Services - Sedation Dentistry: Oral Sedation

Valium

In our office, we used diazepam (Valium®) and meperidine (Demerol®) for many years, which are excellent medications for lowering the level of anxiety, for giving a feeling of euphoria that seems to be needed in erasing some of the prior negative conditioning, or, if necessary, bringing about amnesia: forgetting the entire appointment. Recently, oral triazolam (Halcion®) has become very popular with sedation dentists. It also has a high level of safety and wears off more quickly than diazepam, and thus is more convenient for patients.

Sometimes, with very high levels of anxiety, patients, in spite of very adequate levels of sedative, still cannot seem to endure the dental treatment. However, after the appointment, they may not be able to remember the appointment. The treatment then is successful in their mind and this successful experience works for their benefit by reducing their anxiety in subsequent appointments.

Often, patients with memories of traumatic dental care, after a few appointments with sedation, are able to move away from the sedation. With a few successful dental appointments under their belt, the doctor can lower the level of sedation so that they remember the appointments with greater and greater clarity, until they no longer need sedation.

Oral sedation with the proper medications has an excellent safety record. Valium® by itself is extremely safe, even in large doses. Hoffman-LaRoche, the manufacturer of Valium®, has data on file showing patients who have taken up to 2000 milligrams (that would be the equivalent of two full bottles of 10 mg. tablets) in attempts to commit suicide, and no rescue medications or other rescue measures were needed, because vital functions were not adversely affected. Triazolam is of the same drug family, and is also extremely safe. Nevertheless, as a precaution, most dentists using triazolam or diazepam employ monitoring equipment.

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