Oral Sedation vs. IV Sedation Dentistry – Which is Better?

Which is better for sedation dentistry? IV or Oral Sedation?

Sedation dentistry is a very popular choice for patients who fear the dentist or who need “scary” dental procedures. So what form of sedation is best? Oral or IV?

The short answer is that IV sedation is superior to oral sedation for a number of reasons. We’ll explain the details below.

But why do most dentists then advertise oral sedation? The short answer is because they are not licensed to provide IV sedation. The vast majority of dentists – over 99.9% – cannot provide IV sedation because of the additional training, significant costs, and requirements for licensure. In fact, there are only a select few general dentists in all of Connecticut who have active licenses to provide IV sedation. Because of this, many dentists will then simply offer oral sedation – even though it is vastly inferior to IV sedation.

Dr. Nick Calcaterra is one of Connecticut’s most experienced IV sedation dentists – performing well over 100 hundred sedation cases per year – and is the only general dentist in all of Connecticut to have achieved Master Status through the American Dental Society of Anesthesiology. He is a true expert in this field.

But let’s get to the details on which is better for sedation dentistry – Oral or IV Sedation.

Oral Sedation Takes Longer and is Less Effective

Triazolam is used in oral sedation dentistry.

In oral sedation, you are given pills to take beforehand. Once you arrive at the office, you are often administered additional pills orally. Then, the waiting game of oral sedation begins, as it can take sometimes over an hour for the medications to begin to take an effect.

We like to refer to this as “Pills and Prayers” – in that the oral sedation dentist gives you Pills and then says Prayers for the oral medications to be enough to sedate you but not so much that you become dangerously over-sedated. This manner of oral sedation is unpredictable and inefficient and sometimes does not work!

In contrast to oral sedation, in IV sedation an experienced sedation dentist like Dr. Nick Calcaterra administers IV medications, which begin to take effect within 30 seconds. Usually within 2 to 3 minutes you have entered the twilight state, and Dr. Calcaterra can begin doing the dentistry.

So which do you think is better? Being sedated with IV medications and getting your procedures done quickly and safely or waiting and praying with the dentist that the oral sedation works?

You Cannot Easily Change Nor Reverse Oral Sedation

In oral sedation, you are relying on the digestive system to handle the medication – a process that can take over an hour.

In oral sedation, you are relying on the digestive system to process the medication and deliver it – a process which can take over an hour. And once you swallow the pill, you can’t “undo” the effects. You pretty much have to wait until the drug is entirely metabolized.

Why does this matter? Well, if an oral sedation dentist gives you too much medication – something that happens all too frequenty – you can become overly sedated and are at risk for serious complications. There’s nothing that can be done except to wait. Or conversely, you might not get sedated enough to keep you comfortable.

We’ve had dozens of patients come to us for IV sedation who had “failed oral sedations” at other offices. So we’ve seen/heard of almost everything that can go wrong with oral sedation. We’ve heard stories ranging from the oral sedation not working at all to patients who ended being sedated for 8 hours for a simple 60 minute procedure!

With IV sedation – you can reverse the effects nearly immediately – and can change the level of sedation within a minute or so.

Oral Sedation is Riskier than IV Sedation

An IV in a patient of ours. Without an IV in place, it is very risky!

Oral sedation is inherently riskier than IV sedation. Why?

In oral sedation, the dentist does not have several things:

1. An IV in place to administer potentially life saving medications.
2. Advanced monitors evaluating your heart rhythms, your breathing, and other vital signs.
3. A fully loaded emergency cart mandated by the state of Connecticut with rescue medications used by hospital anesthesiologists.
4. The advanced training to handle sedation related emergencies.

In IV sedation, a trained and IV licensed dentist like Dr. Calcaterra has all of the above. If any issue arises, he/she has the equipment, training, and IV in place to correct the problem. In oral sedation, there is no IV to use to administer reversal and/or rescue medications, and the monitoring is not sufficient to detect problems early on. In addition, and perhaps most importantly, in nearly all cases the oral sedation dentist simply has not completed the advanced training to deal with sedation emergencies.

So, because of all of these factors – and others which we did not list – we feel that IV sedation is better than oral sedation.

Are you looking for sedation dentistry? For sedation performed by one of Connecticut’s most experienced sedation dentists? Did you have a failed oral sedation appointment? If yes, then you’ve come to the right place. We’ve performed thousands of sedations in our office in Orange, CT. You can call us at (203) 799 – 2929 or visit this page to request an appointment.