Dentistry has come a long way since barber-surgeons replaced physicians as the primary caretakers of oral health in the Middle Ages. Patient comfort is of primary importance in modern dentistry and a variety of dental analgesia procedures exist to ensure successful pain management.

The following definitions, cited in the American Dental Association’s (ADA) Guidelines for the Use of Conscious Sedation, give some consumer-friendly definitions for the different types of analgesia and sedation.

Analgesia is the reduction or elimination of pain in the conscious patient, such as novocaine injections.

Conscious Sedation is a minimally depressed level of consciousness during which the patient is able to breathe independently and/or respond purposely to verbal command.

Deep Sedation is a controlled state of depressed consciousness accompanied by a partial loss of protective reflexes, including the ability to breathe independently and/or respond purposely to verbal command.

General Anesthesia is a controlled state of unconsciousness accompanied by partial or complete loss of protective reflexes, including the ability of breathe independently and/or respond purposely to verbal command.

Most in-office dental procedures involve the use of the lowest level of analgesia – what is commonly referred to as the novocaine injection, although the anesthetic most commonly used is actually xylocaine. This provides anesthesia directly to the area in which the dental procedure occurs. This type of anesthesia generally wears off within a short period of time. Your CDA member dentist will advise you to be cautious of eating until all sensation returns, as you can burn your tissue with hot liquids or bite your cheek, lip or tongue without realizing it.

Conscious sedation, deep sedation and general anesthesia, while not used routinely in most dental procedures, are a necessity for some. They provide effective pain and anxiety control, without which it would be virtually impossible for many patients to receive the care they need. Some of these pain control techniques help bring care to many vulnerable patients including children, the elderly and disabled patients.

When discussing the use of dental anesthesia, the patient should disclose information about any illnesses, allergies, other health conditions or concerns. In the case of a child, any medications that a child is taking should be discussed. The parents should ask if the dentist follows ADA guidelines for anesthesia and sedation. The patient or parent should always keep asking questions until the procedures are fully understood and, if there are concerns, it is always appropriate to seek a second opinion.