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Sedation
Oral Sedation
Oral Sedation is a way of reducing anxiety using
medication- either in tablet or liquid form. A
Benzodiazepine (Midazolam) is used. Midazolam
works to block the receptors in the part of the
brain which produce anxiety (the limbic system),
it also causes sleepiness.
Oral Sedation can be used for either adults or
children over the age of three. It is a simple
and safe means of providing anxiety relief. The
main disadvantage of oral sedation is that
individual people will react differently to
different dosages of sedation and the same
individual may react differently on different
days.
The oral route of
administration is one of the least predictable
methods for administering drugs. This is because
all drugs first pass through the liver before
entering the blood stream and it is impossible
to know the exact dose a person receives.
Because of this, all dosages are kept within
known safe values. It is not possible to simply
give someone who does not feel sufficiently
sedated more of a drug and exceed the safe
levels in the guidelines. However, the normal
dosage will be sufficient for the majority of
people.
Midazolam, as a Benzodiazepine, depresses the
Central Nervous System. This means that it can
cause a decrease in blood pressure and
breathing. This can be good, because if your
heart isn't racing, you'll feel calmer. However,
it should NOT be mixed with other CNS
depressants such as alcohol or antihistamines.
We will monitor your heart rate, blood pressure
and oxygen saturation levels.
People for whom Midazolam works well find it
very calming and relaxing. It often makes them
sleep during their appointment and makes
dentistry a more pleasant experience for them.
Adults
You will need to come in one hour minutes prior
to your appointment time to take 1-2 tablets. It
will take 15- 30 minutes before you feel any
effect; the effects will then last for 1-4
hours.
- You will
need a responsible adult to collect your,
take you home and look after you for the
remainder of that day.
- You are not
permitted to drive or operate any machinery
for 12 hours.
- You must
avoid alcohol for the remainder of that day
.
- You must
avoid sleeping tablets for 6 hours.
- Not conduct
any responsible business matters for 24
hours.
Oral Sedation is
not suitable for everyone and it can interact
with a number of other medications. Please
ensure that you give a complete list of all
medications you are taking and a complete
medical history to your dentist.
Children
Midazolam can also be used for children over the
age of three. It is given as a liquid (mixed
with a sweeter drink as it has a very bitter
taste) 30 minutes prior to treatment. Midazolam
works very well for some children but will only
take the top “25%” off their anxiety. An
extremely anxious child may require referral for
a general anesthetic.
Oral Midazolam works well for most,
approximately 95%, of children. For a very small
number of children it may have no effect or make
them more hyperactive (Angry Child Syndrome).
Please let us know if your child has experienced
this with any other sedatives such as Phenergan.
As with adults the main side effects are a
depression of breathing and the cardiovascular
system.
We will monitor your child’s pulse and oxygen
saturation throughout treatment.
It will take several hours for the sedation to
completely wear off. You will need to supervise
your child closely for the remainder of that
day. Often children will simply enjoy a nap once
they return home.
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