MANAGING DENTAL ANXIETY: INTRANASAL & IV CONSCIOUS SEDATION

We tailor your treatment to your specific clinical needs. Other available options include:

• Local Anaesthesia Only: Treatment is completed with the area numbed by local injections while you are fully awake, without any sedation.
• Inhalation Sedation: Often referred to as "laughing gas," this involves breathing a mixture of nitrous oxide and oxygen through a nosepiece to promote a light form of relaxation.
• Oral Sedation: This involves drinking a liquid sedative to help you relax before cannula placement. It is slightly less potent than intranasal sedation and takes longer to take effect.
• General Anaesthesia (GA): This involves being fully unconscious in a hospital operating theatre. GA cannot be offered in a UK dental clinic, and treatment under GA is generally limited to teeth extractions.

We want you to be fully informed about your care. Below is an overview of the key points covered in our patient consent forms:

• Anxiety Reduction: Helps you feel relaxed, calm, and able to tolerate the placement of a cannula.
• Drowsy Relaxation: You remain fully conscious but feel incredibly relaxed and comfortable during your treatment.
• Temporary Amnesia: Midazolam naturally causes a temporary reduction in your memory of the procedure. Many patients remember very little, if anything, about their dental treatment.

While conscious sedation is highly safe when administered by medical professionals, some minor and temporary side effects can occur:

• Nasal Sensations: The intranasal spray may cause a temporary stinging sensation or discomfort inside the nose (to minimise this, it is mixed with a numbing agent). It may also cause sneezing, a temporary unpleasant taste, or a minor nosebleed.
• Slowing of Breathing: Sedatives can slightly slow your breathing. Our Consultant Anaesthetist continuously monitors your breathing and oxygen levels, and supplemental oxygen is always immediately available if needed.
• Cannula Bruising: You may experience minor bruising or discomfort at the cannula site on your hand or arm.
• Varied Effectiveness: Sedation may not be fully effective in a small number of patients (for example, due to medication tolerance). If adequate conscious sedation cannot be safely achieved, the procedure may be stopped and reviewed.

Using Midazolam intranasally is considered an “off-licence” use. This simply means it is being administered in a different way than its original product license. Dentists and doctors are legally and professionally permitted to use medicines in this way when they judge it to be safe, clinically appropriate, and highly effective. Intranasal Midazolam is a widely used technique in dentistry with an excellent safety record.