation and drowsiness during dental treatment. Its most common form is conscious sedation: you are drowsy and calm, you breathe on your own and you can respond to what you are told, but you often remember little of the procedure. General anaesthesia is different: you are put fully to sleep and your breathing is supported by the anaesthesia team.
Sedation is not the treatment itself but a way of making treatment possible. It does not change the filling, the extraction or the implant; it only changes the conditions in which that procedure is carried out.
Who is sedation for?
- Patients who have put off treatment for years because of fear of the dentist and find it hard even to sit in the chair
- People whose gag reflex makes it impossible to continue once instruments are in the mouth
- Long and extensive surgery, such as removing several impacted teeth or full-arch implant treatment
- Patients who find it hard to stay still for long because of a learning or physical disability
- Some children who cannot cooperate and whose treatment cannot be postponed
Not everyone who feels anxious needs sedation. Most patients can complete their treatment under local anaesthetic, with short breaks, once what will happen has been explained in advance and they know they can stop the procedure at any point with a hand signal. We recommend sedation when these approaches are not enough, or when the procedure is genuinely long.
Conscious sedation or general anaesthesia?
| Conscious sedation | General anaesthesia | |
|---|---|---|
| Consciousness | Drowsy but rousable, responds when spoken to | Fully asleep |
| Breathing | You breathe on your own | Supported by the anaesthesia team |
| How it is given | Usually medication through a vein | Intravenous access and a secured airway |
| Setting | A clinic with monitoring equipment | Operating theatre conditions, usually in a hospital |
| Recovery | Home the same day after a short period of observation | Longer observation |
Light sedation with nitrous oxide (often called "laughing gas") is also a form of conscious sedation; its effect is shallower and shorter-lived. We decide which method suits you together with the anaesthetist, based on the procedure planned and your health.
Who gives the sedation, and what is monitored?
Sedation is given by an anaesthetist, who stays at your side for the whole procedure. While the dentist concentrates on the treatment, the anaesthetist's only job is to watch over you: your pulse, blood oxygen level, blood pressure and breathing are monitored continuously. The dose is adjusted to the length of the procedure and to how you respond.
Before the procedure, the anaesthetist reviews your medical history in detail: long-term conditions, the medicines you take, allergies, previous experiences of anaesthesia, snoring and sleep apnoea, and any possibility of pregnancy. Some patients may need additional tests or an opinion from the relevant specialist. If this assessment concludes that sedation is not suitable for you, we continue your treatment with a different plan.
Does sedation replace local anaesthetic?
No, and this is a common source of confusion. Sedation calms you and makes you drowsy; it does not numb the area being treated. That area is always numbed separately with local anaesthetic. What sedation adds is that you go through the whole process, including the anaesthetic injection, without anxiety and often without remembering it. Once the local anaesthetic wears off, there may be some tenderness for a few days depending on the procedure; sedation does not change that.
Rules to follow before and after
These rules are there for your safety and are not relaxed:
- Fasting. You must not eat or drink for a set time before the procedure. Most protocols require at least 6 hours without solid food; the time for clear fluids is shorter. The written instructions you are given take precedence.
- Medicines. Ask the anaesthetist which of your regular medicines to take and which to hold back; do not stop any of them on your own.
- An escort. An adult who will collect you, take you home and stay with you for the first few hours is essential. Without one, the procedure is postponed.
- The next 24 hours. Do not drive or operate machinery, do not drink alcohol, and put off important decisions and signing official documents.
On the day, come without nail polish or false nails, as they can interfere with the oxygen reading taken from your fingertip, and wear comfortable clothes with sleeves that roll up easily. When the procedure is over you stay under observation for a while. You leave with your escort once the anaesthetist decides that you are sufficiently awake and that your pulse, blood pressure and other readings are back to normal. Rest at home for the first few hours and follow the written instructions for the treatment you had; drowsiness can last for the rest of the day.
What are the risks?
With careful patient selection and continuous monitoring, sedation is generally safe, but it is not risk-free. Common side effects are drowsiness, dizziness and nausea; most pass within a few hours. Rarely, more serious problems such as slowed breathing can develop, which is exactly why the anaesthetist stays with you throughout the procedure. We do not recommend sedation for planned treatment during pregnancy.
Which treatments is it most often used for?
It is most often chosen for wisdom tooth removal and impacted tooth surgery, for full-arch treatment such as All-on-4, where several implants are placed in the same session, and when treatment that has been put off for a long time is grouped into a few long sessions. With children we decide more cautiously; most baby tooth treatment can be done without sedation, with a patient approach.
At our İzmir clinic the sedation plan is discussed at the examination, together with the treatment plan. The cost depends on the length of sedation, the method used and the treatment being carried out; after the examination you receive a written, itemised quote.
Common questions
Will I be completely asleep under sedation?
With conscious sedation you are deeply drowsy but not fully unconscious: you respond when spoken to and breathe on your own. Most patients do not remember much of the procedure. Being put fully to sleep means general anaesthesia, which needs separate planning.
How long do I need to fast before sedation?
The anaesthetist sets the time and gives it to you in writing. Most protocols require at least 6 hours without solid food; the time for clear fluids is shorter. If this rule has not been followed, the procedure is postponed for your safety.
Can I go home on my own afterwards?
No. We do not carry out sedation without an adult escort to collect you. Even if you feel well, the effect of the medication can last for hours; for the next 24 hours we ask you not to drive, not to drink alcohol and to put off important decisions.
Will I still have an injection under sedation?
Yes. Sedation does not numb the area being treated, so local anaesthetic is always given. The difference is that you are drowsy and calm when the injection is given, and most patients do not remember it. A thin cannula is also placed in the back of your hand or in your arm for the sedation medication.
I have a very strong gag reflex. Will sedation help?
In most patients it does; under sedation the reflex is noticeably reduced. In milder cases we try other approaches first, such as breathing techniques, splitting the procedure into short stages and keeping the amount of material held in the mouth to a minimum.
I have heart disease or diabetes. Can I have sedation?
Often yes, but an assessment comes first. The anaesthetist looks at how well your condition is controlled and at the medicines you take, and asks the relevant specialist for an opinion if needed. In some cases it is more appropriate for the treatment to be done in a hospital setting.
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