What is Intranasal sedation?

You may require dental treatment under sedation. Anxiety can be reduced by sedative drugs (medicines), which also make the patient drowsy. The dentist will be able to explain why the patient might benefit from having sedation.

Intranasal or “Transmucosal” sedation is generally given through a fine spray, which is squirted into the nose. The sedation drugs are absorbed through the lining of the nose and enter the bloodstream. It can take 5–10 minutes for the effects of the drug to work.

Once the sedation medicine has taken effect, for the patient’s safety, a needle is used to place a cannula (small plastic tube) in a vein in the back of the hand or in the arm. The dentist will use the cannula to reverse the effects of the sedation if necessary.

Benefits and risks of transmucosal sedation

Transmucosal sedation reduces anxiety and fear of dental treatment. This is particularly helpful if the patient is having a long, uncomfortable or more complicated procedure.

The dentist and members of the dental team are trained to give sedation. They watch the patient closely and treat any problems that may develop. An oxygen supply will be available and oxygen will be given by mask if necessary. They are also required to use appropriate monitoring equipment during sedation. There will be a recovery area where the patient will be observed until he or she has made a full recovery from the sedation.

It is a widely used technique but, as with the administration of any medicines, there are risks associated with intranasal sedation. These risks include:

• A reduction of oxygen in the blood stream due to poor breathing during sedation. The patient may be asked by the dentist/sedationist to take deep breaths to correct this. The dentist/sedationist will continually monitor the patient’s breathing and oxygen levels throughout the procedure.
• Bruising at the site of the cannula. This may take several days to fade completely.
• Very rare risks are allergic reactions to the sedative drugs the patient has been given or vomiting during the procedure. The dentist/ sedationist will discuss any concerns that you may have about the patient prior to the procedure taking place.

What to expect

The method of dental treatment planned for the patient in your care will be discussed with you at a separate assessment appointment. The dental treatment will take place at second and subsequent appointments.

In exceptional circumstances, treatment may be carried out on the same day as assessment. It is important that the dentist knows of any recent changes in the patient’s medical history and of any medicines being taken.

If you think you may be pregnant or breastfeeding, you need to let the dentist know. You may need to come back to have the treatment at another time.

Before the treatment is started, the dentist will need to take a full medical history and, if necessary, contact the patient’s general medical practitioner or specialist. You will need to have their blood pressure taken with a cuff on their arm and the level of oxygen in their blood measured with a clip on their finger.